Hodgkins Lymphoma :: Nationwide Children's Hospital

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Hodgkins Lymphoma

Hodgkins Lymphoma (also known as Hodgkin’s Disease) is a form of cancer of the lymphatic (lim FA tik) system. The cause of Hodgkin Lymphoma is not known.

Picture 1 - The lymphatic system inside the body.
Image of lympthatic system

The lymphatic system is a part of the circulatory system. It plays a main role in fighting infection. It is made up of hundreds of lymph nodes. Lymph nodes are about the size of kidney beans. Lymph vessels connect the nodes throughout the body (Picture 1). The lymph nodes make a type of white blood cell (lymphocyte) that fights the spread of infection. The nodes also destroy germs that cause infection. A clear liquid called "lymph" carries infection-fighting cells through the nodes and vessels. 

Signs and Symptoms

Lymph nodes become large and swollen but are rarely painful. The lymph nodes most involved are in the:

Neck:  A lump may appear on the side of the neck.

Chest:  This may be seen by chest X-ray or CT scan. The disease involves the mediastinum (the space between the lungs) and the hilum (the root of the lungs). There may be a cough, shortness of breath, or no symptoms at all.

Axilla:  A lump may appear under the arm.

Groin:  A lump may appear between the thigh and the torso.

Other symptoms may include fever, sweating (especially at night) and weight loss.

Diagnosis

Hodgkin Lymphoma may involve one lymph node or a group of nodes. Different areas of nodes may be affected. The diagnosis is confirmed by looking at the lymph nodes.

Your child will have a node removed. It will be looked at under a microscope. This is called a biopsy.

This cancer can spread to other parts of the body through the bloodstream. It may affect the liver, bones, lung tissue or nervous system.  Once it is diagnosed, other tests are done to learn the extent and the stage of the disease. These tests include: 

  • blood tests to check liver and kidney function
  • PET scan
  • bone scan
  • CT scan
  • bone marrow biopsy

Staging

Staging tells the extent of disease at the time of diagnosis. 

Stage I  A single lymph node region (area) is involved.

Stage II  Two or more lymph node regions on the same side of the diaphragm are involved. The diaphragm is a muscle that separates the chest from the abdomen.

Stage III  Lymph node regions on both sides of the diaphragm are involved.

Stage IV  Organs outside the lymphatic system are involved, for example, the liver, bone marrow, lungs, bone or nervous system.

Each stage is split into (A) or (B).  (A) means there are no other general symptoms. (B) means there are symptoms such as night sweats, fever or weight loss of 10 percent or more during the past six months.

Treatment

Treatment will be radiation therapy, chemotherapy or both. The type of treatment depends on the stage of the disease.  Treatment may last 3 months to one year. Your child’s cancer doctor (oncologist) will talk to you about treatment for your child.

Follow-Up Care

  • Chemotherapy and check-ups are at Nationwide Children’s Hospital Hematology/Oncology Clinic, day hospital, or as a patient in the hospital.
  • Radiation therapy is at The Arthur G. James Cancer Hospital at The Ohio State University.  
  • Your child's blood count will be checked during radiation and before each dose of chemotherapy. This is to be sure the white blood cell, hemoglobin and platelet counts are normal.
  • Your child will have X-rays and scans to see how treatment is working.
  • Your child will follow up with an oncologist, who will check his or her progress.

Other Helping Hands

Ask your nurse for these Helping Hands if they have not already been given to you:

X-ray, HH-III-17

CT Scan, HH-III-19

Bone Marrow Test, HH-III-16

Blood Counts for Patients Receiving Chemotherapy or Radiation Therapy, HH III 76

If you have any questions or concerns, be sure to talk with your doctor or nurse.

Hodgkins Lymphoma (PDF)

HH-I-126 6/90, Revised 5/12 Copyright 1990-2012, Nationwide Children’s Hospital

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