Hodgkin Disease
Lymph node enlargement is a frequent finding on the physical examination of children, and it is important for the pediatrician to recognize the differences between lymphadenopathy related to infection and lymphadenopathy that results from Hodgkin disease.
A lymph node involved with Hodgkin disease usually is not painful or tender; infected nodes characteristically are. The nodes of Hodgkin disease are firm and rubbery, but not hard ("like a rock"). They tend to be fixed, to be minimally moveable if at all, but they may change in size over weeks and months, often becoming larger and smaller prior to diagnosis. Enlarged nodes in the upper half of the neck, in the anterior and posterior chains, and in the submandibular region generally are associated with respiratory tract infections in children; only rarely are cases of Hodgkin disease found here.
