Symptoms and diagnosis of Hodgkin lymphoma

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Symptoms of Hodgkin lymphoma

Main symptom

• A painless swelling in the lymph nodes, in your neck, armpit or groin. These lumps may come and go

Other symptoms

• Night sweats – these can be drenching
• High temperatures or fevers
• Loss of appetite
• Unexplained weight loss
• Feeling tired all the time (fatigue)
• Itchy skin
• Skin rash

You may hear these called ‘B’ symptoms.

Symptoms from lymphoma in other areas of the body

You can have lymphoma diagnosed in other areas of your body. If lymphoma is affecting somewhere else in your body the symptoms will be different. For example:

• Lymphoma in your bowel or stomach: Abdominal pain, diarrhoea or indigestion
• Lymphoma in your chest area: Cough or difficulty swallowing
• Lymphoma in your skin: Rough, red patches of skin

All these symptoms can be caused by conditions other than cancer, but it’s important to go to the GP and get any unusual changes checked out. 

Can I be screened for Hodgkin lymphoma?

Testing for Hodgkin lymphoma when you have no symptoms is called screening. There is no lymphoma screening programme. This is because there have been no tests proven to help predict lymphoma. If you are worried about lymphoma, contact your family doctor (GP).

Diagnosing Hodgkin lymphoma

Your family doctor (GP) will talk to you about your symptoms and arrange blood tests, if needed. If your blood test is abnormal you will be referred to hospital for more tests.

Lymph node biopsy

This test removes a sample of cells from an enlarged lymph node and looks at them closely under a microscope in the laboratory. If the enlarged node is on your neck, the cells can be taken without putting you to sleep. If the node is deeper, like in your chest, you will need a general anaesthetic.

Tests after diagnosis

You may have more tests after your diagnosis to find out:

• The number and location of affected lymph nodes
• If the affected lymph nodes are above or below your diaphragm
• If the disease is found in your bone marrow or in places outside the lymphatic system, such as your liver

This is called staging. Staging helps your doctor to decide the best treatment for you. Read more about how Hodgkin lymphoma is staged.

Some tests may also be used to see how well you’re responding to treatment. 

• PET scan: A radioactive injection that will show up any cancer spread to other parts of your body on a CT scan picture. PET scans are important for managing Hodgkin lymphoma
• CT scan: A special type of X-ray that gives a detailed picture of the inside of your body 
• Ultrasound scan: Using sound waves to look for abnormal changes inside your body, usually your liver and upper abdomen (tummy)
• Bone marrow aspirate and trephine biopsy: Taking a sample of your bone marrow (and maybe bone) and looking at it under a microscope to see the number and type of cells in it
• MRI scan: A scan that uses magnetic energy to build up a picture of the tissues inside your body 

Other tests: As some chemotherapy drugs can weaken your heart muscle, you might have an echocardiogram (Echo) before treatment to check how well your heart is working. An Echo is a type of ultrasound scan used to look at the heart and nearby blood vessels. You may also have breathing tests to measure how well your lungs are working before you start treatment. The main type of breathing test is a pulmonary function test (PTF), which is where you blow into a mouthpiece on a machine. The test is not painful and takes about 20 minutes.