Hodgkin Lymphoma Symptoms and Signs

July 13, 2024

This page was reviewed under our medical and editorial policy by Alex Herrera, M.D., associate professor, division of lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope® Cancer Center Duarte

Not all patients with Hodgkin lymphoma have symptoms, and some of the most common may be mistaken for other conditions. Some symptoms may change over time. Patients who notice changes in their bodies that they don’t understand and can’t explain should bring them to a doctor’s attention.

Symptoms of Hodgkin Lymphoma

A lump: A lump from an enlarged lymph node is the most common symptom of Hodgkin lymphoma and is most likely to be found in the neck, under the arm or in the groin. While the lump may not be painful, it may hurt after the patient drinks alcohol. A lump might grow over time. More lumps might appear elsewhere in the body.

It’s important to note that Hodgkin lymphoma is often not the cause when a lymph node is enlarged. In children, swollen lymph nodes may be from an infection. Lymph nodes that swell due to an infection are known as reactive or hyperplastic nodes. They may be painful to the touch. Infected lymph nodes should return to normal size once the infection, which may need to be treated, is gone. Swollen lymph nodes may also be due to other cancers. A doctor may help determine the cause.

Night sweats, often drenching: A possible reason for this symptom is that lymphoma cells release inflammatory chemicals in the blood. It also may be an immune system reaction to the lymphoma cells. Sometimes sweating is heavy during the day, too.

Weight loss that cannot be explained: Some people with Hodgkin lymphoma lose weight. According to the American Cancer Society, losing 10% of body weight over six months may be part of a cluster of symptoms.

Fever that cannot be explained: A fever is defined as higher than 100.4 degrees Fahrenheit. In this case, there is no apparent infection that could be causing the fever.

Constant fatigue or tiredness: Cancer uses energy and nutrients that the body needs to function. In some people with Hodgkin lymphoma, fatigue is the only symptom.

Cough and shortness of breath: This is likely due to enlarged lymph nodes pressing on the lungs that may be discovered during a chest X-ray.

Itching: The skin may be itchy all over or in one spot after bathing or alcohol use. The cause of this itching, which may be severe, is not known.

Little or no appetite: Loss of appetite is another symptom that is common in people with Hodgkin lymphoma. Having little or no appetite may be due to an enlarged spleen pressing on the abdomen and causing a feeling of fullness.

Pain or swelling in the abdomen: This symptom is likely due to an enlarged spleen (though, it is rare).

Sensitivity to alcohol or lymph node pain after drinking: Alcohol increases blood flow through the lymph nodes. A sensitivity may be the response to the alcohol.

Lymphoma B Symptoms

Three symptoms of Hodgkin lymphoma, called B symptoms, help doctors determine the stage of cancer and a patient’s prognosis. Known as B symptoms, these include:

  • A fever greater than 100.4 degrees Fahrenheit that is not caused by an infection
  • Unexplained weight loss of 10% or more over the last six months
  • Night sweats that soak sheets and bedclothes

Having or not having these B symptoms helps doctors determine which treatment is most appropriate.

Hodgkin Lymphoma Signs

Changes in the body that a patient sees or feels are symptoms. Signs are objective changes that the doctor sees when examining the patient or measurable results in laboratory tests. Not all patients with Hodgkin lymphoma have the same signs and symptoms, and many signs are not noticeable enough to make a definitive Hodgkin lymphoma diagnosis. Some signs and symptoms of Hodgkin lymphoma are the same as those in other cancers and other conditions.

One sign that a patient may have Hodgkin lymphoma is abnormal blood cell counts — red, white or platelets. With Hodgkin lymphoma, a blood test may detect low red blood cells or high white blood cells if the lymphoma impacts the bone marrow.

Another more definitive sign is the presence of Hodgkin lymphoma cells — known as Reed-Sternberg cells — as confirmed in a lymph node biopsy or, less often, a bone marrow biopsy. Imaging tests, such as X-rays, computed tomography (CT) scans, positron emission tomography (PET) scans (typically combined with CT scans during an imaging service referred to as a CT/PET scan) or magnetic resonance imaging (MRI), may also reveal other telltale signs, including whether lymphoma has affected other organs.

References
References
  • American Cancer Society. Signs and symptoms of Hodgkin lymphoma, May 1, 2018 
    https://www.cancer.org/cancer/types/hodgkin-lymphoma/detection-diagnosis-staging/signs-and-symptoms.html

  • Leukemia & Lymphoma Society. Signs and symptoms. 
    https://www.lls.org/lymphoma/hodgkin-lymphoma/signs-and-symptoms

  • Blood Cancer UK. Lymphoma symptoms and signs. 
    https://bloodcancer.org.uk/understanding-blood-cancer/lymphoma/lymphoma-symptoms-signs/

  • Blood Cancer UK. Hodgkin lymphoma symptoms. 
    https://bloodcancer.org.uk/understanding-blood-cancer/lymphoma/hodgkin-lymphoma/hodgkin-lymphoma-symptoms/

  • Leukemia & Lymphoma Society. Hodgkin lymphoma, 2022. 
    https://www.lls.org/sites/default/files/2022-04/PS57_Hodgkin_Lymphoma_2022.pdf

  • Lymphoma Action UK (2022, June). What is Lymphoma? June 2022, 
    https://lymphoma-action.org.uk/about-lymphoma/what-lymphoma

  • American Society of Clinical Oncology. Lymphoma - Hodgkin: symptoms and signs, March 1, 2022. 
    https://www.cancer.net/cancer-types/lymphoma-hodgkin/symptoms-and-signs

  • Lymphoma Research Foundation. Understanding Hodgkin lymphoma: A guide for patients, survivors, and loved ones, Summer 2019. 
    https://lymphoma.org/wp-content/uploads/2018/03/HL-Booklet_2018.pdf

  • American Cancer Society. Tests for Hodgkin lymphoma, May 1, 2018. 
    https://www.cancer.org/cancer/types/hodgkin-lymphoma/detection-diagnosis-staging/how-diagnosed.html