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Characteristics of the histological subtypes of classical Hodgkin lymphoma include the following: The frequency of nodular lymphocyte-predominant Hodgkin lymphoma in the pediatric population ranges from 5% to 10% in different studies, with a higher frequency in children younger than 10 years compared with children aged 10 to 19 years.[12] Nodular lymphocyte-predominant Hodgkin lymphoma is most common in males younger than 18 years.[15,16] A comprehensive review of nodular lymphocyte-predominant Hodgkin lymphoma addressing biology, evaluation, and treatment has been published.[17] Characteristics of nodular lymphocyte-predominant Hodgkin lymphoma include the following: Anatomic information from CT is complemented by PET functional imaging, which is sensitive in determining initial sites of involvement, particularly in sites too small to be considered clearly involved by CT criteria.

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PET-CT, which integrates functional and anatomic tumor characteristics, is often used for staging and monitoring of pediatric patients with Hodgkin lymphoma.

Residual or persistent 18F-FDG avidity has been correlated with prognosis and the need for additional therapy in posttreatment evaluation.[6-9] General concepts to consider in regard to defining lymphomatous involvement by 18F-FDG PET include the following: 18F-FDG PET has limitations in the pediatric setting.

A large proportion of patients with Hodgkin lymphoma have high EBV titers, suggesting that an enhanced activation of EBV may precede the development of Hodgkin lymphoma in some patients.

EBV genetic material can be detected in Reed-Sternberg cells from some patients with Hodgkin lymphoma.

However, this should not be interpreted to mean that a needle biopsy is the optimal methodology.

Small fragments of lymphoma tissue are often inadequate for diagnosis, resulting in the need for second procedures that delay the diagnosis.

Dramatic improvements in survival have been achieved for children and adolescents with cancer.[1] Between 19, childhood cancer mortality decreased by more than 50%.

For Hodgkin lymphoma, the 5-year survival rate has increased over the same time from 81% to more than 95% for children and adolescents.[1] Childhood and adolescent cancer survivors require close monitoring because late effects of cancer therapy may persist or develop months or years after treatment.

(Refer to the PDQ summary on Late Effects of Treatment for Childhood Cancer for specific information about the incidence, type, and monitoring of late effects in childhood and adolescent cancer survivors.) Childhood Hodgkin lymphoma is one of the few pediatric malignancies that shares aspects of its biology and natural history with an adult cancer.

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