The staging of Hodgkin's disease in children reviewed.

The accurate staging of Hodgkin's disease is of greater importance in children than in adults, because the deleterious effects of extensive radiation therapy and of prolonged multiple-agent chemotherapy are of greater significance in this age group. The physician concerned with Hodgkin's disease in children must separate those aspects of developments in this field which are applicable to the pediatric age group from the relatively large adult experience. Isotope scanning is effective in demonstrating disseminated disease in pediatric patients. Lymphangiograms are useful, but are more difficult to perform and to interpret in children. When laparotomy is performed in children with clinical Stage I, II, or III Hodgkin's disease, stage will be altered (upward or downward) in approximately 40% of children subjected to the procedure. As growth retardation, skeletal deformity, and secondary neoplasia follow radiotherapy in children, the major function of the laparotomy is to delineate the extent of the disease and thus define appropriate limitations of therapy.