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Symptoms and Signs of Lymphoma Cancer: Hodgkin’s vs. Non-Hodgkin’s

Doctor's Notes on Lymphoma Cancer: Hodgkin’s vs. Non-Hodgkin’s

Hodgkin's and Non-Hodgkin's disease are both lymphoma cancers that develop in the lymphatic system. Signs and symptoms of both diseases are similar and include lymph node swelling (neck, underarms, groin, or stomach), fevers, night sweats, fatigue, itchy skin, and weight loss. In addition, non-Hodgkin's lymphoma may include a skin rash and pain in the chest, abdomen, or bones with no pain source found. Non-Hodgkin's disease begins in B, T, or natural killer cells while Hodgkin's begins in other lymphocytes, such as a Reed-Sternberg cell.

The root cause of both diseases is unknown, but risk factors for Hodgkin's include being young or in late adulthood, male, infection with Epstein-Barr virus, and having a first-degree relative with the disease. Risk factors for non-Hodgkin's include being an older male, having an autoimmune disease, HIV/AIDS, taking immunosuppressant drugs, and infection with human T-lymphocyte virus type 1, Epstein-Barr virus, or H. pylori.

Medical Author:
Medically Reviewed on 6/3/2019

Lymphoma Cancer: Hodgkin’s vs. Non-Hodgkin’s Symptoms

Hodgkin’s Lymphoma

These and other signs and symptoms may be caused by adult Hodgkin lymphoma or by other conditions. Check with your doctor if any of the following do not go away:

  • Painless, swollen lymph nodes in the neck, underarm, or groin.
  • Fever for no known reason.
  • Drenching night sweats.
  • Weight loss for no known reason.
  • Itchy skin.
  • Feeling very tired.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's past illnesses and treatments will also be taken.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells, white blood cells, and platelets.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the sample made up of red blood cells.
  • Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
  • Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube. The sedimentation rate is a measure of how much inflammation is in the body. A higher than normal sedimentation rate may be a sign of lymphoma or another condition. Also called erythrocyte sedimentation rate, sed rate, or ESR.
  • Lymph node biopsy: The removal of all or part of a lymph node. One of the following types of biopsies may be done:
    • Excisional biopsy: The removal of an entire lymph node.
    • Incisional biopsy: The removal of part of a lymph node.
    • Core biopsy: The removal of part of a lymph node using a wide needle.

A pathologist views the tissue under a microscope to look for cancer cells, especially Reed-Sternberg cells. Reed-Sternberg cells are common in classical Hodgkin lymphoma.

The following test may be done on tissue that was removed:

  • Immunophenotyping: A laboratory test used to identify cells, based on the types of antigens or markers on the surface of the cell. This test is used to diagnose the specific type of lymphoma by comparing the cancer cells to normal cells of the immune system.

Non-Hodgkin’s Lymphoma

These signs and symptoms may be caused by adult non-Hodgkin lymphoma or by other conditions. Check with your doctor if you have any of the following:

  • Swelling in the lymph nodes in the neck, underarm, groin, or stomach.
  • Fever for no known reason.
  • Recurring night sweats.
  • Feeling very tired.
  • Weight loss for no known reason.
  • Skin rash or itchy skin.
  • Pain in the chest, abdomen, or bones for no known reason.

When fever, night sweats, and weight loss occur together, this group of symptoms is called B symptoms.

Other signs and symptoms of adult non-Hodgkin lymphoma may occur and depend on the following:

  • Where the cancer forms in the body.
  • The size of the tumor.
  • How fast the tumor grows.

Lymphoma Cancer: Hodgkin’s vs. Non-Hodgkin’s Causes

Hodgkin’s Lymphoma

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for adult Hodgkin lymphoma include the following:

  • Being in young or late adulthood.
  • Being male.
  • Being infected with the Epstein-Barr virus.
  • Having a first-degree relative (parent, brother, or sister) with Hodgkin lymphoma.

Pregnancy is not a risk factor for Hodgkin lymphoma.

Non-Hodgkin’s Lymphoma

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk.

These and other risk factors may increase the risk of certain types of adult non-Hodgkin lymphoma:

  • Being older, male, or white.
  • Having one of the following medical conditions:
    • An inherited immune disorder (such as hypogammaglobulinemia or Wiskott-Aldrich syndrome).
    • An autoimmune disease (such as rheumatoid arthritis, psoriasis, or Sjögren syndrome).
    • HIV/AIDS.
    • Human T-lymphotrophic virus type I or Epstein-Barr virus infection.
    • Helicobacter pylori infection.
  • Taking immunosuppressant drugs after an organ transplant.

Understanding Cancer Metastasis, Stages of Cancer, and More Slideshow

Understanding Cancer Metastasis, Stages of Cancer, and More Slideshow

In the most basic terms, cancer refers to cells that grow out-of-control and invade other tissues. Cells may become cancerous due to the accumulation of defects, or mutations, in their DNA. Certain inherited genetic defects (for example, BRCA1 and BRCA2 mutations) and infections can increase the risk of cancer. Environmental factors (for example, air pollution) and poor lifestyle choices—such as smoking and heavy alcohol use—can also damage DNA and lead to cancer.

Most of the time, cells are able to detect and repair DNA damage. If a cell is severely damaged and cannot repair itself, it usually undergoes so-called programmed cell death or apoptosis. Cancer occurs when damaged cells grow, divide, and spread abnormally instead of self-destructing as they should.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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