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Hodgkins Lymphoma - Stages and Types of Hodgkins Lymphoma

Home> Hodgkin’s lymphoma> Overview and Types

Hodgkin's lymphoma, also known as Hodgkin lymphoma or Hodgkin cancer, occurs when lymphocytes, a type of white blood cells, divide uncontrollably and form a mass. The commonly observed symptoms of this condition include enlarged lymph nodes, night sweats, persistent fatigue, and fever. Due to the availability of advanced diagnostic and treatment techniques in recent decades, the survival rates of Hodgkin’s cancer have improved, and the prognoses have been far more promising.

What Is Hodgkin's Lymphoma?

The lymphatic system is an integral part of our immune system and comprises T lymphocytes, B-lymphocytes, and natural killer cells. They play a pivotal role in destroying germs and infections. When the B lymphocytes or T lymphocytes divide uncontrollably and form a mass, it is referred to as lymphoma.

As for Hodgkin lymphoma meaning, it is a condition where the B-cells, a type of WBC, undergo uncontrolled division due to DNA mutations and form a mass. Lymphoid tissues are present in various body areas, including lymph vessels, lymph nodes, bone marrow, thymus, spleen, adenoids, and tonsils. Hodgkin disease most commonly occurs in the lymphoid tissues of upper body parts, such as the neck, chest, or under the arms.

How common is Hodgkin's Lymphoma?

Although Hodgkin's lymphoma is a rare disease, it is one of the most common cancers found in individuals between 15 and 19 years of age. Globally, Hodgkin's lymphoma comprises 0.4% of all cancer cases and 0.2% of all cancer-related deaths. The incidence rate of Hodgkin’s lymphoma is 0.98 per 100,000, and mortality is 0.26 per 100,000. Being a male, a history of Epstein-Barr virus infection, HIV infection, exposure to pollution, family history, cigarette smoking, and autoimmune diseases are risk factors for Hodgkin’s lymphoma. In recent times, there has been an increasing incidence of Hodgkin's lymphoma in females, in Asian countries, and in the younger population.

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What is the Difference between Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma?

There are several differences between Hodgkin’s lymphoma and non-Hodgkin’s lymphoma, and the predominant ones include the following:

Cell Types

Reed-Sternberg cells, abnormal cells in the lymph nodes, are present in Hodgkin's lymphoma but not in non-Hodgkin’s lymphoma.

Lymph Node Involvement

Hodgkin’s lymphoma usually initiates in a single lymph node and then spreads to the nearby nodes. In contrast, non-Hodgkin’s lymphoma occurs in multiple lymph nodes and may affect organs and tissues outside the lymphatic system.

Spread and Stage at Diagnosis

Hodgkin’s lymphoma usually spreads predictably and is thus diagnosed at early stages. On the other hand, non-Hodgkin’s lymphoma is highly unpredictable in spread and is thus diagnosed at different stages.

Prognosis

The prognosis of Hodgkin’s lymphoma is generally favorable, even in patients with advanced disease. The prognosis of non-Hodgkin’s lymphoma depends on the subtypes. Some subtypes are aggressive, while others are slow-growing.

Different Types of Hodgkin Lymphoma

Following are the different types of Hodgkin lymphoma:

Classical Hodgkin lymphoma

Classical Hodgkin’s lymphoma accounts for almost 90% of all Hodgkin’s disease cases. This type is characterized by Reed-Sternberg cells (abnormal B-lymphocytes). Classical Hodgkin’s lymphoma is further divided into subtypes based on the appearance of Reed-Sternberg cells and other features.

Nodular Sclerosis Hodgkin Lymphoma

This type of Hodgkin’s lymphoma usually initiates in the neck and chest and is one of the most common types of Hodgkin’s lymphoma in developed countries. It accounts for almost 70% of cases. Although it may occur at any age, teens and young adults are at high risk for this subtype.

Mixed Cellularity Hodgkin Lymphoma

It accounts for almost 35 to 40% of Hodgkin’s lymphoma cases. In this type, the Reed-Sternberg cells are usually surrounded by histiocytes, plasma cells, and eosinophils.

Lymphocyte-rich Hodgkin Lymphoma

Relatively fewer Reed-Sternberg cells are present in the tumor. The tumor has abundant lymphocytes that give it a unique appearance under the microscope. It mostly affects individuals between 30 and 40 years of age.

Lymphocyte-depleted Hodgkin Lymphoma

Unlike lymphocyte-rich Hodgkin’s lymphoma, lymphocyte-depleted Hodgkin’s lymphoma is characterized by significantly fewer lymphocytes. It is usually diagnosed in individuals over 55 years of age and is relatively less common in young people.


What are the other Categories of Hodgkin Lymphoma?

Apart from classical Hodgkin’s lymphoma, the other types of Hodgkin’s lymphoma include:

Nodular Lymphocyte-Predominant Hodgkin Lymphoma

This type of Hodgkin’s lymphoma is characterized by lymphocyte-predominant (LP) cells. These are large, atypical cells. The nodular lymphocyte-predominant Hodgkin’s lymphoma does not have Reed-Sternberg cells. It is a slow-growing tumor with a favorable prognosis.

Diffuse Large B-cell Lymphoma

It is an aggressive form of lymphoma that arises from B-cells and results in various symptoms. Reed-Sternberg cells are absent in diffuse large B-cell lymphomas. The risk of diffuse large B-cell lymphoma increases with age. It is not usually found in children.

Diffuse Large T-cell Lymphoma

Diffuse large T-cell lymphoma originates from mature T-cells. It is relatively less common than diffuse large B-cell lymphoma. It is aggressive and involves rapid, diffused growth of abnormal T-cells.

What are the Different Hodgkin’s Lymphoma Stages?

Following are the different Hodgkin’s lymphoma stages:

Stage 1 Hodgkin's Lymphoma

In Hodgkin’s lymphoma stage 1, the tumor is present only in one lymph node, OR only one extra lymphatic organ is invaded by cancer.

Stage 2 Hodgkin's Lymphoma

Stage 2 Hodgkin lymphoma is characterized by the presence of cancer in two or more lymph node regions on the same side (below or above) of the diaphragm.

Stage 2E Hodgkin's Lymphoma

In this Hodgkin’s lymphoma stage, the disease may be present in a single organ and its lymph nodes, with or without the invasion of the tumor to regions of other lymph nodes on the same side of the diaphragm.

Stage 2B (bulky) Hodgkin's Lymphoma

Hodgkin’s lymphoma stage 2B is similar to stage 2 or stage 2E, along with a mass present in the chest.

Stage 3 Hodgkin's Lymphoma

The tumor has invaded the lymph node regions above and below the diaphragm.

Stage 4 Hodgkin's Lymphoma

It involves at least one organ beyond the lymph nodes, such as the bone marrow, liver, or lungs.

Conclusion

Hodgkin lymphoma is a tumor growing in the lymphatic system. It usually occurs in the upper part of the body. There are various subtypes of Hodgkin lymphoma, such as classical Hodgkin lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, diffuse large B-cell lymphoma, and diffuse large T-cell lymphoma. The stage of Hodgkin lymphoma ranges from stage 1 to stage 4.

Frequently Asked Questions

Can you live a full life after Hodgkin's lymphoma?

Survival after Hodgkin’s lymphoma depends upon several factors, such as stage of diagnosis, age, and response to treatment. Overall, the prognosis is favorable for Hodgkin’s lymphoma.

Hodgkin’s lymphoma is curable in its early stages, and the chances of favorable outcomes reduce as the stage of diagnosis increases (more advanced).

Some types of Hodgkin’s lymphoma are slow-growing, such as classical Hodgkin’s lymphoma. However, other types, such as diffuse large B cell and diffuse T cell lymphoma, are aggressive.

Hodgkin’s lymphoma is not contagious; it does not spread from one person to another.

Stage 4 is considered the terminal stage of lymphoma, as at this stage, multiple organs such as the lungs, liver, and bone marrow are affected.

Hodgkin lymphoma is not a type of leukemia. Hodgkin lymphoma usually occurs in the lymphatic system, while leukemia occurs in the bone marrow.

Not necessarily. Hodgkin lymphoma can be diagnosed in stages 1, 2, and 3 too. However, if it is left undiagnosed and untreated, it has the potential to advance to stage 4.