Hodgkin's lymphoma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Mohsen Basiri M.D.

Overview

The most common symptoms of classic Hodgkin lymphoma include painless localized peripheral lymphadenopathy, B symptoms (fever, night sweats, weight loss), and pruritus. Less common symptoms of Hodgkin lymphoma include cough, chest pain, breathing problems, pain or feeling of fullness below the ribs, pain in lymph nodes after drinking alcohol, skin blushing or flushing, bone pain, and leg swelling.

History and Symptoms

The presentation of Hodgkin lymphoma may vary depending on the location of tumor and organ involvement, mass size and stage of disease.

History

• Hodgkin lymphoma begins at a single site of the lymphatic system, generally a lymph node, and then progresses to adjacent lymph nodes through lymphatic vessels before spreading to other sites and organs. The majority of patients present with an asymptomatic lymphadenopathy most often a site above the diaphragm, or as an accidental mediastinal mass on chest x-ray.

• Occasionally patients may present with nonspecific symptoms and signs that are more compatible with infection than malignant disease.
• B symptoms or constitutional symptoms, include fever (>100.4°F), drenching night sweats, and unexplained weight loss (>10% of total body weight) may present up to 50 percent of patients with advanced disease.
• Pruritus may be present before the diagnosis of Hodgkin lymphoma by months or even a year or more.

Symptoms

Common symptoms

• Painless lymphadenopathy with a rubbery consistency most often a site above the diaphragm,
• Systemic B symptoms:

• Fever (Pel-Ebstein fever): persistent temperature >38°C (>100.4°F)
• Drenching night sweats
• Unexplained weight loss >10% of total body weight within the past 6 months

• Pruritus
• Fatigue
• Mediastinal mass effects include:

• Chest pain
• Cough
• Shortness of breath

Less common symptoms

• Less common symptoms of Hodgkin's lymphoma include the following:

• Pain or feeling of fullness below the ribs due to swollen spleen or liver
• Pain in lymph nodes after drinking alcohol
• Skin blushing or flushing
• Bone pain
• Swelling of legs may be caused by extra fluid if swollen lymph nodes are blocking the flow of lymph fluid