Hodgkin’s vs. Non-Hodgkin’s Lymphoma: Key Differences Explained
Posted on June 9, 2026 in Lymphoma
If you or someone you love has recently been diagnosed with lymphoma, one of the first questions you’ll likely encounter is whether it’s Hodgkin’s or non-Hodgkin’s. The two names sound similar, and both are cancers of the lymphatic system, but they are distinct diseases with different cell characteristics, age patterns, treatment approaches, and outlooks.
Understanding which type you’re dealing with matters, because the answer shapes nearly every decision your care team will make. The encouraging news is that both Hodgkin’s and non-Hodgkin’s lymphoma are among the more treatable cancers, and outcomes continue to improve as treatment advances.
Below, you’ll learn what separates these two types of lymphoma, how doctors tell them apart, and what treatment looks like for each.
Jump to section
- What Is Lymphoma?
- What Is Hodgkin’s Lymphoma?
- What Is Non-Hodgkin’s Lymphoma?
- Key Differences at a Glance
- How Doctors Tell Them Apart
- Treatment Options
- Prognosis
- Frequently Asked Questions
What Is Lymphoma?
Lymphoma is cancer of the lymphatic system, the network of lymph nodes, lymph vessels, and lymphatic tissue that runs throughout your body and plays a central role in fighting infection. The cancer begins in lymphocytes, the white blood cells that populate this system.
The two main categories are Hodgkin lymphoma, which accounts for roughly 10-15% of lymphoma cases, and non-Hodgkin lymphoma, which makes up the remaining 85-90%. According to the American Cancer Society, about 79,320 people in the United States will be diagnosed with non-Hodgkin lymphoma in 2026, compared to about 8,920 new cases of Hodgkin lymphoma.
Both types can cause similar early symptoms, most commonly a painless swelling of lymph nodes in the neck, armpit, or groin. Patients may also experience what doctors call “B symptoms”: unexplained fever, drenching night sweats, and unintentional weight loss. Because the symptoms overlap so heavily, only laboratory testing can determine which type a patient has.
What Is Hodgkin’s Lymphoma?
Hodgkin lymphoma, sometimes called Hodgkin’s disease, is defined by the presence of Reed-Sternberg cells, which are large, abnormal B lymphocytes with a distinctive appearance under a microscope. Finding these cells in a lymph node biopsy is what confirms a Hodgkin diagnosis.
There are two broad forms:
- Classic Hodgkin lymphoma (cHL) accounts for more than 9 in 10 Hodgkin cases in developed countries. The most common subtype, nodular sclerosis, makes up about 7 in 10 classic cases and tends to start in lymph nodes of the neck or chest.
- Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) accounts for about 5% of cases. Its cancer cells are sometimes called “popcorn cells” because of their shape. This form tends to grow more slowly and is treated differently from classic Hodgkin lymphoma.
Hodgkin lymphoma has an unusual age pattern. It is most common in early adulthood and again after age 55, and it remains the most frequently diagnosed cancer among teens ages 15 to 19. A history of Epstein-Barr virus infection (the virus that causes mononucleosis) and a weakened immune system are known risk factors.
One of the most important characteristics of Hodgkin lymphoma is how it spreads: in an orderly, predictable way, moving from one group of lymph nodes to the next. This predictability is part of why Hodgkin lymphoma responds so well to treatment, including targeted radiation therapy.
What Is Non-Hodgkin’s Lymphoma?
Non-Hodgkin lymphoma is not a single disease but a large family of related cancers. Researchers have identified dozens of subtypes, which is part of why diagnosis and treatment planning require such careful testing.
About 85% of non-Hodgkin lymphomas in the United States are B-cell lymphomas, with the rest starting in T cells. The two most common subtypes are:
- Diffuse large B-cell lymphoma (DLBCL), which accounts for about 1 in 3 cases. This is an aggressive, fast-growing lymphoma that usually requires prompt treatment.
- Follicular lymphoma, a typically slow-growing (indolent) lymphoma that may not need immediate treatment and can sometimes be monitored through watchful waiting.
This split between aggressive and indolent subtypes is one of the defining features of non-Hodgkin lymphoma. Indolent lymphomas grow slowly and may be watched closely, while aggressive lymphomas grow quickly and usually need treatment right away.
Unlike Hodgkin lymphoma, non-Hodgkin lymphoma spreads in a less predictable pattern. It can appear in multiple lymph node regions at once and may involve organs outside the lymphatic system, including the stomach, skin, or bone marrow. It also skews older: the risk rises with age, and most patients are over 60 at diagnosis.
Key Differences at a Glance
| Hodgkin Lymphoma | Non-Hodgkin Lymphoma | |
| Defining feature | Reed-Sternberg cells present in biopsy | No Reed-Sternberg cells; dozens of distinct subtypes |
| How common | About 8,920 new US cases expected in 2026 | About 79,320 new US cases expected in 2026 |
| Common age groups | Young adults, plus adults over 55; most common cancer in ages 15-19 | Risk increases with age; most patients over 60 |
| How it spreads | Orderly, from one lymph node group to the next | Less predictable; can involve multiple regions and organs outside the lymph nodes |
| Growth pattern | Usually consistent within type | Varies widely; can be slow-growing (indolent) or fast-growing (aggressive) |
| Five-year relative survival | 89% | 74.2% |
How Doctors Tell Them Apart
Because the symptoms of Hodgkin’s and non-Hodgkin’s lymphoma overlap so much, the diagnosis comes down to what pathologists see in the lab.
The process typically begins with a physical exam and a biopsy of an affected lymph node, in which all or part of the node is removed for testing. A pathologist examines the tissue under a microscope, looking for the cell characteristics that distinguish one type from another.
A lab technique called immunohistochemistry plays a key role. This test looks for specific proteins on the surface of cells, such as CD15 and CD30, which are found on the Reed-Sternberg cells of classic Hodgkin lymphoma. Different protein patterns point instead toward non-Hodgkin lymphoma or a specific NHL subtype.
Once the type is confirmed, imaging such as PET and CT scans helps determine how far the lymphoma has spread, and in some cases a bone marrow biopsy is needed. Both Hodgkin’s and non-Hodgkin’s lymphoma are assigned a stage from I to IV based on these findings, which guides the treatment plan.
Treatment Options
Treating Hodgkin’s Lymphoma
The foundation of Hodgkin lymphoma treatment is combination chemotherapy, often paired with radiation therapy, particularly in early-stage disease. Because Hodgkin lymphoma spreads in a predictable pattern, radiation can be precisely targeted to affected lymph node regions. Modern techniques such as intensity modulated radiation therapy (IMRT) allow radiation oncologists to deliver effective doses while limiting exposure to nearby healthy tissue, an especially important consideration for younger patients with decades of life ahead of them.
Immunotherapy and targeted drugs are also options for Hodgkin lymphoma that does not respond to initial treatment or that returns after treatment.
Treating Non-Hodgkin’s Lymphoma
Treatment for non-Hodgkin lymphoma depends heavily on the subtype, stage, and how quickly the lymphoma is growing.
Aggressive subtypes such as diffuse large B-cell lymphoma are usually treated promptly with chemotherapy, often combined with immunotherapy drugs such as rituximab. Slow-growing subtypes such as follicular lymphoma may not need treatment right away; watchful waiting, in which the lymphoma is monitored closely but not actively treated, is a recognized approach for some patients.
Radiation therapy plays several roles in non-Hodgkin lymphoma care. For some early-stage indolent lymphomas, radiation alone can be an effective treatment. In other cases, it is used alongside chemotherapy or to relieve symptoms caused by enlarged lymph nodes. Newer options, including CAR T-cell therapy, are available for certain subtypes that resist standard treatment.
SERO’s Role
SERO’s board-certified radiation oncologists work as part of a multidisciplinary team treating both Hodgkin’s and non-Hodgkin’s lymphoma across the Charlotte region. Whether radiation is being used with curative intent, to consolidate a response to chemotherapy, or to relieve symptoms, SERO’s physicians apply the most advanced techniques available to make treatment as safe, precise, and effective as possible. Our team also works closely with each patient’s hematologist-oncologist to ensure the radiation plan fits the larger treatment strategy.
Prognosis
Both types of lymphoma have seen meaningful improvements in outcomes over the past several decades. Based on NCI SEER data, the five-year relative survival rate is 89% for Hodgkin lymphoma and 74.2% for non-Hodgkin lymphoma.
Keep in mind that these are broad averages. Within non-Hodgkin lymphoma especially, outcomes vary widely by subtype, stage, age, and overall health, and survival statistics reflect patients treated at least five years ago, before some of today’s newest therapies were widely available. Your care team can give you the most accurate picture of your individual outlook.
Frequently Asked Questions
Is Hodgkin’s or non-Hodgkin’s lymphoma more serious?
Neither is automatically more serious. Hodgkin lymphoma has a higher overall cure rate, but many non-Hodgkin subtypes respond very well to treatment, and some grow so slowly that they may not need treatment for years. The specific subtype, stage, and individual factors matter far more than the broad category.
Why is it called “non-Hodgkin’s” lymphoma?
The naming is historical. Hodgkin lymphoma was identified first, described by Dr. Thomas Hodgkin in the 1800s. As researchers later identified many other lymphomas that lacked Reed-Sternberg cells, those cancers were grouped together as “non-Hodgkin” lymphomas.
Can non-Hodgkin’s lymphoma turn into Hodgkin’s lymphoma?
No, one type does not transform into the other. However, some slow-growing non-Hodgkin subtypes, such as follicular lymphoma, can transform over time into a faster-growing non-Hodgkin subtype like diffuse large B-cell lymphoma, which is one reason ongoing monitoring matters.
Are the symptoms different?
The symptoms overlap almost entirely: swollen lymph nodes, fever, night sweats, fatigue, and weight loss can occur with either type. Only a biopsy can determine which type a patient has, which is why it’s important to see a doctor promptly about any persistent swollen lymph node.
Is radiation therapy used for both types?
Yes. Radiation is a long-established part of Hodgkin lymphoma treatment, particularly for early-stage disease, and it also treats certain non-Hodgkin subtypes, supports chemotherapy, and relieves symptoms. Your radiation oncologist will determine whether and how radiation fits into your treatment plan.
If you or a loved one is facing a lymphoma diagnosis, SERO’s team is here to help. Contact us to learn more about radiation therapy for lymphoma, or explore our patient resources for additional support.
Additional Resources
American Cancer Society: Hodgkin Lymphoma
American Cancer Society: Non-Hodgkin Lymphoma
National Cancer Institute SEER: Hodgkin Lymphoma Stat Facts
