Hodgkin lymphoma

Last reviewed: 7 Jan 2023
Last updated: 15 Oct 2019



History and exam

Key diagnostic factors

  • lymphadenopathy
More key diagnostic factors

Other diagnostic factors

  • unexplained fevers
  • night sweats
  • weight loss
  • dyspnea
  • cough
  • chest pain
  • superior vena cava syndrome
  • abdominal pain
  • generalized pruritus
  • alcohol-induced pain at involved sites
  • hepatomegaly and/or splenomegaly
  • tonsillar enlargement
Other diagnostic factors

Risk factors

  • history of Epstein-Barr virus (EBV) infection
  • family history of Hodgkin lymphoma
  • young adults from higher socioeconomic class
  • HLA types
  • Jewish ancestry
More risk factors

Diagnostic investigations

1st investigations to order

  • CBC with differential
  • metabolic panel
  • erythrocyte sedimentation rate (ESR)
  • CXR
  • PET-CT scan
  • gallium scan
  • contrast CT neck, chest, and abdomen/pelvis
  • excisional lymph node biopsy
  • immunohistochemical studies
More 1st investigations to order

Investigations to consider

  • bone marrow biopsy
  • thyroid function tests
  • echocardiogram or multigated acquisition (MUGA) scan
  • pulmonary function tests
More investigations to consider

Treatment algorithm


early (stage I to stage II) classical HL

advanced (stage III to stage IV) classical HL

early (stage I to stage II) nodular lymphocyte-predominant HL

advanced (stage III to stage IV) nodular lymphocyte-predominant HL


refractory and relapsed disease after first-line therapy



Alison Moskowitz, MD

Assistant Attending

Lymphoma Service

Memorial Sloan-Kettering Cancer Center

New York City



AM has received honoraria for serving on advisory boards for Seattle Genetics, BMS, Merck, and Erytech. She has received honoraria from Seattle Genetics and Takeda for educational lectures.


Dr Alison Moskowitz would like to gratefully acknowledge Dr Chris R. Kelsey, Dr Leonard R. Prosnitz, and Dr Timothy M. Zagar, the previous contributors to this topic.


CRK, LRP, and TMZ declare that they have no competing interests.

Peer reviewers

Joachim Yahalom, MD

Radiation Oncologist

Director of Postgraduate Education

Department of Radiation Oncology

Memorial Sloan-Kettering Cancer Center

New York



JY declares that he has no competing interests.

Rebecca Connor, MD

Chief Fellow

Section of Hematology and Oncology

Department of Internal Medicine

Wake Forest University Baptist Medical Center




RC declares that she has no competing interests.

Kirit Ardeshna, MD, MA (Cantab), MB, BChir, FRCP, FRCPath

Consultant Haematologist

University College London Hospitals




KA declares that he has no competing interests.

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