Abstract
Aim An accurate diagnosis can be achieved
Material and Method Hodgkin’s lymphoma is a rare cancer of lymphatic system can affect any age group but common in those aged 20–40. With roughly 2100 patients diagnosed a year in the United Kingdom, it is one of the most common cancers affecting those under the age of 40. With treatment 8 out of 10 will survive a further 5 years, many cured. We herein report a case of 6 year old boy who presented with HL
Results The child presented with a latero-cervical solitary lymphnode on left side, of which had been present for the last 5 weeks. His history revealed he was experiencing night sweats, his parents had declined the MMR vaccine. Physical exam and blood tests normal. A week later, no improvement in symptoms. New lymphnodes palpated on the left and right side. Chest xray no abnormalities. The ultrasound suggested reactive lymphnodes, however lymphoproliferative disease cannot be excluded. Biopsy revealed nodular sclerosing classical Hodgkin’s lymphoma. Staging CT abdominal/pelvis showed no lymphnodes below the diaphragm. A PET scan of his neck showed stage I Hodgkin’s lymphoma with extensive involvement of nodes in the left side of the neck only. He has now completed 15 days of vincristine chemotherapy and the lymphnodes are now difficult to palpate. He is due for a repeat pet scan after his second round of chemotherapy. He is currently well, apart from wind, constipation and lethargy.
Conclusions The most common presentation of HL is asymptomatic lymphadenopathy. With this many differential diagnosis can be considered including several viruses and bacterical infections. The importance of close follow up to assess whether there is improvement of symptoms is crucial to a timely diagnosis and treatment. This case shows an example of the most likely cause of lymphadenopathy proving to be untrue, but with repeated follow up an accurate diagnosis can be achieved.