What is Hodgkin disease?
Hodgkin disease (Hodgkin lymphoma) is a type of lymphoma, a cancer that starts in white blood cells called lymphocytes. Lymphocytes are part of the body’s immune system. There are 2 kinds of lymphoma:
- Hodgkin disease (named after Dr. Thomas Hodgkin, who described it in 1832)
- Non-Hodgkin lymphoma
These 2 main types of lymphomas differ in how they behave, spread, and respond to treatment, so it’s important to tell them apart. Doctors can most often tell the difference between them by looking at the cancer cells under a microscope. In some cases, lab tests may be needed to do this.
Both children and adults can get Hodgkin disease. This document covers treatment in both groups.
To learn about non-Hodgkin lymphoma, please see our document, Non-Hodgkin Lymphoma.
The lymph system and lymphoid tissue
To better understand Hodgkin disease, it helps to know something about the body’s lymph (pronounced “limf”) system. The lymph system is made up of lymphoid tissue, lymph vessels, and a clear fluid called lymph.
Lymphoid tissue includes the lymph nodes and other organs that are part of the body’s immune and blood-forming systems. Lymph nodes are small, bean-shaped organs found in many places throughout the body. Other parts of the lymph system include the spleen, the bone marrow (soft inner part of some bones), and the thymus.
Lymphoid tissue is made up mainly of lymphocytes, which are special white blood cells that fight infection. There are 2 types of lymphocytes: B lymphocytes (or B cells) and T lymphocytes (or T cells). Almost all cases of Hodgkin disease start in B lymphocytes.
Start and spread of Hodgkin disease
Lymphoid tissue is found in many parts of the body like the lymph nodes, the spleen, the bone marrow, and the digestive tract. So Hodgkin disease can start almost anywhere. Most often it starts in lymph nodes in the upper part of the body (in the chest, neck, or under the arms).
Hodgkin disease can spread through the lymph vessels in a stepwise fashion from lymph node to lymph node. Rarely, and late in the disease, the cancer can get into the blood vessels and then spread to almost any other place in the body.
The Hodgkin disease cell
The cancer cells in most cases of Hodgkin disease are called Reed-Sternberg cells after the doctors who first described them. They are most often an abnormal type of B lymphocyte that is much larger than normal lymphocytes.
Types of Hodgkin disease
There are 2 main types of Hodgkin disease:
- Classic Hodgkin disease (which has 4 subtypes) accounts for about 95% of cases.
- Nodular lymphocyte predominant Hodgkin disease (NLPHD) makes up about 5% of cases.
The types differ in the way the cancer cells look under a microscope. The types are important because each grows and spreads in a different way. Often they are treated in different ways. You can ask your doctor about the exact type of Hodgkin disease you (or your loved one) has.
All types of Hodgkin disease are cancer because as they grow they may press on, invade, and destroy normal tissue and spread to other tissues. There is no form of Hodgkin disease that is not cancer.
Hodgkin disease occurs in both children and adults. Because Hodgkin disease is much the same in both children and adults, this document covers treatment in both groups.
Last Medical Review: 02/05/2013
Last Revised: 02/07/2014