If childhood Hodgkin lymphoma spreads

Cancer cells can spread from where cancer starts to other parts of the body. This spread is called metastasis.

Understanding how a type of cancer usually grows and spreads helps the healthcare team plan treatment and future care. Childhood Hodgkin lymphoma (HL) usually starts in lymph nodes in the upper part of the body, including the chest, the neck or under the arms. It usually spreads through the lymphatic system in a predictable, orderly way. Cancer spreads through the lymph vessels from one group of lymph nodes to the next.

Most often, childhood HL spreads from lymph nodes in the neck (called the cervical lymph nodes) to the lymph nodes above the collarbone (called the supraclavicular lymph nodes). HL then spreads from the lymph nodes above the collarbone to lymph nodes under the arms (called the axillary lymph nodes). It then spreads to lymph nodes in the chest (called the mediastinal and hilar lymph nodes). Classical HL usually doesn’t usually skip an area of lymph nodes as it spreads.

Childhood HL can also spread to the following:

  • the spleen
  • the liver
  • the lungs
  • the bone marrow
  • the bone

Expert review and references

  • American Cancer Society. Hodgkin Disease. Atlanta, GA: American Cancer Society; 2013.
  • de Alarcon, Pedro A. Pediatric Hodgkin Lymphoma Clinical Presentation. 2017: http://emedicine.medscape.com/.
  • Lona Roll . Hodgkin Disease. Baggott C, Fochtman D, Foley GV & Patterson Kelly, K (eds.). Nursing Care of Children and Adolsecents with Cancer and Blood Disorders. 4th ed. APHON; 2011: 28:pp.. 1013-1022.
  • National Cancer Institute. Childhood Hodgkin Lymphoma Treatment (PDQ®) Health Professional Version. Bethesda, MD: National Cancer Institute; 2013.

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