The symptoms of Hodgkin lymphoma vary widely and often begin subtly, making early diagnosis challenging. They arise due to abnormal lymphocyte growth, causing immune disruption, inflammation, and swelling.
Common Symptoms
- Painless lymph node swelling:
Enlarged lymph nodes in the neck, armpits, or groin that gradually grow over weeks or months. These nodes are usually not tender but can cause a feeling of pressure if pressing nearby tissues. - B symptoms:
A group of systemic symptoms significant for staging and prognosis:- Persistent low-grade fever (cyclical)
- Night sweats (intense, drenching)
- Unexplained weight loss (>10% of body weight in six months)
- Fatigue:
Persistent, profound tiredness not relieved by rest, caused by inflammation and bone marrow involvement. - Itchy skin (pruritus):
Generalised or localised itching, sometimes preceding diagnosis. In addition, possibly caused by immune system chemical messengers. - Alcohol-induced lymph node pain:
Rare but nearly diagnostic symptom where nodes hurt after alcohol consumption. Furthermore, possibly due to blood vessel dilation in affected nodes.
Respiratory and Chest Symptoms
- Shortness of breath, cough, chest pain:
Occur when enlarged chest (mediastinal) lymph nodes compress airways or lungs. - Superior vena cava syndrome:
Facial swelling and congestion from compression of blood vessels in the chest.
Symptoms from Organ Involvement
- Bone pain:
Especially in spine or pelvis, indicating bone marrow spread. - Splenomegaly:
Enlarged spleen causing fullness or discomfort in the left upper abdomen. - Liver involvement:
Rarely causes jaundice (yellow skin and eyes).
Pediatric and Subtype Variations
- In children and adolescents, lymph node swelling is the most common symptom; systemic symptoms may be less obvious.
- Different Hodgkin lymphoma subtypes show varying symptom patterns:
- Nodular sclerosis subtype often has mediastinal mass and respiratory symptoms.
- Lymphocyte-depleted subtype is more aggressive with pronounced systemic symptoms.
Asymptomatic Cases
- Some early-stage patients have no symptoms and are diagnosed incidentally during unrelated medical exams or imaging.
Diagnostic Challenges
- Many symptoms overlap with common infections, autoimmune diseases, or other cancers.
- This overlap can cause delays in diagnosis.
- Persistent, unexplained symptoms—especially multiple together—should prompt thorough medical evaluation.
Psychological Impact
- Vague symptoms can cause anxiety, uncertainty, and concentration difficulties before diagnosis.
- Early supportive care helps patients cope emotionally during investigation.
Summary
Hodgkin lymphoma symptoms range from painless lymph node swelling and systemic “B symptoms” to fatigue, itching, and respiratory issues. Rare signs like alcohol-induced lymph node pain may aid diagnosis. Awareness and early recognition of these symptoms enable timely diagnosis and improve outcomes.
