Non-Hodgkin Lymphoma and Hodgkin Lymphoma: What’s the Difference?

Medically Reviewed By: Philippe Armand, MD, PhD
  • Hodgkin lymphoma is a malignancy of lymphocytes marked by the presence of Reed-Sternberg cells, mature B cells that have become malignant.
  • Non-Hodgkin lymphoma is also a malignancy of lymphocytes and can be derived from B cells or T cells.
  • The diseases are different in numerous ways and often follow different courses of progression.

Hodgkin and non-Hodgkin lymphoma are the two main types of lymphoma, a cancer that affects the lymphatic system. The lymphatic system produces and transports white blood cells to fight infection.

While they have many characteristics in common, there are some significant differences between Hodgkin and non-Hodgkin lymphoma, including the age groups they affect, how they spread, the type of white blood cell they affect, and the likelihood of early detection.

Hodgkin lymphomaNon-Hodgkin lymphoma
Age groupMost common in adolescents and young adults and those over 60Most common in those over the age of 60  
Type of cell affectedArises from B cells (a type of white blood cell that makes protein antibodies to attack infections, viruses, and other invaders).  Non-Hodgkin lymphoma can arise from either B cells or T cells (another type of white blood cell that sends chemical instructions to kill infected and tumorous cells). 
SymptomsMost common
Painless lump under skin (often in the neck or armpits), or respiratory symptoms (eg, cough, trouble breathing) if the disease is mostly in the chest. Occasionally the enlarged lymph nodes may hurt after drinking alcohol. It’s important to note that in most cases, swollen lymph nodes are not cancerous. Swelling is often caused by inflammation instead of cancer.

Drenching night sweats
Unexplained weight loss
Same as those for Hodgkin lymphoma except there may be other symptoms depending on where the disease originates:

Swelling or abdominal pain
Loss of appetite
Feeling full after eating a small amount
Enlarged lymph nodes in the groin

Cough and trouble breathing
Chest pain
Swelling in the head, arms, or upper chest  

Trouble thinking Personality changes
Double vision
Trouble speaking    
Where it originatesTypically begins in lymph nodes of the upper body, including the head, neck, chest, and armpits.  Can originate in lymph nodes throughout the body and sometimes outside of lymph nodes.
How it spreadsProgresses predictably from one set of lymph nodes to the next and rarely reaches other organs until the later stages of the disease. Often diagnosed in early stages.Spreads more randomly. Most patients are diagnosed at a more advanced stage.
Subtypes of the diseaseThere are only two main forms of Hodgkin lymphoma: classic (more than 90 percent of all cases) and nodular lymphocyte predominant Hodgkin lymphoma.Non-Hodgkin lymphoma includes more than 60 types of cancer which are divided into two main groups: B-cell and T-cell cancers.

What is the lymphatic system?

The lymphatic system produces and transports white blood cells (lymphocytes) to fight infection and disease. It also helps control the amount of fluid in the body. The lymphatic system includes:

  • Lymph nodes: Hundreds of bean-size sacs that are spread throughout the body
  • Spleen: Filters the blood and helps make white blood cells
  • Thymus: Makes T-cell lymphocytes
  • Tonsils: Help make lymphocytes
  • Bone marrow: Makes white blood cells, red blood cells, and platelets.

The lymphatic system is connected by a series of tubes, much like the cardiac circulatory system. Instead of blood, a colorless watery liquid (lymphatic fluid) flows through these tubes to transport white blood cells to fight disease and infection.

How is lymphoma diagnosed?

There are no reliable screening tests specifically for Hodgkin or non-Hodgkin lymphoma. The chain of diagnosis typically proceeds as follows:

  • A physical exam, during which your health care provider checks for swollen lymph nodes in your neck, underarms, and groin. They will also check for a swollen spleen or liver.
  • A biopsy is the most reliable test used to diagnose lymphoma. The preferred method is to remove the lymph node through a small incision in the skin, which can usually be done with local anesthetic. Alternatively, a core needle biopsy may be done, which takes a small sample through a hollow needle, with CT scan or ultrasound used to guide the needle.
  • Bone marrow biopsy involves the removal of bone marrow, blood, and a small piece of bone marrow by inserting a hollow needle into the hipbone. This procedure is not needed for all patients.
  • Blood tests are often performed to understand your general health and look for signs of cancer.
  • Imaging tests such as X-rays, CT scans, MRIs, or PET scans can be used to look for an enlarged spleen, enlarged lymph nodes, etc, which can indicate the presence of lymphoma.
  • Molecular testing, if needed, creates a precise “tumor profile” that provides information that may reveal genetic or chromosomal abnormalities. The specific mutation “profile” of a person’s cancer can be predictive of very different outcomes. Knowing the particular combination of mutations driving a patient’s disease can help physicians select a treatment option.

How is lymphoma treated?

Treatments vary depending on the type of disease, its aggressiveness, and location, along with the age and general health of the patient. The treatment options at Dana Farber’s Hematologic Oncology Treatment Center can generally include:

  • Radiation
  • Chemotherapy:
  • Immunotherapy: a form of treatment that stimulates a person’s immune system to attack cancer cells
  • Stem cell transplants: also known as bone marrow transplants, this procedure is most commonly used when there has been a recurrence of the disease. The procedure is most often performed using the patient’s stem cells but can occasionally be done using a donor’s stem cells. The Dana-Farber Brigham Cancer Center stem cell transplant program is one of the largest and most sophisticated in the country.
  • CAR T-cell therapy is used to retrain the body’s cancer-fighting T-cells to attack the disease more effectively.
  • Clinical trials of new chemotherapy combinations and other potential treatments can also be an option for patients in all stages of lymphoma.

What are the risk factors for lymphoma?

Risk factors for lymphoma can include:

  • A family history of lymphoma
  • HIV infection and other forms of immunosuppression

If you have any of these risk factors, it is important to let your primary care team know so they can be especially vigilant in watching for possible signs of lymphoma.

About the Medical Reviewer

Philippe Armand, MD, PhD

Dr. Armand received his MD and PhD from the University of California, San Francisco in 2000. He completed his postgraduate training at Brigham and Women's Hospital and at Dana-Farber Cancer Institute in Boston. In 2007, he joined DFCI and is a member of the Hematologic Malignancies staff.

12 thoughts on “Non-Hodgkin Lymphoma and Hodgkin Lymphoma: What’s the Difference?”

  1. Curious if an older sibling had CLL how likely would younger siblings get this?
    Thank you.

    • Dear Colleen – Thank you for your comment and for reading our blog. Although it is a rare disease, family history is a risk factor for the development of CLL. For first-degree relatives of CLL patients (parents, siblings, and children), the risk is estimated to be about 5 to 7 times higher than the general population. We hope this is helpful. If you have questions about your specific risk, please ask your doctor. Wishing you all the best. – DFCI

  2. This article is very informative, my take on this. There are a few distinct differences between HL and NHL including how the disease spreads, where tumors are most commonly found in the body and variances in symptomology experienced by individuals. Additionally, treatment protocols are very different. HL is not as common as NHL and the age of onset for HL occurs in a bimodal (2 age time points) distribution with the average age of onset at 28 years and a less substantive peak after age 55, whereas it is less common to see cases of NHL in people under age 50 . For both HL and NHL the most common location of the tumors is in the lymph nodes and occurs above the collarbone.

  3. I am in remission from NHL and I also have relapsing remitting multiple sclerosis. Are people with auto immune diseases more likely to develop NHL?

    • Dear Jeannie —

      Thank you for your question and for reading Insight. While we cannot comment on your specific medical background, problems with regulation of the immune system can lead to both autoimmune diseases and, in some cases, lymphoma. We hope this is helpful! All the best.

  4. What is your personal opinion on the possible connection of HL and NHL to exposure to chemicals containing glyphosate?


  5. My Dr threw the word HLD b4 sending me away with a pile of tests I need to do tomorrow. I have to say in afraid, not for me but my 4 year old daughter. Its just me and I don’t know what to expect if it does turn up as cancer. What kind of quality of life will I be able to offer her, what kind of care will I need and will it take away from my care for the one thing I that’ll get me through this. What should I plan? Thank you

  6. Dear Ldavis,

    Thank you for your comment. We’re very sorry to hear of your medical troubles, and understand your concern for your daughter, which is normal at such an emotional time. We have resources on our website for parents being treated for cancer, which can help make life easier for you and your daughter through treatment:

    We also recommend you speak to a member of your care team, such as a social worker, about your worries, as they should be able to provide you with helpful resources and support as well.

    We wish you all the best.

  7. Im 60 and not menopausal any more. I’ve been suffering from sweats where either at night or during the day, where I feel soaking wet all over my body. I look like I’ve just came out a shower wet and not dried myself. I also suffer dryness in my vagina, tiredness, bad mood swings, and short term memory. I do get some pain discomfort near my left armpit, sometimes the odd chest pain. Should I get checked out for Non Hodgkin Lymphoma,?

    • Hi Linda,

      Thank you for your message. Unfortunately, we cannot provide any medical advice without a consultation. We would recommend making an appointment with your doctor to discuss your health concerns. Please call us at 877-442-3324 if you would like to schedule a consultation, or second opinion.

      Wishing you all the best,

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