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Hodgkin lymphoma, previously called Hodgkin’s disease, is one type of lymphoma. Lymphoma is a cancer of the lymphatic or lymph node system. Lymphoma begins when cells in the lymphatic system change and grow uncontrollably, which may form a tumor.
About the lymphatic system
The lymphatic system is made up of thin tubes that branch out to all parts of the body. Its job is to fight infection and other diseases. The lymphatic system carries lymph, a colorless fluid containing lymphocytes (white blood cells). Lymphocytes fight germs in the body. B-lymphocytes (also called B cells) make antibodies to fight bacteria, and T-lymphocytes (also called T cells) kill viruses and foreign cells and trigger the B cells to make antibodies.
Groups of bean-shaped organs called lymph nodes are located throughout the body at different areas in the lymphatic system. Lymph nodes are found in clusters in the neck, chest, underarms, abdomen, pelvis and groin. Other parts of the lymphatic system include the spleen, which makes lymphocytes and filters blood; the thymus, an organ under the breastbone; and the tonsils, which are located in the throat.
Hodgkin lymphoma most commonly affects lymph nodes in the neck or the area between the lungs and behind the breastbone (called the mediastinum). It can also begin in groups of lymph nodes under the arms, in the groin, or in the abdomen or pelvis.
If Hodgkin lymphoma spreads, it typically spreads along the lymphatic channels to other lymph nodes and the spleen, or outside of the lymphatic system, most commonly to the lungs, liver, bone marrow, or bone.
Types of Hodgkin lymphoma
It’s important to know the type of Hodgkin lymphoma, as this may affect the patient’s treatment plan. Doctors determine the type of Hodgkin lymphoma based on how the cells in a tissue sample look under a microscope and whether the cells contain abnormal patterns of certain proteins. There are two main types of Hodgkin lymphoma: nodular lymphocyte predominant and classical.
Nodular lymphocyte predominant Hodgkin lymphoma. This is more common among male and younger patients. The disease is usually found in the neck, underarm, or groin.
Classical Hodgkin lymphoma. There are four subtypes of classical Hodgkin lymphoma: nodular sclerosing, mixed cellularity, lymphocyte rich, and lymphocyte depleted.
- Nodular sclerosis Hodgkin lymphoma. This is the most common type of Hodgkin lymphoma in adolescents and young adults in the United States and in other developed countries. Tumors are often very bulky; they most often begin in the lymph nodes in the neck, chest, or abdomen and may spread to the lungs.
- Mixed cellularity Hodgkin lymphoma. This type is more common in children age 10 years or younger and shows the strongest link to the Epstein-Barr virus (the virus that causes mononucleosis). It usually begins in the lymph nodes in the abdomen or in the spleen.
- Lymphocyte rich Hodgkin lymphoma. This type is rare and may be hard to distinguish from nodular lymphocyte predominant Hodgkin lymphoma. It usually begins in the lymph nodes of the neck, underarm, and groin, and sometimes involves the spleen and nodes in the chest.
- Lymphocyte depleted Hodgkin lymphoma. This is a very rare, aggressive type that is uncommon in children. This type is usually more widespread, involving lymph nodes as well as the bones and bone marrow.
Age and Hodgkin lymphoma
There are three different forms of Hodgkin lymphoma:
- A childhood form (in children 14 years or younger)
- A young adult form (in people 15 to 34 years old)
- An older adult form (in people 55 to 74 years old)
The childhood form of Hodgkin lymphoma is less common in the United States and is especially rare in children younger than five years. Hodgkin lymphoma is most commonly diagnosed in the young adult form and older adult form. In children younger than 5 years, Hodgkin lymphoma is more common in boys than in girls. Among adolescents, the rates of Hodgkin lymphoma are roughly equal among boys and girls.
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