What is the difference between Hodgkin and non-Hodgkin lymphoma?

Hodgkin lymphoma and non-Hodgkin lymphoma are two main types of cancer of the lymphatic system, which is a vital part of the body's immune system. Although both affect the lymphatic system, they differ primarily in the type of lymphocytes affected, which influences the diagnosis, disease progression, and treatment options.

Key Differences in Affected Cells

The fundamental difference between Hodgkin and non-Hodgkin lymphoma lies in the presence of specific cells called Reed-Sternberg cells. These large, abnormal cells are a hallmark of classical Hodgkin lymphoma and are seen when examining a lymph node tissue sample under a microscope [2]. In contrast, Reed-Sternberg cells are not found in non-Hodgkin lymphoma [1].

Hodgkin lymphoma is classified into two main types: classical Hodgkin lymphoma (the most common) and nodular lymphocyte-predominant Hodgkin lymphoma. Meanwhile, non-Hodgkin lymphoma is a wide and diverse group of cancers that arise from lymphocytes and can be of different types based on the type of lymphocyte affected (B-cells or T-cells) and their behavior (indolent or aggressive) [2].

Diagnosis and Tests

To diagnose any type of lymphoma, a biopsy of a lymph node or suspected tissue is taken and examined under a microscope to determine the presence of cancer cells and classify them [2]. In the case of Hodgkin lymphoma, finding Reed-Sternberg cells is crucial for diagnosis [2]. Other tests used in diagnosis and staging include:

• Blood tests: such as a complete blood count (CBC) which measures the number of red and white blood cells and platelets, blood chemistry tests, and the erythrocyte sedimentation rate (ESR) [1][3].
• Imaging tests: such as a computed tomography (CT) scan and positron emission tomography (PET) scan to determine the extent of disease spread in the body [1].
• Bone marrow biopsy: may be performed to assess whether the cancer has spread to the bone marrow [1].

Disease Staging and Treatment Options

Similar stages (from stage I to IV) are used for both types to determine the extent of cancer spread [1]. However, the course of the disease and response to treatment can differ significantly. Hodgkin lymphoma often starts in the lymph nodes above the diaphragm, specifically in the chest area (mediastinum) [2].

Modern treatment options for both types may include chemotherapy, radiation therapy, targeted therapy, and immunotherapy [1]. However, specific treatment protocols vary based on the lymphoma subtype, disease stage, and other patient-specific factors [2]. In general, Hodgkin lymphoma is considered curable in most cases, especially if detected and treated early [1].

The Importance of Accurate Diagnosis

Given the fundamental differences between Hodgkin and non-Hodgkin lymphoma, an accurate diagnosis is crucial for determining the most appropriate treatment plan. Anyone experiencing symptoms such as painless swelling of lymph nodes in the neck, armpits, or groin, unexplained fever, drenching night sweats, unexplained weight loss over 6 months, skin itching, or fatigue should consult a doctor to evaluate their condition [1][2]. These symptoms may be caused by lymphoma or other conditions, and medical evaluation is essential. For more information on the diagnosis, staging, and treatment options for Hodgkin lymphoma, you can visit Hodgkin Lymphoma: Diagnosis, Staging, and Modern Treatment Options (Arabic).

Medical references

• Hodgkin Lymphoma
• Hodgkin Lymphoma Treatment (PDQ®)–Patient Version
• Blood Count Tests