Hodgkin Lymphoma Clinical Presentation

  • Author: Scott K Dessain, MD, PhD; Chief Editor: Emmanuel C Besa, MD   more...
 
Updated: May 24, 2012
 

History

Features of Hodgkin lymphoma include the following:

  • Asymptomatic lymphadenopathy may be present (above the diaphragm in 80% of patients)
  • Constitutional symptoms (eg, unexplained weight loss, fever, night sweats) are present in 40% of patients. Collectively, these are known as "B symptoms."
  • Intermittent fever is observed in approximately 35% of cases; infrequently, the classic Pel-Ebstein fever is observed (high fever for 1-2 wk followed by an afebrile period of 1-2 wk)
  • Chest pain, cough, shortness of breath, or a combination of these things may be present due to a large mediastinal mass or lung involvement; rarely, hemoptysis occurs
  • Patients may present with pruritus
  • Pain at sites of nodal disease, precipitated by drinking alcohol, occurs in less than 10% of patients but is specific for Hodgkin lymphoma
  • Back or bone pain may rarely occur
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Physical Examination

Physical examination findings in Hodgkin lymphoma are as follows:

  • Palpable, painless lymphadenopathy can be seen in the cervical area (neck, 60-80%), axilla (armpit, 6-20%), and, less commonly, in the inguinal area (groin, 6-20%); it is described as rubbery adenopathy
  • Involvement of the Waldeyer ring (back of the throat, including the tonsils) or occipital (lower rear of the head) or epitrochlear (inside the upper arm near the elbow) areas is infrequently observed
  • Splenomegaly and/or hepatomegaly may be present
  • Superior vena cava syndrome may develop in patients with massive mediastinal lymphadenopathy
  • Central nervous system (CNS) symptoms or signs may be due to paraneoplastic syndromes, including cerebellar degeneration, neuropathy, Guillain-Barre syndrome, or multifocal leukoencephalopathy.
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Contributor Information and Disclosures
Author

Scott K Dessain, MD, PhD  Associate Professor, Lankenau Institute for Medical Research

Disclosure: Nothing to disclose.

Coauthor(s)

Bradley W Lash, MD  Fellow in Hematology/Oncology, The Lankenau Medical Center

Bradley W Lash, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Clinical Oncology, and American Society of Hematology

Disclosure: Nothing to disclose.

James L Spears, MD  Consulting Staff, Bux-Mont Hematology Oncology Medical Associates

James L Spears, MD is a member of the following medical societies: American Society of Clinical Oncology

Disclosure: Nothing to disclose.

Athanassios Argiris, MD  Professor, Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine

Athanassios Argiris, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Koyamangalath Krishnan, MD, FRCP, FACP  Paul Dishner Endowed Chair of Excellence in Medicine, Professor of Medicine and Chief of Hematology-Oncology, James H Quillen College of Medicine at East Tennessee State University

Koyamangalath Krishnan, MD, FRCP, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society of Hematology, and Royal College of Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Emmanuel C Besa, MD  Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Clinical Oncology, American Society of Hematology, and New York Academy of Sciences

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Virginia Kaklamani, MD, and Christine Wasilewski, MD, MPH,to the development and writing of the source article.

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Mixed cellularity Hodgkin lymphoma showing both mononucleate and binucleate Reed-Sternberg cells in a background of inflammatory cells (hematoxylin and eosin, original magnification X200).
A positron emission tomography (PET) scan obtained with fluorodeoxyglucose (FDG) that shows increased FDG uptake in a mediastinal lymph node.
A CT scan showing bulk disease.
Hodgkin Lymphoma
Hodgkin Lymphoma PET
 
 
 
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