Symptoms of Hodgkin lymphoma

The first clinical sign of Hodgkin lymphoma is in most cases a rough and rubber-like painless swelling of the lymph nodes. In the majority of patients it appears at the neck (approx. 70%) and, more rarely, in the lymph nodes above the collarbone, in the armpits or in the groin.

In one third of Hodgkin patients, a lymph node swelling behind the breastbone (mediastinum) is detected. It can disturb breathing and cause a feeling of pressure and continuous coughing.

If only individual abdominal lymph nodes are involved, abdominal pain, a feeling of pressure or unexplained diarrhea are possible hints.

In some rare cases, drinking of alcohol causes pain of the involved nodes, which is a relatively characteristic sign for Hodgkin lymphoma.

One third of affected people present with unspecific common symptoms like a decrease in general performance, tiredness, weakness and itching all over the body.

Special attention should be paid to the presence or absence of the so-called B symptoms. They are stage-defining factors and therefore directly related to the choice of therapy.

B-symptoms are:

Due to the increase of tumor cells in the lymph nodes, the balance of the immune system is disturbed and weakened. An accumulation of bacterial, viral or fungal infections may be the consequence. If the disease has spread outside the lymph nodes to other organs like bones or liver, this can cause further symptoms and complaints. If bones are affected, bone pain and frequent fractures are typical signs. If the bone marrow is infiltrated, this may lead to changes in the blood count. A liver affection may present itself as an enlargement of the organ that leads to pressure or pain in the upper abdomen and to changes of the laboratory values (e.g. liver values).