Generally the disease starts with a single swelling of a gland on one side of the neck. When first noticed several glands might be involved. The swelling are of various sizes, are not tender and are of a firm rubbery consistency. They may adhere to deeper tissues but the skin remains freely movable above the swelling.

Sometimes the glands inside the chest are involved so that an early symptom may be difficulty in breathing associated with a dry, unproductive cough.

Late symptoms of the established disease include tiredness, excessive night sweating, itching of the skin and weight loss particularly in the older patient.

Pressure on the spinal cord by growing masses of glandular tissue may produce partial to complete paralysis of the lower limbs associated with back pain.

Sometimes the enlarging glandular tissue is located exclusively in the abdomen with no evidence of superficial glandular swelling. The accompanying fever with no obvious cause can be a problem for diagnosis. Eventually the spleen, the liver, bone marrow and all internal organs can be involved in the spreading of this abnormal glandular tissue.

The earlier the disease is treated, the better the chances for survival. There can be recurrences and treatment may have to be repeated over the years. In the early stages of the disease, if there are no new manifestations for five years after treatment, then the outlook for a complete cure is extremely good.

If not diagnosed and treated early, wasting, malnutrition and eventually death from infection will occur.

Diagnosis is made by examining a small portion of the abnormal glandular tissue. Abdominal surgery to obtain such a specimen may be necessary in the case enlargement of the spleen or liver and the absence of superficial swellings. Once diagnosed then intensive investigation including blood tests, x-rays, scans, liver function tests, bone marrow biopsy all have to be used to determine the extent of the disease before treatment is commenced.

Radiation treatment is used for the early stages of the disease. Late stages are treated with chemotherapy, generally a combination of anti-cancer drugs. Occasionally both forms of treatment are combined.