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Updated: Aug 9, 2025
Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
Published on: January 9, 2019
Multimodality imaging workup of classical Hodgkin lymphoma in an 8-month-old child
Maad Galal1, Nader Ashraf1, Areez Shafqat1
1College of Medicine, Alfaisal University, Al Takhassousi, Al Zahrawi Street interconnecting with, Riyadh 11533, Saudi Arabia.
Insights
This case report details the youngest patient diagnosed with classical Hodgkin lymphoma (HL), an 8-month-old infant. The rare presentation lacked typical lymphadenopathy, highlighting the importance of considering HL in pediatric immunodeficiency and neurological delays.
Area of Science:
- Pediatric Oncology
- Hematology
- Radiology
Background:
- Hodgkin lymphoma (HL) incidence peaks in adolescents (15-19 years), with cases in infants under 3 years being exceptionally rare.
- Classical HL typically presents with lymphadenopathy, a key diagnostic feature.
Observation:
- A male infant, 8 months old, presented with immunodeficiency and delayed neurologic milestones, notably without lymphadenopathy.
- Radiologic imaging revealed bilateral paravertebral masses, T3 vertebral collapse, spinal cord compression, and involvement of the lungs, liver, and spleen.
Findings:
- Histopathological examination of the paravertebral mass confirmed classical Hodgkin lymphoma.
- The differential diagnosis included various pediatric conditions like tuberculosis, Langerhans cell histiocytosis, leukemia, and neuroblastoma.
Implications:
- This case represents the youngest reported instance of classical Hodgkin lymphoma.
- The unusual presentation underscores the need for comprehensive radiologic and histopathological evaluation in infants with non-specific symptoms suggestive of malignancy.
- Multimodality imaging plays a crucial role in diagnosing and staging pediatric Hodgkin lymphoma, especially in atypical presentations.
Abstract:
The incidence of Hodgkin lymphoma (HL) varies by age, most commonly affecting 15-19-year-olds. Cases in children less than 3 years old are exceedingly rare. We report a case of classical HL in an 8-month-old male; the youngest case reported thus far in the literature to our knowledge. Furthermore, while lymphadenopathy is a salient feature of HL, it was absent in our patient, who presented with immunodeficiency and delays in achieving neurologic milestones. A thorough radiologic workup demonstrated bilateral paravertebral masses, collapse of the T3 vertebrae, and severe spinal cord compression. Involvement of the lung, liver, and spleen was also noted. Histopathological evaluation of the paravertebral mass revealed a diagnosis of classical HL. Various non-neoplastic and malignant disorders, such as tuberculosis, Langerhans cell histiocytosis, leukemia, and neuroblastoma, amongst others, could be included in the differential diagnosis of our patient. Using an Illustrative case report, we review the multimodality imaging workup of Hodgkin lymphoma.
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