Hodgkin disease or Hodgkin lymphoma is a type of lymphoma. There are 2 kinds of lymphoma:

• Hodgkin disease (named after Dr. Thomas Hodgkin, who recognized it in 1832)
• non-Hodgkin lymphoma

Non-Hodgkin lymphoma is covered in a separate American Cancer Society document.

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.

Lymphatic 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 lymphatic system include the spleen, the bone marrow, and the thymus gland.

The lymph nodes make and store 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). Most cases of Hodgkin disease start in B lymphocytes.

Start and spread of Hodgkin disease

Because lymph tissue is found in many parts of the body, 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). This disease causes the lymph nodes to swell and press on nearby structures. But lymph nodes can become swollen for many reasons, such as when the body is fighting an infection.

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 gets into the blood vessels and can then spread to almost any other place in the body.

The Hodgkin disease cell

The cancer cells in Hodgkin disease are unique. They are called Reed-Sternberg cells (or Hodgkin cells). They are an abnormal type of B lymphocyte that is much larger than normal lymphocytes.

Types of Hodgkin disease

There are different types of Hodgkin disease. The 2 main types are classic Hodgkin disease (which has several subtypes) and nodular lymphocyte predominant Hodgkin disease. 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 differently. Ask your doctor about the exact type of Hodgkin disease you (or your loved one) has.

Classical Hodgkin disease

Classical Hodgkin disease (HD) accounts for about 95% of all cases of Hodgkin disease in developed countries. It has 4 subtypes, all of which have Reed-Sternberg cells that can be seen under the microscope.

Nodular lymphocyte predominant Hodgkin disease

Nodular lymphocyte predominant Hodgkin disease (NLPHD) accounts for about 5% of Hodgkin disease. This type is more common in men than women, and it mostly involves lymph nodes in the neck and under the arm.

All types of Hodgkin disease are cancer because as they grow they can press on, spread into, and attack and destroy normal tissue.

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: 08/06/2009
Last Revised: 08/06/2009