Source: Cancer Resource Room
Childhood Hodgkin's Lymphoma
Childhood Hodgkin's lymphoma is a disease
in which malignant (cancer) cells form
in the lymph system.
Childhood Hodgkin's lymphoma is a type
of cancer that develops in the lymph system,
part of the body's immune system. The
lymph system is made up of the following:
- Lymph: Colorless, watery fluid that
travels through the lymph system and
carries white blood cells called lymphocytes.
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
- Lymph nodes: Small, bean-shaped structures
that filter substances in lymph and
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 underarm, pelvis,
neck, abdomen, and groin.
- Spleen: An organ that produces lymphocytes,
filters the blood, stores blood cells,
and destroys old blood cells. It is
located 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 produce lymphocytes.
- Bone marrow: The soft, spongy tissue
in the center of large bones. Bone
marrow produces white blood cells,
red blood cells, and platelets.
Because lymph tissue is found throughout
the body, Hodgkin's lymphoma can start
in almost any part of the body and spread
to almost any tissue or organ in the body.
Lymphomas are divided into two general
types: Hodgkin's lymphoma and non-Hodgkin's
Hodgkin's lymphoma can occur in both children
and adults; however, treatment for children
may be different than treatment for adults.
There are two types of childhood Hodgkin’s
lymphoma. The they are:
- Classical Hodgkin's lymphoma.
- Nodular lymphocyte predominant Hodgkin's
Classical Hodgkin's lymphoma is divided
into four subtypes, based on how the cancer
cells look under a microscope:
- Lymphocyte-rich classical Hodgkin’s
- Nodular sclerosis Hodgkin’s
- Mixed cellularity Hodgkin’s
- Lymphocyte-depleted Hodgkin’s
Age, gender, and Epstein-Barr virus
infection can affect the risk of developing
childhood Hodgkin's lymphoma.
Risk factors include the following:
- Being between the ages of 5 and 14.
In children younger than 14 years,
it is more common in boys than in
- Being infected with the Epstein-Barr
- Having a brother or sister with Hodgkin's
the symptoms of childhood Hodgkin's
Possible signs of childhood Hodgkin's
lymphoma include swollen lymph nodes,
fever, night sweats, and weight loss.
These and other symptoms may be caused
by childhood Hodgkin's lymphoma or by
other conditions. A doctor should be consulted
if any of the following problems occur:
- Painless, swollen lymph nodes in the
neck, chest, underarm, or groin
- Night sweats
- Weight loss for no known reason
- Itchy skin
childhood Hodgkin's lymphoma diagnosed?
Tests that examine the lymph system are
used to detect (find) and diagnose childhood
Hodgkin's 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 past illnesses
and treatments will also be taken.
- Lymph node biopsy: The removal of
all or part of a lymph node that is
then viewed under a microscope and
checked for signs of disease. One
of the following types of biopsies
may be done:
- Excisional biopsy: The removal of
an entire lymph node.
Incisional biopsy or core biopsy:
The removal of part of a lymph node.
- Needle biopsy or fine-needle aspiration:
The removal of a sample of tissue
from a lymph node with a needle.
- 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
- CT scan (CAT scan): A procedure that
makes a series of detailed pictures
of areas inside the body, 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.
- 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 amount of hemoglobin (the
protein that carries oxygen)
in the red blood cells.
- The portion of the blood sample
made up of red blood cells.
- 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.
- 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 in the organ or tissue
that produces it.
- Gallium scan: A procedure to detect
areas of the body where cells, such
as cancer cells, are dividing rapidly.
A very small amount of radioactive
material, gallium, is injected into
a vein and travels through the bloodstream.
The gallium collects in the bones
or other tissues (organs) and is detected
by a scanner.
- Bone scan: A procedure to check if
there are rapidly dividing cells,
such as cancer cells, in the bone.
A very small amount of radioactive
material is injected into a vein and
travels through the bloodstream. The
radioactive material collects in the
bones and is detected by a scanner.
- Immunophenotyping: A test in which
the cells in a sample of blood or
bone marrow are looked at under a
microscope to find out the type of
malignant (cancerous) lymphocytes
that are causing the lymphoma.
Certain factors affect prognosis
(chance of recovery) and treatment options.
The prognosis (chance of recovery)
and treatment options depend on the following:
- The stage of the cancer.
- The size of the tumor and how quickly
it shrinks after initial treatment.
- The patient's symptoms when diagnosed.
- Certain features of the cancer cells.
- Whether the cancer is newly diagnosed,
does not respond to initial treatment,
or has recurred (come back).
The treatment options also depend on:
- The child's age and gender.
- The risk of long-term side effects.
Most children and adolescents with newly
diagnosed Hodgkin's lymphoma can be cured.
To read more about Hodgkin's
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