The term lymphoma refers to cancers that originate in the body's lymphatic tissues. Lymphatic tissues include the lymph nodes (also called lymph glands), thymus, spleen, tonsils, adenoids, and bone marrow, as well as the channels (called lymphatics or lymph vessels) that connect them. Although many types of cancer eventually spread to parts of the lymphatic system, lymphomas are distinct because they actually originate there.
About 1,700 kids younger than 20 years old are diagnosed with lymphoma each year in the United States. Lymphomas are divided into two broad categories, depending on the appearance of their cancerous (malignant) cells. These are known as Hodgkin's lymphoma and non-Hodgkin lymphoma (NHL). Together, they are the third most common type of cancer in children.
This type of lymphoma is defined by the presence of specific malignant cells, called Reed-Sternberg cells, in the lymph nodes or in some other lymphatic tissue. Hodgkin's lymphoma affects about 3 out of every 100,000 Americans, most commonly during early and late adulthood (between ages 15 and 40 and after age 55).
The most common first symptom of Hodgkin's lymphoma is a painless enlargement of the lymph nodes (a condition known as swollen glands) located in the neck, above the collarbone, in the underarm area, or in the groin.
If cancer involves the lymph nodes in the center of the chest, pressure from this swelling may trigger an unexplained cough, shortness of breath, or problems in blood flow to and from the heart.
About a third of patients have other nonspecific symptoms, including fatigue, poor appetite, itching, or hives. Unexplained fever, night sweats, and weight loss are also common.
There are about 500 new cases of non-Hodgkin lymphoma diagnosed each year in kids in the United States. It may occur at any age during childhood, but is rare before age 3. NHL is slightly more common than Hodgkin disease in kids younger than 15 years old.
In non-Hodgkin lymphoma, there is malignant growth of specific types of lymphocytes (a kind of white blood cell that collects in the lymph nodes). Malignant growth of lymphocytes is also seen in one of the forms of leukemia (acute lymphoblastic leukemia, or ALL), which sometimes makes it difficult to distinguish between lymphoma and leukemia in children. In general, people with lymphoma have no or only minimal bone marrow involvement, whereas those with leukemia have extensive bone marrow involvement.
Both Hodgkin disease and NHL tend to occur more often in people with certain severe immune deficiencies — including people with inherited immune defects, adults with human immunodeficiency virus (HIV) infection, or those who have been treated with immunosuppressive drugs after organ transplants.
Although no lifestyle factors have been definitely linked to childhood lymphomas, kids who have received either radiation treatments or chemotherapy for other types of cancer seem to have a higher risk of developing lymphoma later in life.
In most cases, neither parents nor kids have control over the factors that cause lymphomas. Most lymphomas come from noninherited mutations (errors) in the genes of growing blood cells. Regular pediatric checkups can sometimes spot early symptoms of lymphoma in the relatively rare cases where this cancer is linked to an inherited immune problem, HIV infection, prior cancer treatment, or treatment of immunosuppressive drugs for organ transplants.
The doctor will check your child's weight and perform a physical examination to look for enlarged lymph nodes and signs of local infection. He or she will also examine your child's chest using a stethoscope and will feel the abdomen to check for pain, organ enlargement, or fluid accumulation.
In addition to doing a physical exam, the doctor will take a medical history by asking you about your child's past health, your family's health, and other issues.
Sometimes, when a child is found to have an enlarged lymph node for no apparent reason, the doctor will watch the node closely to see if it continues to grow. The doctor may prescribe antibiotics if the gland is believed to be infected by bacteria, or do blood tests for certain types of infection. If the lymph node remains enlarged, the next step is a biopsy (the removal and examination of tissue, cells, or fluids from the body). Biopsies are also necessary for lymphomas that involve the bone marrow or structures within the chest or abdomen.
Depending on the location of the tissue to be sampled, the biopsy may be done using a thin hollow needle (known as needle aspiration) or a small surgical incision made under general anesthesia. Sometimes, a biopsy may require a surgical excision under anesthesia, where a piece of the lymph node or the entire lymph node is removed.
In the laboratory, tissue samples obtained from the biopsy are examined to determine the specific type of lymphoma. In addition to these basic lab tests, more sophisticated tests are also generally done, including genetic studies, to distinguish between specific types of lymphoma.
To identify which areas of the body are affected by lymphoma, the following tests are also commonly used:
These tests are important for determining the spread of the lymphoma within the body to guide which type of treatment should be used.
Treatment of childhood lymphoma is largely determined by staging. Staging is a way to categorize or classify patients according to how extensive the disease is at the time of diagnosis.
Chemotherapy (the use of highly potent medical drugs to kill cancer cells) is the primary form of treatment for all types of lymphoma. In certain cases, radiation (the use of high-energy rays to shrink tumors and keep cancer cells from growing), may also be used.
Intensive lymphoma chemotherapy affects the bone marrow, causing anemia and bleeding problems, and increasing the risk for serious infections. Chemotherapy and radiation treatments have many other side effects — some short-term (such as hair loss, changes in skin color, increased infection risk, and nausea and vomiting) and some long-term (such heart and kidney damage, reproductive problems, thyroid problems, or the development of another cancer later in life) — that parents should discuss with their doctor.
Although most kids do recover from lymphoma, some with severe disease will have a relapse (reoccurrence of the cancer). For these children, bone marrow transplants and stem cell transplants are often among the newest treatment options.
During a bone marrow/stem cell transplant, intensive chemotherapy with or without radiation therapy is given to kill residual cancerous cells. Then, healthy bone marrow/stem cells are introduced into the body in the hopes that it will begin producing white blood cells that will help the child fight infections.
Promising new treatments being developed for childhood lymphomas include several different types of immune therapy, specifically the use of antibodies to deliver chemotherapy medicines or radioactive chemicals directly to lymphoma cells. This direct targeting of lymphoma cells may avoid the toxic side effects that occur when today's chemotherapy and radiation treatments damage normal, noncancerous body tissues.
Reviewed by: Jonathan L. Powell, MD
Date reviewed: April 2013
|American Childhood Cancer Organization ACCO provides support and information for children and teens with cancer.|
|CureSearch for Children's Cancer CureSearch for Children's Cancer supports and sponsors research and treatment for childhood cancers.|
|American Cancer Society The American Cancer Society is the nationwide community-based voluntary health organization dedicated to preventing cancer, saving lives and diminishing suffering from cancer through research, education, advocacy, and service. Call:(800) ACS-2345|
|National Marrow Donor Program (NMDP) The NMDP is a nonprofit organization that facilitates unrelated marrow and blood stem cell transplants for people with life-threatening diseases who do not have matching donors in their families.|
|Alex's Lemonade Stand Foundation for Childhood Cancer A unique foundation that evolved from a young cancer patient's front-yard lemonade stand to a nationwide fundraising movement to find a cure for pediatric cancer.|
|Leukemia & Lymphoma Society The Leukemia & Lymphoma Society is dedicated to funding blood-cancer research, education, and patient services. The Society's mission is to cure leukemia, lymphoma, Hodgkin's disease, and myeloma, and to improve the quality of life of patients and their families. Call: (914) 949-5213|
|Cancer Basics Get the basics on cancer and cancer treatments in this article.|
|Hodgkin Lymphoma Hodgkin lymphoma is a type of cancer that affects the lymphatic system.|
|Non-Hodgkin Lymphoma A lymphoma is a cancer of the lymphatic system. The majority of kids with this type of cancer are cured.|
|Late Effects of Cancer and Cancer Treatment Long-term side effects, or late effects, happen to many cancer survivors. With early diagnosis and proper follow-up care, most late effects can be treated or cured.|
|Immunotherapy This promising new type of cancer treatment stimulates a person's immune system so it is better able to fight disease.|
|What Is Cancer? When kids get cancer, it can often be treated and cured. Find out more in this article for kids.|
|Acute Lymphoblastic Leukemia (ALL) ALL is the most common type of leukemia, affecting nearly 75% of kids who have this cancer of the blood cells. With treatment, most recover.|
|Coping With Your Child's Cancer: Liz Scott's Story Liz discusses how her family dealt with her daughter Alex's cancer, and tells the inspiring story that led them to raise money for cancer research through Alex's Lemonade Stand Foundation for Childhood Cancer Research.|
|Side Effects of Chemotherapy and Radiation Side effects of cancer treatment can include fatigue or flu-like symptoms, hair loss, and blood clotting problems. After treatment ends, most side effects gradually go away.|
|Cancer Center Cancer is a serious illness that needs special treatment. Find out more about how kids can cope with cancer.|
|Chemotherapy Chemotherapy is a big word for treatment with medicines used to help people who have cancer. This medicine kills the cancer cells that are making the person sick.|
|Life After Hospitalization: Helping Kids With Cancer Adjust Learn how to help kids get back into the swing of being at home and going to school.|
|Knowing Your Child's Medical History In an emergency, health care professionals will have many questions about a patient's medical history. It's easy to compile this information now, and it could save critical minutes later.|
|Radiation Therapy Radiation therapy is a treatment that can help people with cancer. Learn what's involved and how it works.|
|Radiation Therapy More than half of all people with cancer are treated with radiation therapy. Get the facts on radiation therapy, including what it is, what to expect, and how to cope with side effects.|
|Types of Cancer Teens Get While cancer is rare in teens, some types are more likely to affect young people. Learn about these types of cancer, including warning signs, symptoms, and treatments.|
|Some Kinds of Cancer Kids Get Cancer mostly affects adults, but there are some kinds that kids get, too. Find out more in this article for kids.|
|Chemotherapy Chemotherapy, or chemo, is the use of medications to treat cancer. This article explains how chemo works and what to expect when getting treatment.|
|Non-Hodgkin Lymphoma Non-Hodgkin lymphoma is a disease in which cancer cells form in a person's lymphatic system and start to grow uncontrollably.|
|Caring for a Seriously Ill Child Taking care of a chronically ill child is one of the most draining and difficult tasks a parent can face. But support groups, social workers, and family friends often can help.|
|Taking Care of You: Support for Caregivers It's common to put your own needs last when caring for a child you love. But to be the best you can be, you need to take care of yourself, too. Here are some tips to help you recharge.|
|Cancer Center Visit our Cancer Center for teens to get information and advice on treating and coping with cancer.|
|Dealing With Cancer It's unusual for teens to have cancer, but it can happen. The good news is that most will survive and return to their everyday lives. Learn about how to cope if you or someone you know has cancer.|
|Childhood Cancer Different kinds of childhood cancer have different signs, symptoms, treatments, and outcomes. But today, over 80% of all children with cancer live 5 years or more.|
|Cancer Center From treatments and prevention to coping with the emotional aspects of cancer, the Cancer Center provides comprehensive information that parents need.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.