Hodgkin's disease in children. Pathologic study of 87 cases

From 1963 to 1977 at the Istituto Nazionale Tumori at Milan, 112 patients below the age of 16 years with Hodgkin's disease (HD) were observed, representing 13.2% of all the cases of this disease seen during the stated time interval. Eighty-seven of these cases are the subject of the present study. Fifty-nine patients were males and 28 females (2.1:1 ratio). The age range varied from 2 years 10 months to 15 years 10 months (median 10 years). Forty-three (49.4%) children, of whom 35 were males and 8 females, were below the age of 10 years at the onset of their disease. The clinical staging resulted in 34 patients as stage I, 33 as stage II, 13 as stage III and 7 as stage IV. The histologic type was nodular sclerosis (NS) in 49 cases (56.3%), lymphocytic predominance (LP) in 15 cases (17.2%), mixed cellularity (MC) type in 9 cases (10.3%) and lymphocytic depletion (LD) in 8 cases (9.2%). In the remaining 6 cases the histologic classification was not applicable. LP type in 15/15 (100%) patients was associated with stages I and II, and NS in 38/49 (77%) patients was related to stage I and stage II. The latter was also the istologic type most often encountered in patients with stage II disease (23/33 or 70%). Eleven patients have died, and their survival varied from 6 to 47 months (median 30 months). The histologic type was LD in 4 cases, NS in 3 cases, MC in 1 case, and LP in 1 case. In the other 2 nonsurvivors, the histologic type was not identifiable. Of the 23 patients with more than a 5-year survival, 14 (60.8%) had NS HD. As in adults, LP and NS were associated with early stages of the disease and with long survival.