The majority of patients present with painless lymphadenopathy (most commonly cervical or supraclavicular).
- mediastinal masses (present in around 80% of patients) is more common in nodular sclerosing HL and are sometimes discovered after routine chest radiography,
- peripheral or sub-diaphragmatic lymphadenopathy is more common in mixed-cellularity classical HL (1,2)
Other systemic symptoms:
- B symptoms:
- seen in approximately 25% of patients and includes
- unexplained fever >38°C
- drenching night sweats
- weight loss of >10% over 6 months (1)
- generalised pruritus
- chest discomfort with a cough or dyspnoea (2)
- immune dysfunction
In advanced disease there may be infiltration of any organ often presenting with hepatosplenomegaly. Other sites for tumour localisation include bone, bone marrow, lung, kidneys.
- bone marrow involvement is detected in only 5-8% of patients with conventional staging but in up to 18% with PET/CT staging
The Ann Arbor system is used to stage Hodgkin's disease.
- (1) Guidelines for the First Line Management of Classical Hodgkin Lymphoma (2014). British Committee for Standards in Haematology (BCSH)
- (2) Yung L, Linch D. Hodgkin's lymphoma. Lancet. 2003;361(9361):943-51
Last reviewed 01/2018