B lineage malignant lymphoid neoplasm. Typically presents with painless lymphadenopathy, often cervical (70–80%) or supraclavicular (25%). Mediastinal mass present in 50%. Constitutional symptoms (e.g., fatigue, fever, night sweats, weight loss, cough, pruritus) may or may not be present. Constitutional symptoms sometimes precede development of lymphadenopathy.
- Represents 7% of childhood cancer
- 11.7 cases/million/y age <20 years
- Most common cancer for ages 15 to 19 years
- Rarely seen in children age <5 years
- M > F age <15 years
- F > M age 15 to 19 years
- Bimodal age distribution in adults: early peak mid/late 20s; late peak > age >50 years
- Few known risk factors include the following:
- Immune deficiency (e.g., HIV infection)
- Autoimmune disorders
- Lower socioeconomic status for childhood form (age 14 years or younger)
- Higher socioeconomic status for young adult form
- Decreased risk if
- Multiple older siblings
- Exposure to common infections in preschool
- Familial Hodgkin lymphoma (HL) rare, accounting for 4.5% of cases
- Familial cases may reflect
- Genetic influences, including inherited immunodeficiency states
- Environmental factors
- Exposure to viruses
- Reed-Sternberg cells, a clonal population of large binucleate cells arising from B cells, are the malignant cells in HL. Surface antigen expression includes CD30 but not CD20.
- Only 1% of cells in involved nodes are Reed-Sternberg cells and morphologic variants; the rest are inflammatory cells: lymphocytes, macrophages, fibroblasts, plasma cells, eosinophils.
- Two clinically distinct subtypes of HL recognized:
- Classical HL (90–95% of cases)
- Nodular sclerosing
- Mixed cellularity
- Lymphocyte depleted
- Lymphocyte rich
- Nodular lymphocyte predominant (5–10% of cases; treated differently from classical HL. See National Comprehensive Cancer Network (NCCN) guidelines for treatment recommendations.)
- Classical HL (90–95% of cases)
- Cause unknown
- Association between Epstein-Barr virus (EBV) infection and HL: 20–50% of patients with classical HL have monoclonal or oligoclonal proliferation of EBV-infected cells.
There's more to see -- the rest of this topic is available only to subscribers.
Cabana, Michael D., editor. "Hodgkin Lymphoma." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617268/all/Hodgkin_Lymphoma.
Hodgkin Lymphoma. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617268/all/Hodgkin_Lymphoma. Accessed June 4, 2023.
Hodgkin Lymphoma. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617268/all/Hodgkin_Lymphoma
Hodgkin Lymphoma [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2023 June 04]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617268/all/Hodgkin_Lymphoma.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hodgkin Lymphoma ID - 617268 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617268/all/Hodgkin_Lymphoma PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -