Pediatric Hodgkin Lymphoma

Etiology: Malignancy arising from lymphocytes or lymphoblasts
Imaging:
— Lobular and bulky mass of lymphadenopathy
— Bulk mediastinal disease is defined as involving greater than 1/3 of the diameter of chest
— Rarely lymph nodes can be calcified
— 5% have chest wall invasion
— 10% have lung involvement
DDX:
Complications:
Treatment:
Clinical:
— 33% present with anterior or middle mediastinal mass
— At presentation can cause airway compression and superior vena cava syndrome

Radiology Cases of Hodgkin Lymphoma

CXR and CT of Hodgkins lymphoma — CXR and CT with contrast of the chest shows a large, heterogeneous, primarily middle mediastinal mass causing airway compression and a small right pleural effusion.

CXR and CT of Hodgkins lymphoma — CXR shows diffuse narrowing of the trachea due to infiltrative adenopathy shown on the axial CT without contrast of the chest.

CXR and CT of Hodgkins lymphoma with chest wall invasion — CXR PA and lateral shows a large lobulated mediastinal mass compressing and displacing the trachea to the right. Axial CT without contrast of the chest shows the mass to be in the anterior and middle mediastinum, compressing the left mainstem bronchus and eroding into the sternum and chest wall soft tissues.