Presentation
Most children and adolescents with Hodgkin lymphoma are reasonably well and only present with minor symptoms.
The most common presentation is finding a mass due to peripheral lymphadenopathy(most common site is cervical LNs).
Sometimes mediastinal adenopathy can cause a cough or shortness of breath and may potentially lead to SVCO.
B-symptoms:
Specific systemic symptoms with important prognostic significance.
Occur in roughly one third of cases with:
- Fever > 38.0 degrees C
- Anorexia and weight loss (>10% of baseline body weight over past 6 months)
- Drenching night sweats
Other systemic symptoms that are not B symptoms and have no clear prognostic implications:
- Tiredness.
- Generalized pruritus (itching) seen in 15-25%; usually mild
- Pel-Ebstein Fever (waxing-and-waning course over days to weeks)
HL patients may also have:
- Cough and shortness of breath may be due to pulmonary disease.
- Alcohol-induced pain at site of involved LNs
- Neurological symptoms due to epidural disease tend only to be seen in very advanced cases.
- Increased risk of infection - Herpes zoster commonly encountered.
- Bone marrow involvement can cause tiredness due to anemia.
- Bone involvement can cause significant bone pain.
- Paraneoplastic syndromes associated with Hodgkin lymphoma are very rare.
- Skin nodules can occur - very rare - usually in the setting of advanced disease
Summary of Hodgkin lymphoma symptoms:
Region of Involvement |
Symptoms |
Peripheral lymph nodes (90% of cases) |
|
Mediastinal lymph nodes (60% of cases)
|
Can cause mediastinal syndrome with:
|
Systemic symptoms (30% of cases) |
|
Lungs (15 - 20% of cases) |
|
Bone Marrow (5% of all cases) |
|
Bone (2% of all cases) |
|
Liver (1 - 2% of all cases) |
|
Paraneoplastic syndromes (less than I% of cases) |
|
Skin (less than 1% of cases) |
|
