Enlarged cervical lymph nodes are a common finding in pediatric patients. The exclusion of Hodgkin lymphoma is a main indication for performing an excisional biopsy in the setting of persistently enlarged nodes or progressive involvement of other nodal groups. This case series demonstrates the close histologic characteristics of progressive transformation of germinal centers and lymphocyte-predominant Hodgkin lymphoma. Prompt surgical excision of persistently enlarged lymph nodes and close monitoring for recurrence is recommended.