# Hodgkin lymphoma

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Hodgkin Lymphoma - StatPearls - NCBI Bookshelf (NBK499969) - https://www.ncbi.nlm.nih.gov/books/NBK499969/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class BD25.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
HODGKIN LYMPHOMA
Sources: Hodgkin Lymphoma - StatPearls - NCBI Bookshelf (NBK499969) -
         https://www.ncbi.nlm.nih.gov/books/NBK499969/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class BD25.00 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (5)
    - Presentation is usually painless lymph node swelling above the diaphragm, involving one or two
      node regions  [lymphadenopathy]
    - B symptoms - unexplained major weight loss, spiking fevers, and soaking night sweats - occur
      in up to 30% of patients  [night sweats · weight loss]
    - Alcohol intake can trigger pain in affected lymph nodes, a paraneoplastic feature
    - Persistent itching without a rash can be a presenting complaint  [itching]
    - A bulky mass in the chest can cause chest pain and breathlessness from compression of nearby
      structures  [breathlessness · chest pain]
  SIGNS - what you find (4)
    - Nodular sclerosis disease affects mostly young adults and tends to present at an early stage
    - Mixed cellularity disease occurs across children and the elderly and usually presents at an
      advanced stage
    - Lymphocyte-depleted disease presents with extensive spread outside the nodes, mainly in older
      patients and those with AIDS
    - The nodular lymphocyte-predominant form typically appears in men as localized painless neck
      nodes that spare the mediastinum
  TESTS (7)
    - Diagnosis requires biopsy of a lymph node or the suspected involved organ
    - Needle biopsies often give non-specific results because malignant cells are sparse and tissue
      architecture is lost, so excisional biopsy is preferred when suspicion is high
    - Finding a Reed-Sternberg cell or an LP cell in the specimen confirms the diagnosis
    - Baseline labs include a complete blood count, metabolic panel, ESR, and hepatitis B, hepatitis
      C, and HIV testing
    - LDH tracks disease bulk, and a raised alkaline phosphatase suggests liver or bone involvement
    - PET-CT is now the standard scan for judging treatment response
    - Chest x-ray and CT of the chest, abdomen, and pelvis assist with staging
  IF NOT THIS - what else fits (5)
    - Infectious mononucleosis is on the differential
    - Peripheral T cell lymphoma is on the differential
    - ALK1-positive anaplastic large cell lymphoma is on the differential
    - Non-Hodgkin lymphoma is on the differential
    - Diffuse large B cell lymphoma is on the differential
  Source  StatPearls "Hodgkin Lymphoma" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Treated with chemotherapy/radiotherapy by an oncology/haematology unit; the GP's role is
            prompt referral on suspicion (painless rubbery lymphadenopathy plus B symptoms) and
            symptomatic relief in the meantime. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Treated with chemotherapy/radiotherapy by an oncology/haematology unit; the GP's role is
            prompt referral on suspicion (painless rubbery lymphadenopathy plus B symptoms) and
            symptomatic relief in the meantime.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - A significant mediastinal mass can cause chest pain and shortness of breath
            from mass effect - a presentation distinct from simple painless lymphadenopathy that may
            need more urgent assessment.
            RED FLAG - Fever, night sweats or unexplained weight loss (B symptoms), painless rapidly
            enlarging lymph nodes, a mediastinal mass causing cough or breathlessness, or persistent
            itching.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
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