Hodgkin's lymphoma is a disease that invades the lymphatic system, mostly affecting young people. The disease develops slowly in early clinical stages and is mainly characterized by superficial lymph node enlargement. Due to different locations of lesion invasion, their clinical manifestations vary. Next, let's take a closer look at the symptoms of classic Hodgkin's lymphoma?
1. Initial symptoms and lymph node enlargement
The first symptom of 60% to 80% of patients is painless swelling of lymph nodes in the neck or clavicle, with more on the left than on the right, followed by swelling of lymph nodes in the armpits and groin. The swollen lymph nodes have a tough and elastic texture, and do not adhere to each other in the early stage. In the future, the lymph nodes can fuse with each other and adhere to deep tissues, losing their mobility. Deep lymph node enlargement can cause compression symptoms, which are related to the organ and degree of compression.
2. Extranodal lesions
Extranodal lesions of HL are rare in primary cases and mostly secondary, with spleen, lungs, and other lesions being slightly more common. One third of patients show splenomegaly, and spleen size cannot be used as a basis for HL involvement. In clinical practice, 30% of patients without splenomegaly have HL involvement, while enlarged spleens may not have lesions. Therefore, to determine whether HL involves the spleen, laparotomy and splenectomy are necessary to confirm the diagnosis. Hepatomegaly accounts for about 10% and is generally seen in the late stages of the disease.
3. Systemic symptoms
30% to 40% of HL patients present with unexplained fever as the initial symptom. These patients are older and more common in males, often with involvement of retroperitoneal lymph nodes. HL can have fever in the early stage, manifested as periodic fever type, called Pel Epstein fever, which accounts for about 1/6 of patients and is more common in females.
4. Concurrent diseases
The most commonly reported complications of HL are concurrent leukemia and myelodysplastic syndrome, which are the most serious long-term complications in modern treatment and may be related to radiation therapy and the toxicity of alkylating agents. HL can also cause varying degrees of anemia and thrombocytopenia, and can also be accompanied by idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia, but they are less common.
