Hodgkin lymphoma
Hodgkin lymphoma is a cancer of the lymph glands. It is named after the man who first described it, Dr Thomas Hodgkin, in 1832. The lymphatic system is made up of the lymph nodes (glands), thymus, spleen and bone marrow.
Cancers that develop in the lymphatic system are called lymphomas. There are two main types: Hodgkin lymphoma and non-Hodgkin lymphoma.
Who gets Hodgkin lymphoma?
About 60 children develop Hodgkin lymphoma in the UK each year. It is rare in children under five years and is more common in teenagers and young adults. Boys and girls are equally affected. The exact cause of Hodgkin lymphoma is unknown. We see it more often in children with immune problems.
Signs and symptoms
The most common symptom is painless swelling of one gland or a group of glands, usually in the neck. Other glands may be enlarged, such as in the armpit or groin.
Other symptoms include:
- fever
- night sweats
- weight loss
- tiredness or lethargy
- itching
- cough or breathlessness.
Tests / investigations
We will need to carry out some tests to find out as much as possible about the type, position and size of the tumour. These tests will include:
- Blood tests – these will tell us how well the kidneys are working as well as some other information about general health.
- Chest X-ray – this will tell us whether the glands in the chest are enlarged.
- Ultrasound scan – this will tell us whether the liver and spleen are enlarged.
- CT scan – a scan of your child’s neck, chest and abdomen will be carried out. This will give us more detailed information about which glands are enlarged and if the liver, spleen or lungs are affected.
- Biopsy – this is a small operation, usually carried out under general anaesthetic, to remove either part, or all, of a swollen lymph gland.
Staging
Staging refers to the size and position of the lymphoma and whether it has spread. Knowing the particular type and stage of the cancer helps the doctors decide of the most appropriate treatment. The following describes the staging system we use for Hodgkin lymphoma:
- Stage I: One group of lymph glands is affected and the lymphoma is only on one side of the diaphragm (the breathing muscle that separates the lungs from the abdomen).
- Stage II: Two or more groups of lymph glands are affected and the lymphoma is only on one side of the diaphragm.
- Stage III: Lymph nodes are affected above and below the diaphragm. The spleen may also be affected.
- Stage IV: The lymphoma has spread beyond the lymph glands, for example to the lungs, liver or bone marrow.
The stage is classified as A if your child does not have fever, night sweats or weight loss, or B if these symptoms are present.