Unusual presentations of hodgkin lymphoma in children and adolescents: Extranodal disease, autoimmune and infection-like disorders

Hodgkin lymphoma (HL) is a great mimicker of a variety of pathologies 1. In the hands of an experienced oncologist the diagnosis of HL is straightforward. HL usually presents with involvement of cervical or supraclavicular lymphadenopathy that are easily palpable on physical exam in 60–70% of the cases. Almost two thirds of patients with newly diagnosed HL have evidence of mediastinal adenopathy. The association of systemic symptoms like fever, night sweats or weight loss is also common. Here we present a case series of patients whose clinical presentation and lack of superficial palpable adenopathy lead to suspect a diagnosis different from HL.