Lymphoma

Non-Hodgkin's Lymphoma

Signs and Symptoms
Diagnosis
Treatment

Signs and Symptoms

Non-Hodgkin's lymphoma affects boys almost three times more often than girls, and is more common among Caucasian children than among African-Americans and children of other races. There are three major types of childhood non-Hodgkin's lymphomas:

• Lymphoblastic -- Lymphoblastic non-Hodgkin's lymphoma accounts for about 35 percent of lymphoma cases. This condition usually involves the T-cells, though it also can involve B-cells, and usually occurs with a mass in the chest and swollen lymph nodes with or without the involvement of bone marrow and the central nervous system.

• Small Noncleaved Cell -- Small noncleaved cell lymphoma, also referred to as Burkitt's lymphoma, is common in Africa and North America. Burkitt's lymphoma originating in Africa is almost always associated with the Epstein-Barr virus and often occurs with a jaw mass and central nervous system disease. Burkitt's lymphoma originating in North America is rarely associated with Epstein-Barr virus, arises in the abdomen and often spreads to bone marrow.

• Large Cell or Diffuse Histiocytic -- Large cell or diffuse histiocytic non-Hodgkin's involves either the B-cells or T-cells and accounts for about 15 percent to 20 percent of lymphoma cases. Large cell B cell lymphoma often originates in the abdomen and can spread to the bone marrow and central nervous system. Large cell T cell, also called anaplastic lymphoma, can involve the skin, lymph nodes, lungs, testicles, muscles and gastrointestinal tract.

In many children, non-Hodgkin's lymphoma is already extensive when first diagnosed. About a third originate in the neck or chest, a third in the abdomen and another third elsewhere in the body.

There is often pain and swelling at the site of the cancer. Other symptoms include:

• Abdominal bloating
• Change in bowel habits
• Fever
• Sweating, especially at night
• Weight loss

If the cancer is in the abdomen, the area can become very swollen, sometimes so much as to look like a pregnancy. When the cancer causes the lymph tissue near the kidney or intestines to swell, passage of urine or feces through that area can become blocked, causing abdominal pain.

If the chest is involved, head and neck may swell and causes breathing difficulty. The large vein that carries blood from the head and arm back to the heart, called the superior vena cava or SVC, passes next to the thymus. Pressure on the SVC from the cancer can cause the head, arm and upper chest to turn a bluish-red color. This is known as SVC syndrome and can affect the brain and threaten your child's life. Children with SVC syndrome need immediate treatment.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated May 8, 2007