How to rule out lymphoma in children

Written by Zhang Xiao Le
Hematology
Updated on February 01, 2025
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Lymphoma is a malignant tumor originating from the lymphatic system. The main clinical manifestation is painless lymph node enlargement, which can occur in superficial lymph nodes such as in the neck, armpits, or groin, as well as deeper lymph nodes in the mediastinum or abdominal cavity. In pediatric patients with lymphoma, a significant number also present with abdominal pain, intestinal obstruction, or intussusception, which often indicates intestinal lymphoma. If children exhibit lymph node enlargement or deep lymph node enlargement is discovered through imaging studies, it is necessary to perform a puncture or biopsy and conduct a pathological examination to further confirm whether it is lymphoma.

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What are the symptoms of lymphoma?

The symptoms of lymphoma usually involve painless, progressive enlargement of the lymph nodes, typically located in areas like the neck, under the jaw, and below the chin. However, beyond these localized symptoms, lymphoma can also present with systemic symptoms, which include fever, night sweats, weight loss, as well as rashes and itching skin. Thus, lymphoma encompasses both local and systemic symptoms.

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Early symptoms of lymphoma

The early symptoms of lymphoma involve the painless enlargement of both superficial and deep lymph nodes, most commonly located in areas such as the neck, armpits, and groin. Of course, lymphoma also presents with systemic symptoms, such as fever, night sweats, weight loss, and skin itching. Since lymphoma commonly occurs in the neck, armpits, and groin, if it develops in other areas, such as the lungs or elsewhere, it may cause respiratory symptoms, including coughing, expectoration, and shortness of breath.

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What is lymphoma Ki-67?

Lymphoma Ki67, also known as the proliferation index, is one of the indicators in immunohistochemistry performed after the pathological diagnosis of lymphoma. If this proliferation index is higher, it indicates that the activity of the tumor is stronger, and its proliferation is more active, thus the tumor should be given sufficient attention. Of course, active treatment should be pursued. Therefore, Ki67 reflects the activity of a tumor; if the index is very high, greater than 90%, it sometimes implies that the tumor can grow very rapidly, or not only grows significantly but might also spread to many places.

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How is malignant lymphoma treated?

The common treatments for malignant lymphoma currently include chemotherapy, targeted therapy, radiation therapy, and the use of immunosuppressants. There are also newer treatments such as cell reinfusion. The choice of treatment for malignant lymphoma definitely depends on the specific pathological type. Another factor is the stage of the lymphoma—it could be in stages one, two, three, or four, which definitely matters. The third factor is whether the lymphoma causes any symptoms or signs in the patient because some minor lymphomas may allow for observation and waiting, but many require active treatment.

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Is lymphoma hereditary?

Lymphoma is generally not hereditary, as it is not a genetic disease. However, I must mention that most neoplastic diseases do have some hereditary factors to some extent. The reason for this is that the cause of lymphoma is currently unclear, and it may be related to genetic mutations, which raises the issue of heredity. Another point is that heredity often refers to transmission among direct relatives. This means there could be a problem in that you might share similar environments and lifestyles, including diet. If there are factors in your diet or living environment that could trigger lymphoma, and you are both exposed to these factors, then your probability of developing lymphoma could indeed be higher than in patients without a family history, leading to such a concern.