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Lymphoma


Introduction

Lymphoma is a malignancy of the lymphoid tissue.  The lymphoid tissue is normally widely distributed in the body.  One of its functions is to combat infection.  Lymphoma accounts for around 10% of all childhood cancer.  About 20 children develop the disease each year.  There are two kinds of lymphoma: Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL).  Non-Hodgkin's lymphoma is more malignant, more common, and affects all ages.  Hodgkin's lymphoma, on the other hand, rarely affects children under 3 years old.

 

I. Hodgkin's Lymphoma

 

Symptoms

a) Painless enlargement of lymph glands in the neck, armpits and groins

b) Coughing, difficulty with breathing

c) Fever, fatigue, itchiness, night sweating, weight loss

 

Diagnostic Tests

a) Blood counts, renal function and liver function tests

b) computerized tomography (CT) scan of chest and/or abdomen, lymphangiogram

c) Ultrasound examination

d) Biopsy of lymph gland

e) Bone marrow aspiration to determine if the disease has spread to the bone marrow

 

Treatment

Treatment of Hodgkin's disease depends on the stage of the disease at diagnosis.

a) Chemotherapy - this is the mainstay of treatment.  Six to eight courses of anti-cancer drugs are given depending on the response.

b) Radiotherapy - when the disease is localized at the neck, local radiation to the affected area is often preferred.

 

Prognosis

More than 80% of affected children are cured.  If it recurs, further treatment is necessary.

 

II. Non-Hodgkin's Lymphoma

 

Symptoms

a) Painless enlargement of lymph glands in the neck, armpits and groins

b) Coughing and breathlessness

c) Abdominal swelling

d) Fever, skin irritation, weight loss, anaemia or bleeding

 

Diagnostic Test

a) Blood tests

b) X-ray, CT scan

c) Ultrasound examination

d) Biopsy of lymph gland, liver or spleen

e) Bone marrow aspiration, spinal tap

 

Treatment

Chemotherapy is the mainstay of treatment.  The anti-cancer drugs will be given by injection or taken orally.  Treatment usually lasts 2 years.

 

Prognosis

The prognosis depends on the histological features and stage of the disease.  The overall cure rate is about 50%.