Lymphoma – Non-Hodgkin

Signs and Symptoms

Symptoms of non-Hodgkin lymphoma vary depending on the type of lymphoma and where a tumor is located. Some kids may feel stomach pain, constipation, and decreased appetite. Others may have trouble breathing, difficulty swallowing, coughing, wheezing, or chest pain.
Other symptoms may include:

• painless swollen lymph nodes
• fever, chills, or night sweats
• itchy skin
• weight loss despite eating normally
• tiredness
• bone or joint pain
• recurring infections

The symptom that some kids first experience is swollen lymph nodes — usually in the neck, armpits, and groin. Of course, swollen lymph nodes do not usually mean cancer — they’re most often a sign of a common illness, like an infection. In fact, all of the symptoms of non-Hodgkin lymphoma can also be caused by other conditions, which is why only a doctor can determine what’s really wrong with a child.

Diagnosis

After performing a thorough evaluation, which includes a medical history and physical examination, a doctor who suspects that a child has non-Hodgkin lymphoma will refer the child to an oncologist, or cancer doctor.
The doctor may perform a biopsy, or tissue sample, of lymph nodes. During a biopsy, a tiny bit of tissue is removed from the body and sent out to a laboratory for analysis. Depending on the type of biopsy ordered, the doctor may use local anesthesia (where only a part of the body is numbed) or general anesthesia (which puts a child to sleep) to ensure that the child doesn’t feel any pain.

Biopsies used to test for non-Hodgkin lymphoma include excisional biopsy (where the doctor opens the skin to remove an entire lymph node) or incisional biopsy (where the doctor removes only a part of the lymph node).
Another type of biopsy, fine needle aspiration (where a doctor uses a very thin needle to suction out a small amount of tissue from the lymph node), is used on some rare occasions to diagnose non-Hodgkin lymphoma.
Doctors also may perform a bone marrow biopsy, where a needle is used to take samples of the soft tissue found inside a bone.
Other tests used to diagnose non-Hodgkin lymphoma include:

• blood tests
• a chest X-ray, a simple procedure in which the person lies on a table while an X–ray machine takes an image of the chest
• a computerized tomography (CT or CAT) scan, which rotates around the patient and creates an X-ray picture of the inside of the body from different angles
• an ultrasound, which uses high-frequency sound waves to create pictures of the inside of the body
• a magnetic resonance imaging (or MRI) scan, which uses magnets and radio waves to allow doctors to see inside the body.
• a gallium scan, which uses the injection of a material known as gallium to help show tumors and inflammation
• a bone scan to detect bone changes