Hodgkin's lymphoma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hodgkin's lymphoma must be differentiated from sarcoidosis, lymphocytic lymphoma, miliary tuberculosis, infectious mononucleosis, thoracic aortic aneurysm, substernal goiter, thymoma, actinomycosis, chronic lymphocytic leukemia, superior vena cava syndrome, unicentric castleman disease, adult still disease, small cell lung carcinoma, and malignant histiocytosis.

Differentiating Hodgkin's Lymphoma From Other Diseases

Differentiating diagnosis of Lymphoma	Symptoms					Signs			Diagnosis	Additional Findings
	Fever	Rash	Diarrhea	Abdominal pain	Weight loss	Painful lymphadenopathy	Hepatosplenomegaly	Arthritis	Lab Findings
Lymphoma	✔	✘	✘	✔	✔	✘	✔	✘	Increase ESR, increased LDH	Night sweats, constant fatigue
Brucellosis	✔	✔	✘	✔	✔	✔	✔	✔	Relative lymphocytosis	Night sweats, often with characteristic smell, likened to wet hay
Typhoid fever	✔	✔	✘	✔	✘	✘	✔	✔	Decreased hemoglobin	Incremental increase in temperature initially and than sustained fever as high as 40°C (104°F)
Malaria	✔	✘	✔	✔	✘	✘	✔	✔	Microcytosis, elevated LDH	"Tertian" fever: paroxysms occur every second day
Tuberculosis	✔	✔	✘	✔	✔	✔	✘	✔	Mild normocytic anemia, hyponatremia, and hypercalcemia	Night sweats, constant fatigue
Mumps	✔	✘	✘	✘	✘	✔	✘	✘	Relative lymphocytosis, serum amylaseelevated	Parotidswelling/tenderness
Rheumatoid arthritis	✘	✔	✘	✘	✘	✘	✘	✔	ESR and CRP elevated, positive rheumatoid factor	Morning stiffness
SLE	✘	✔	✘	✔	✔	✘	✘	✔	ESR and CRP elevated, positive ANA	Fatigue
HIV	✘	✘	✘	✔	✔	✔	✘	✔		Constant fatigue