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Hodgkin lymphoma

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If Hodgkin lymphoma spreads

Cancer cells have the potential to spread from the lymph nodes to other parts of the body where they can grow into new tumours. This process is called metastasis. The tumours are also called metastasis (singular) or metastases (plural). Metastases are also called secondary tumours.

Understanding the usual progression of cancer helps the doctor to predict its probable course, plan treatment and anticipate further care.

The most common sites where Hodgkin lymphoma (HL) spreads are:

  • other groups of lymph nodes
  • spleen
  • liver
  • lung
  • bone marrow
  • bone
  • central nervous system – rarely

Pattern of spread

A unique feature of HL is the pattern of spread. The disease usually progresses in a predictable, orderly way from one lymph node group to the next group on the same side or opposite side of the body. Spread of HL takes place by way of the lymphatic system, the bloodstream and direct extension (the cancer spreads into the tissues or organs immediately surrounding it).

  • Most often, the disease spreads from the lymph nodes in the neck (cervical lymph nodes) to the lymph nodes above the collarbone (supraclavicular lymph nodes).
  • The disease usually then spreads from the supraclavicular lymph nodes to the lymph nodes under the arms (axillary lymph nodes) and then to the lymph nodes in the chest (mediastinal and hilar lymph nodes).
  • It is unusual for an area of lymph nodes to be skipped.


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