HodgkinLymphom

Hodgkin lymphoma is a cancer of the lymphatic system characterized by the presence of Reed-Sternberg cells. It has two main recognized subtypes: classic Hodgkin lymphoma (cHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). The disease shows a bimodal age distribution, commonly affecting young adults and older adults. Risk factors include infection with Epstein-Barr virus in some cases and immune suppression.

Symptoms typically include painless swelling of lymph nodes, often in the neck, armpit, or groin. Mediastinal involvement can cause chest symptoms. B symptoms, such as fever, night sweats, and unintentional weight loss, may occur. Itching (pruritus) is also reported in some patients.

Diagnosis relies on lymph node biopsy showing Reed-Sternberg cells. Immunophenotyping helps classify the subtype, with classic Hodgkin lymphoma usually CD15 and CD30 positive and PAX5 weak, while nodular lymphocyte-predominant Hodgkin lymphoma features lymphocyte-predominant cells that are CD20 positive. Staging uses the Ann Arbor system and imaging, including PET-CT.

Treatment depends on stage. Early-stage disease is often treated with ABVD chemotherapy for a few cycles, with involved-site radiotherapy in selected cases. More advanced disease may require additional chemotherapy or regimens such as escalated BEACOPP. NLPHL may have different approaches, including rituximab-containing regimens. Fertility discussions and long-term follow-up are important aspects of care.

Prognosis is generally favorable, with high cure rates, especially for early-stage disease. Five-year survival typically exceeds 85% in developed settings, though relapse can occur and late effects from treatment, such as secondary cancers or cardiovascular issues, require ongoing surveillance.