What is Hodgkin's lymphoma?
Hodgkin's lymphoma is a cancer of the lymphatic system. The lymphatic system is made up of vessels that run throughout the body. A colorless liquid called lymph travels through these vessels and carries white blood cells called lymphocytes. The lymph nodes, spleen, and thymus are organs in the lymphatic system that produce and store infection-fighting cells (lymphocytes.) Other organs like the tonsils, stomach, small intestine and skin also contain lymphatic tissue.
Hodgkin's lymphoma occurs most frequently in young adults. In children, it is rare before age five and it occurs most frequently in the teen years. The cause of Hodgkin's lymphoma is not known. Possible contributing causes that are being studied include infections, environmental factors and genetics. Hodgkin's is not contagious and nothing you have done or not done is responsible for your child's tumor.
What are the symptoms of Hodgkin's lymphoma?
One of the first symptoms of Hodgkin's lymphoma is a painless swelling of the lymph nodes. These lymph nodes normally produce a type of white blood cell that fights infection (lymphocytes). The nodes that are most often affected and enlarged are those in the neck, chest, abdomen, or groin, or under the arm.
A child or teen may complain of feeling tired. They may have appetite loss and/or weight loss. They may develop fevers for no apparent reason, experience night sweats, and appear pale.
How is Hodgkin's lymphoma diagnosed?
Because of the possibility that Hodgkin's disease can spread through the lymph system to other parts of the body, your child may have many different tests performed. These tests are done to carefully diagnose and determine the extent of the disease. This is very important to make sure your child receives the most effective treatment. The tests may include any or all of the following:
- Surgical biopsy. This is the most accurate way to diagnose Hodgkin's lymphoma and is done in all cases. Cells from the suspected area are removed and closely examined under a microscope by a pathologist.
- X-rays. X-rays of the chest may be done to look for spread of the disease.
- Blood tests. Blood tests that may be done include a complete blood count (CBC), sedimentation rate, and blood chemistries test.
- Bone marrow aspirate and biopsy. This may help determine if the disease has invaded the bone marrow.
- Computed tomography (CT) scan. This test produces images of the scanned body part and may be used to see the size of the tumor and whether it has spread.
- PET scan. A position emission tomography (PET) scan creates computerized images of chemical changes that take place in tissue. It involves injecting a small amount of radioactive compound and seeing how much of it collects in areas where Hodgkin's lymphoma is present.
After the diagnosis of Hodgkin's disease is made and all the tests are completed, the doctors can determine what stage the disease is in or how extensive it is. The stages for Hodgkin's disease are as follows:
- Stage I. Disease is confined to a single group of lymph nodes.
- Stage II. More than one group of lymph nodes is involved but disease is confined to one side of the diaphragm, the membrane that separates the chest and the abdomen.
- Stage III. Disease is present in lymph tissue above and below the diaphragm.
- Stage IV. Disease has spread to non-lymphoid tissue, such as lungs, liver or bone marrow.
Patients will also be classified as having "A" or "B" Hodgkin's lymphoma. If your child has generalized symptoms like fevers, night sweats or weight loss of more than 10 percent of normal body weight, it is said that he or she has Hodgkin's lymphoma "B." If your child does not have these symptoms then it is Hodgkin's lymphoma "A" disease.
How is Hodgkin's lymphoma treated?
Once tests are completed, your oncologist will discuss the test results and will recommend a plan of treatment. Factors that affect this plan are: the stage of Hodgkin's lymphoma (whether the disease is localized or spread to other areas), whether "B" symptoms are present, and your child's age and medical condition.
Treatment will include chemotherapy. Some patients also will need radiation therapy; current clinical trials are investigating the role of chemotherapy vs. chemotherapy-and-radiation treatment for certain patients with Hodgkin's lymphoma. Some chemotherapy may be given as an inpatient. Follow-up studies may include chest x-rays, CT scans and blood tests. These are done periodically during and after treatment.
About treatment for Hodgkin's lymphoma at Children's
Children's hematology/oncology program consistently achieves treatment results ranking it as one of the top ten programs in the U.S. Children's treats the majority of children with cancer and blood disorders in Minnesota and provides patients with access to a variety of clinical trials of groundbreaking new treatments. Through our renowned leukemia/lymphoma program, patients experience unparalleled family support, a nationally renowned pain management team, and compassionate, coordinated care.
If you are a family member looking for a Children's hematologist or oncologist or wanting to schedule an appointment, please call our clinic at Children's – Minneapolis at (612) 813-5940.
If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free) and ask for the on-call hematologist/oncologist.