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The most common sign of both Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) is a painless swelling in one or more of the lymph nodes of the neck, collarbone region, armpits, or groin. But it is important to remember that most lymph node swelling—especially in children—is caused by an infection, not by lymphoma. Affected lymph nodes usually return to normal size within a few weeks or months after an infection has cleared. Physicians often observe swollen lymph nodes during this time to see if they change in size following antibiotic treatment. However, if a lymph node(s) is larger than one inch in size (> 1 in), and if there are other suspicious symptoms, the physician may choose to perform an immediate biopsy to rule out or confirm a diagnosis of cancer.

Hodgkin's disease has a characteristic pattern of lymphatic spread that may aid in diagnosis. The disease typically invades the lymph nodes of the neck, collarbone, armpits, and/or chest above the diaphragm (large abdominal muscle that controls breathing) without "skipping" a nodal group.

If HD or NHL involves lymphatic tissue within the abdomen the belly may become swollen, and even resemble pregnancy in some female patients. Fluid may build up within the abdominal cavity, and swelling near the intestines may block the normal passage of feces. Such blockage may cause sensations of abdominal pressure or pain.

A. Risk factors

Doctors seldom know why one person develops Hodgkin lymphoma and another does not. But research shows that certain risk factors increase the chance that a person will develop this disease.

The risk factors for Hodgkin lymphoma include the following:

Age: Hodgkin lymphoma is most common among teens and adults aged 15 to 35 years and adults aged 55 years and older.

Certain viruses: Having an infection with the Epstein-Barr virus (EBV) or the human immunodeficiency virus (HIV) may increase the risk of developing Hodgkin lymphoma. However, lymphoma is not contagious. You can't catch lymphoma from another person.

Family history: Family members, especially brothers and sisters, of a person with Hodgkin lymphoma or other lymphomas may have an increased chance of developing this disease.

Weakened immune system: The risk of developing Hodgkin lymphoma may be increased by having a weakened immune system (such as from an inherited condition or certain drugs used after an organ transplant).

Having one or more risk factors does not mean that a person will develop Hodgkin lymphoma. Most people who have risk factors never develop cancer.

B. Symptoms

Hodgkin lymphoma can cause many symptoms:
  • Becoming more sensitive to the effects of alcohol or having painful lymph nodes after drinking alcohol
  • Coughing, trouble breathing, or chest pain
  • Fever that does not go away
  • Itchy skin
  • Soaking night sweats
  •  Swollen lymph nodes (that do not hurt) in the neck, underarms, or groin
  • Weight loss for no known reason
  • Weakness and tiredness that don't go away
Most often, these symptoms are not due to cancer. Infections or other health problems may also cause these symptoms. Anyone with symptoms that last more than 2 weeks should see a doctor so that problems can be diagnosed and treated.
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