Learn the key differences between Hodgkin lymphoma and Non-Hodgkin lymphoma. This knowledge can help patients and their families make informed healthcare choices.
Written by: Mihir Raval, MD, MPH
Board-Certified Hematologist, specializing in Benign & Hematologic Disorders
Understanding the difference between Hodgkin lymphoma and Non-Hodgkin lymphoma can help patients and their families feel more informed and confident when making healthcare decisions. While both are types of blood cancer that affect the lymphatic system, they differ in how they develop, how they spread, and how they are treated. The most significant distinction is the specific type of cancer cell involved. Hodgkin lymphoma is identified by the presence of large, abnormal cells called Reed-Sternberg cells. In contrast, Non-Hodgkin lymphoma does not contain these cells and instead develops from a large group of related cancers involving B cells or T cells.
Lymphoma is a type of blood cancer that begins in the lymphatic system, which plays a vital role in the body’s immune defense. The lymphatic system includes lymph nodes, the spleen, thymus, and bone marrow. It helps the body fight infection and disease.
Lymphoma develops when white blood cells called lymphocytes grow abnormally and multiply out of control. These cancerous cells can crowd out healthy cells and weaken the immune system’s ability to function properly.
There are two main types of lymphoma:
Understanding how these two types differ is an important first step after diagnosis.
The key difference between Hodgkin lymphoma and Non-Hodgkin lymphoma is the type of cancer cell involved.
Hodgkin lymphoma is identified by the presence of Reed-Sternberg cells, which are large, abnormal lymphocytes visible under a microscope. These cells are a defining feature of the disease.
Hodgkin lymphoma often spreads in a predictable pattern, typically moving from one group of lymph nodes to the next.
Non-Hodgkin lymphoma does not contain Reed-Sternberg cells. Instead, it includes a large group of related cancers that can develop from different immune cells, most commonly B cells or T cells.
Non-Hodgkin lymphoma can:
These differences help doctors determine the most effective diagnostic and treatment approach.
Both types of lymphoma often cause similar symptoms, including:
Other symptoms may depend on where the cancer is located. For example, swollen lymph nodes in the chest can cause shortness of breath or chest discomfort, while abdominal involvement may cause bloating or pain. Some types of Non-Hodgkin lymphoma can also affect the skin, leading to rashes or changes in skin appearance.
These symptoms can be caused by other conditions, but persistent or unexplained symptoms should always be evaluated by a healthcare provider.
Diagnosis usually begins with a physical exam and a review of symptoms. Doctors may then order blood tests and imaging studies such as CT scans, PET/CT scans, or MRI to look for enlarged lymph nodes or organ involvement.
A lymph node biopsy is essential for diagnosis. During this procedure, a sample of lymph node tissue is examined by a pathologist to look for cancer cells. The presence or absence of Reed-Sternberg cells helps distinguish Hodgkin lymphoma from Non-Hodgkin lymphoma.
Additional testing, such as bone marrow biopsy or genetic studies, may be used to identify the specific subtype and determine the stage of the disease. Staging shows how far the cancer has spread and plays a key role in treatment planning.
Treatment for lymphoma is highly individualized and depends on the type, subtype, and stage of the disease, as well as a patient’s overall health.
Common treatment options include:
Hodgkin lymphoma is often very responsive to treatment, and cure rates are high, especially when diagnosed early.
Non-Hodgkin lymphoma includes many subtypes, each with its own outlook. Some slow-growing forms may not require immediate treatment and can be closely monitored, while aggressive types require prompt therapy. Advances in research and treatment have significantly improved outcomes for many patients.
Hodgkin lymphoma and Non-Hodgkin lymphoma are both serious blood cancers, but they differ in cell type, behavior, and treatment approach. Understanding these differences can help patients feel more informed and better prepared to discuss diagnosis and treatment options with their care team.
If you have symptoms or concerns about lymphoma, early evaluation and expert care are essential.
What is the main difference between Hodgkin and Non-Hodgkin lymphoma?
The main difference is the presence of Reed-Sternberg cells. Hodgkin lymphoma contains these abnormal cells, while Non-Hodgkin lymphoma does not. This difference helps doctors identify the type of lymphoma and choose the most effective treatment.
Is Hodgkin lymphoma more serious than Non-Hodgkin lymphoma?
Not necessarily. Both are serious conditions, but many cases of Hodgkin lymphoma respond very well to treatment. Non-Hodgkin lymphoma includes many subtypes, some slow-growing and others more aggressive, so the seriousness depends on the specific type and stage.
Which type of lymphoma is more common?
Non-Hodgkin lymphoma is more common than Hodgkin lymphoma. It accounts for most lymphoma diagnoses and includes many different subtypes with varying behaviors and treatment approaches.
Can lymphoma be cured?
Many lymphomas can be cured or well controlled. Hodgkin lymphoma has high cure rates, especially when diagnosed early. Some types of Non-Hodgkin lymphoma are also curable, while others may be managed as long-term conditions.
How is lymphoma staged?
Lymphoma staging is based on how far the cancer has spread in the body. Doctors use imaging tests, biopsies, and sometimes bone marrow testing to determine the stage. Staging helps guide treatment decisions and predict outcomes.
When should someone see a doctor about possible lymphoma symptoms?
You should see a doctor if you notice swollen lymph nodes that do not go away, ongoing fatigue, unexplained weight loss, night sweats, fevers, or other symptoms. Early evaluation is important, especially if these symptoms persist or worsen over time.