What are the key clinical features and symptoms that should raise suspicion for Hodgkin Lymphoma in a primary care setting?

Key clinical features and symptoms that should raise suspicion for Hodgkin lymphoma in a primary care setting include:

• Unexplained lymphadenopathy, particularly persistent or progressive lymph node enlargement.
• Associated systemic symptoms such as fever, night sweats, and unexplained weight loss.
• Pruritus (itching) occurring with unexplained lymphadenopathy.
• Shortness of breath, which may indicate mediastinal involvement.
• Alcohol-induced pain in lymph nodes, a distinctive symptom sometimes seen in Hodgkin lymphoma.

When these features are present, especially in adults, a suspected cancer pathway referral should be considered for specialist assessment within 2 weeks. For children and young people (up to 24 years), an urgent referral for specialist assessment within 48 hours is recommended. The presence of these symptoms alongside unexplained lymphadenopathy warrants prompt investigation to exclude Hodgkin lymphoma ¹,².