lymphoma in children | Child lymphoma

Child lymphoma

In children, lymphoma is the third most common type of cancer. According to statistics, they account for 11% of childhood cancer cases after leukemia (19%) and central nervous system tumours (24%). Other forms of non-Hodgkin (NHL) lymphoma are exceptional in children.

Three primary lymphomas in children
Lymphomas in children are mostly diagnosed after the age of 5 years. They are rare in babies under 2 years of age.

There are three main types of lymphoma in children:

Burkitt lymphoma, the most common in children;
Lymphoblastic lymphoma (B or T in 90% of cases);
Anaplastic lymphoma with large cells (and secondarily diffuse B lymphomas with large cells).
These are three fast-changing, aggressive non-Hodgkin lymphomas (as opposed to slow-moving, non-Hodgkin indolent lymphomas). It is also important to mention Hodgkin's lymphoma, which is the most frequently encountered cancer in adolescents aged 15 to 19 (22% of cases). On the other hand, it accounts for less than 10% of cancer cases in children under 15 years of age.

Child Cancer
Diagnosis of lymphoma in children
Generally, the diagnosis of lymphoma in children is easy because they have a typical morphological and clinical aspect, in particular:

Burkitt lymphomas with cecum lesion;
Lymphoblastic lymphomas with a mediastinal mass.
However, it can happen that the diagnosis is more complex because it is necessary to succeed to differentiate correctly:

A Hodgkin's disease or a tumor of the amygdala of an infectious mononucleosis;
T-lymphoma of a papulosis lymphomatoid (indolent T-cell lymphoma);
Cutaneous T-lymphoma of skin disease, etc.
In all cases, to diagnose lymphoma, it is necessary to analyze the clinical morphological, cytogenetic and molecular data.

Childhood Cancer: Burkitt's lymphoma
Burkitt lymphomas occurring in African children are caused by a succession of infections following a primary infection with Epstein-Barr virus.

Generally, the tumour of Burkitt's lymphoma is observed in the abdomen (gastrointestinal tract), particularly in the right iliac cavity (appendix Region). She is found by chance, during an examination due to constipation or intestinal occlusion. The child usually has symptoms such as:

Tummy aches

nausea;

The onset of lymph nodes.

In Africa, where Burkitt lymphoma has an endemic form, it often touches the maxillary bones (jaw) of children aged 6 years.

The diagnosis of lymphoma should be confirmed by a tumor-mass biopsy, its analysis for the retrieval of mature B-lymphoid cells. Cytogenetic examination of tumor cells will result in a translocation of chromosomes 8 and 14 (rarely 8 and 22 or 2 and 8).

This is a therapeutic emergency because Burkitt's lymphoma has an extremely rapid development. Moreover, to ensure that lymphoma has not spread, an extension balance must be carried out with:

Abdominal ultrasound;

X-ray of the thorax and nasopharynx;

of Myélogrammes;

A lumbar puncture in search of a meningeal impairment.

The management must also be carried out with great rigour as chemotherapy will very quickly destroy the tumor. Intensive treatment will last between 1 and 6 months depending on the extension balance. It will be composed, among other things, of the administration of corticosteroids, methotrexate, anthracyclines and sometimes rituximab (a monoclonal antibody).

The cure rate is between 70 and 90% depending on the stage at which the disease was discovered and treated. If relapse are to occur, it will be in the first year after the end of the treatment.

Note: Large B-cell diffuse lymphomas are treated identically to Burkitt lymphomas with comparable results.

Childhood Cancer: lymphoblastic lymphoma

In children, lymphoblastic T lymphoma develops primarily at the thorax (thymus) level, resulting in symptoms related to mediastinal impairment:

Shortness

Dry cough;

Signs of compression with possibly edema;

Pleural or pericardial effusion;

Swelling of the lymph nodes of the neck and armpits;

More rarely an ENT tumor.

For lymphoblastic B lymphomas, much more exceptional, they can cause bone or skin problems.

The diagnosis of lymphoma is done through:

A puncture of a pleural effusion, a lymph node;

By biopsy of a tumor.

The cytological study is complemented by immunological and cytogenetic analysis. We realize equal