Lymphomas are solid tumours that affect the lymphatic system, which is part of the body’s overall immune system. The lymphatic system is made up of the bone marrow, thymus, spleen and lymph nodes all of which are connected by lymphatic vessels.

Lymphomas can often resemble leukaemia in their pattern of spread and therefore are treated with leukaemia-type treatments.

The two main types of lymphomas in children are;

• Hodgkins Disease

• Non-Hodgkins Lymphoma

Hodgkins Disease

Hodgkins Disease (HD) usually presents as enlargement of the lymph glands which are located in the neck, chest, armpits and groin.

It is a rare disease in very young children and is more often seen in older children and adolescents.

Children with HD have a very high cure rate. If a patient doesn’t suffer a relapse, survival rates for early stages of disease is more than 90%. Even for late stage disease survival is more than 85%.

Symptoms

Patients may present with a variety of symptoms. These include;

• Lumps in the lymph glands

• Fever

• Night sweats

• Weight loss

• Itchy skin

Diagnosis

A definitive diagnosis of HD is done via a biopsy. Patients may also undergo x-rays, ultrasounds, CT scans, PET scans and blood tests to determine how far the lymphoma has spread throughout the body.

Staging

There are a number of different stages of HD and by staging HD, doctors can determine the extent of disease. It helps the medical team work out the most effective treatment and how well the child is likely to respond:

• Stage I – disease is not found anywhere except the original lump.

• Stage II – two or more lumps are found close to each other.

• Stage III – disease involves both the upper and lower parts of the body.

• Stage IV – disease has entered the blood stream or spread to organs other than the lymph glands and related structures.

Treatment

Both chemotherapy and radiation are effective against HD and a combination of both may be recommended.

Non-Hodgkins Lymphoma

Non-Hodgkins Lymphona (NHL) is more common than Hodgkins Disease and has many features in common with leukaemia.

There are different types including;

• Burkitt lymphoma

• Lymphoblastic lymphoma

• Anaplastic large cell lymphoma

• Large B-cell lymphoma

NHL usually presents as a lump, which often produces no symptoms until it is very large, but can spread quickly via the blood stream very early in the course of the disease.

The two most common sites where NHL presents are the abdomen and chest where glands associated with the lymphatic system are located.  

Symptoms

Patients may present with a variety of symptoms. These include;

• Lumps in the lymph glands
• Fever
• Weight loss

Staging

As in HD, there are a number of different stages of NHL. These include:

• Stage I – cancer only in one lymph node or one area of the body.

• Stage II – cancer only in one area and one neighbouring lymph gland on the same side of the diaphragm or two areas or two lymph nodes on the same side of the diaphragm.

• Stage III – cancer on both sides of diaphragm, or in the chest cavity or near/around spine.

• Stage IV – cancer spread beyond lymph nodes (for example to bone marrow or nervous system).

Treatment 

Chemotherapy is the main form of treatment for most forms of NHL. Intensive chemotherapy may be required for a period of up to two years.

Prognosis

Overall, more than 85% of children with NHL can be cured.