Lymphoma is a cancer in the lymphatic cells of the immune system. Typically, lymphomas present as a solid tumor of lymphoid cells.These malignant cells often originate in lymph nodes, presenting as an enlargement of the node (a tumor).It can also affect other organs in which case it is referred to as extranodal lymphoma. Extranodal sites include the skin,brain, bowels and bone.

Lymphomas are closely related to lymphoid leukemia’s, which also originate in lymphocytes but typically involve only circulating blood and the bone marrow and do not usually form static tumors. There are many types of lymphomas, and in turn,lymphomas are a part of the broad group of diseases called hematological neoplasm’s.


The simplest classification divides lymphoma into two classes:

  • Hodgkins Lymphoma 
  • Non Hodgkins Lymphoma(NHL)
  • In pediatric population the NHL is further classified as B cell type, T cell type, Anaplastic Large Cell Lymphoma (ALCL)

SYMPTOMS (As noted by the parent):

  • Anorexia
  • Dyspnea
  • Fatigue
  • Fever of unknown origin
  • Lymphadenopathy
  • Night sweats
  • Pruritus
  • Weight loss

Commonly children present with fever and swellings in region of neck or axilla along with weight loss. These symptoms prompt the parents to seek medical attention.


Requires to test the lymphnode for histopathology and markers to differentiate the type of lymphoma as treatment differs for the two classes. A baseline testing is done for blood counts and chemistries and a lymphnode biopsy is carried out. In order to stage the tumor Ultrasound or preferably CT scan of neck,chest and abdomen is done to look for nodes.A bone marrow and Lumbar puncture are done to ascertain if there sites are free of tumor. For HL the latest test in staging is a PET scan (Positron emmission scan)


  • Once the tumor is identified and classified, treatment is commenced.
  •  HL is usually treated for 6 months commonly with ABVD (Adriamycin, Bleomycin, Vinblastic, Dcarbazine) protocol.Radiotherapy maybe required depending on response to chemotherapy using PET scan.
  •  NHL is treated on a leukemia based protocol for 2 years if it is a T cell type or for 6 months using the LMB (French Protocol) protocol if B cell type.
  • With proper treatment the cure rates for HL are close to 60-90% and for NHL around 75-80% depending on the stages of the tumor.

Follow Up:

Has to be done to monitor side effects of chemotherapy. A Pulmonary function test and ECHO are usually done. Counseling is done for side effects during chemotherapy- fever, nausea, hair fall, requirement for blood and platelet transfusions.