Hodgkin Lymphoma

Hodgkin lymphoma (HL), formerly Hodgkin disease, is a rare hematologic malignancy arising from B lymphocytes within the lymphatic system. It is histologically defined by the presence of characteristic multinucleated Reed–Sternberg cells in an inflammatory background. HL accounts for about 15% of all lymphomas and shows a bimodal age distribution, peaking in young adults (15–35 years) and again after age 50.

The most common presentation is painless, progressive enlargement of cervical or supraclavicular lymph nodes. Up to 30% of patients exhibit systemic “B symptoms”: unexplained fever (>38°C), drenching night sweats, and unintentional weight loss (>10% in 6 months). Other features include fatigue, pruritus (often after bathing or alcohol), cough, chest pain, or abdominal discomfort due to nodal or extranodal involvement.

Diagnosis requires excisional lymph node biopsy demonstrating Reed–Sternberg cells with appropriate immunophenotype (typically CD15+, CD30+, CD20?/weak). Staging uses the Ann Arbor system with PET-CT for extent assessment.

HL is one of oncology’s success stories, with cure rates approaching 80–90% overall. Early-stage favorable disease is managed with brief chemotherapy (e.g., 2 cycles ABVD) plus involved-site radiotherapy. Advanced stages receive multi-agent chemotherapy (e.g., 6 cycles ABVD or A+AVD), sometimes with brentuximab vedotin or checkpoint inhibitors. Relapsed/refractory cases may undergo high-dose chemotherapy with autologous stem-cell transplant or novel immunotherapies. Long-term follow-up monitors for treatment-related toxicities, including cardiopulmonary effects and secondary malignancies.