Symptoms of Hodgkin lymphoma may include the following:

• A painless swelling in the lymph nodes in the neck, axilla, or groin
• Unexplained recurrent fevers
• Night sweats
• Unexplained weight loss
• Itchy skin
• Loss of appetite
• Fatigue

Although these symptoms may be associated with conditions like the flu, when symptoms like this persist, an evaluation with a healthcare practitioner should occur.

In addition, patients may experience pain in the lymph nodes after drinking alcohol, an uncommon but distinctive finding in Hodgkin lymphoma. The spleen may also be enlarged.

Physical Exam: A thorough physical examination with attention to assessment for enlarged lymph nodes especially in the neck, underarm, and groin and enlargement of the liver or spleen.

Chest x-ray

CT scan of the chest, and abdomen/pelvis or PET/CT scan

Biopsy: removal of part or all of a lymph node. Reed-Sternberg cells are the cells characteristic of this disease and are usually found with Hodgkin lymphoma.

Blood cell counts: Assessment of the CBC, comprehensive metabolic panel, and liver function tests.

Bone marrow biopsy: assessment for HL in the bone marrow.

Pathologists currently use the World Health Organization (WHO) modification of the Revised European-American Lymphoma (REAL) classification for histologic classification for adult Hodgkin lymphoma.

Classical HL

• nodular sclerosis
• mixed cellularity
• lymphocyte depletion
• lymphocyte-rich classical

Nodular lymphocyte-predominant

Nodular lymphocyte-predominant HL is considered to be a separate entity distinct from classic HL. Patients with lymphocyte-predominant disease have earlier-stage disease, longer survival, and fewer treatment failures than those with classic HL. Lymphocyte-predominant HL is usually diagnosed in asymptomatic young males with cervical or inguinal lymph nodes but usually without mediastinal involvement.

Note: The treatment and prognosis in Hodgkin's lymphoma depends primarily on the stage of disease rather than the histology.