Childhood Hodgkin lymphoma is a disease in which malignant
(cancer) cells form in the lymph system.
There are two types of childhood Hodgkin lymphoma.
Epstein-Barr virus infection increases
the risk of childhood Hodgkin lymphoma.
Signs of childhood Hodgkin lymphoma include swollen
lymph nodes, fever, night sweats, and weight loss.
Tests that examine the lymph system are used to detect (find) and diagnose
childhood Hodgkin lymphoma.
Certain factors affect prognosis (chance
of recovery) and treatment options.
Childhood Hodgkin lymphoma is a disease in which malignant
(cancer) cells form in the lymph system.
Childhood Hodgkin lymphoma
is a type of cancer
that develops in the lymph system, which is part of the body's immune system.
The immune system protects the body from foreign
substances, infection, and diseases. The lymph system is made up of the following:
Lymph
: Colorless,
watery fluid
that carries white blood cells
called lymphocytes
through the lymph system. Lymphocytes protect the
body against infections and the
growth of tumors.
Lymph vessels
: A network of thin tubes that collect lymph
from different parts of the body and return it to the bloodstream.
Lymph nodes
:
Small, bean-shaped structures that filter lymph and store white blood cells that help fight
infection and disease. Lymph nodes are located along the network of lymph vessels
found throughout the body. Clusters of lymph nodes are found in the neck,
underarm, abdomen, pelvis, and groin.
Spleen
: An organ
that makes lymphocytes, filters the blood, stores blood cells, and destroys
old blood cells. The spleen is on the left side of the abdomen near the stomach.
Thymus
: An organ
in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.
Tonsils
: Two small
masses of lymph tissue
at the
back of the throat. The tonsils make lymphocytes.
Anatomy of the lymph system, showing the lymph vessels and lymph organs including lymph nodes, tonsils, thymus, spleen, and bone marrow. Lymph (clear fluid) and lymphocytes travel through the lymph vessels and into the lymph nodes where the lymphocytes destroy harmful substances. The lymph enters the blood through a large vein near the heart.
Lymph tissue is also found in other parts of the body such as the stomach, thyroid gland, brain, and skin.
Hodgkin lymphoma often occurs in adolescents 15 to 19 years of age. The
treatment for children and adolescents is different than treatment for adults. (See the
PDQ summary on Adult Hodgkin Lymphoma Treatment for more information.)
There are two types of childhood Hodgkin lymphoma.
Classical Hodgkin lymphoma is divided into four subtypes, based on how the cancer cells look under a microscope
:
Lymphocyte-rich classical Hodgkin lymphoma.
Nodular sclerosis Hodgkin lymphoma.
Mixed cellularity Hodgkin lymphoma.
Lymphocyte-depleted Hodgkin lymphoma.
Epstein-Barr virus infection increases
the risk of childhood Hodgkin lymphoma.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your child’s doctor if you think your child may be at risk.
Risk factors for childhood Hodgkin lymphoma include the following:
Having a parent or sibling
with a personal history of Hodgkin lymphoma.
Being exposed to common infections in early childhood may decrease the risk of Hodgkin lymphoma in children because of the effect it has on the immune system.
Signs of childhood Hodgkin lymphoma include swollen
lymph nodes, fever, night sweats, and weight loss.
These and other signs
and symptoms
may be caused by childhood Hodgkin lymphoma or by other conditions. Check with your child's doctor if your child has any of the following:
Painless, swollen lymph nodes near the collarbone
or in the neck, chest, underarm, or groin.
Fever, weight loss, and night sweats are called B symptoms.
Tests that examine the lymph system are used to detect (find) and diagnose
childhood Hodgkin lymphoma.
The following tests and procedures may be used:
Physical exam
and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
CT scan
(CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the neck, chest, abdomen, or pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
Computed tomography (CT) scan of the abdomen. The child lies on a table that slides through the CT scanner, which takes x-ray pictures of the inside of the abdomen.
PET scan
(positron emission tomography scan): A procedure to find malignant
tumor cells in the body. A small amount of radioactiveglucose
(sugar) is injected into a vein. The PET scanner
rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. Sometimes a PET scan and a CT scan are done at the same time. If there is any cancer, this increases the chance that it will be found.
Positron emission tomography (PET) scan. The child lies on a table that slides through the PET scanner. The head rest and white strap help the child lie still. A small amount of radioactive glucose (sugar) is injected into the child's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Complete blood count
(CBC): A procedure in which a sample of blood is drawn and checked for the following:
The number of red blood cells, white blood cells, and platelets.
The portion of the blood sample made up of red blood cells.
Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube. The sedimentation rate is a measure of how much inflammation
is in the body. A higher than normal sedimentation rate may be a sign of lymphoma. Also called erythrocyte sedimentation rate, sed rate, or ESR.
Lymph node biopsy:
The removal of all or part of a lymph node. The lymph node may be removed during an image-guided CT scan or a thoracoscopy, mediastinoscopy, or laparoscopy. One of the following types of
biopsies may be done:
A pathologist
views the tissue under a microscope
to look for cancer cells, especially Reed-Sternberg cells. Reed-Sternberg cells are common in classical Hodgkin lymphoma.
Reed-Sternberg cell. Reed-Sternberg cells are large, abnormal lymphocytes that may contain more than one nucleus. These cells are found in Hodgkin lymphoma.
The following test may be done on tissue that was removed:
Immunophenotyping: A laboratory test
used to identify cells, based on the types of antigens
or markers
on the surface of the cell. This test is used to diagnose
the specific type of lymphoma by comparing the cancer cells to normal cells of the immune system.
Certain factors affect prognosis (chance
of recovery) and treatment options.
The prognosis
(chance of recovery) and treatment options depend
on the following:
