When it is no longer confined to lymph nodes, it may spread to the spleen, liver, lungs, bones and bone marrow. Symptoms depend on where the lymphoma is located. The lymph nodes most often involved are those in the neck, underarms and groin. These nodes become large, firm and are usually not painful. Enlarged lymph nodes may also be located in the chest and produce a cough or breathing problems.
Some children develop night sweats, fever and weight loss.
If Hodgkin's disease is suspected, it is important that a complete evaluation for sites of disease occur in order to establish extent of spread. The likelihood of cure is related to the extent of disease. Surgery is beneficial to establish a diagnosis. Chemotherapy , radiation or a combination of the two is necessary. It is very important that children with suspected Hodgkin's disease be cared for at a hospital with specialists in children's cancer care, such as the University of Michigan.