Symptoms in children | Lymphoma symptoms

Symptoms in children

Lymphomas are the third most common cancer in children in Germany. In total, they account for ~ 12% of all childhood and adolescent cancers. A distinction is also made between Hodgkin’s and non-Hodgkin’s lymphomas in children.

The two forms of the disease are often not clearly distinguishable by their symptoms alone. A classification is often only made after histological-microscopic examination of affected tissue, usually lymph nodes. In Hodgkin’s lymphoma, so-called B lymphocytes are degenerated into cancer cells.

In healthy individuals, these lymphocytes are transformed into plasma cells after activation, which finally produce antibodies for the immune system. Older children in particular suffer from this form of lymphoma, while small children under 3 years of age are hardly ever affected. However, the main peak of the disease is in adulthood.

Why the cells degenerate is not yet known. In the course of various investigations and studies it has been observed that especially people with congenital or acquired immune defects and/or those who have developed Pfeiffer’s glandular fever (pathogen Epstein-Barr virus) are more likely to develop lymphoma than those who were previously completely healthy. The cancer becomes noticeable through various lymph node swellings, but especially in the area of the neck and the nape of the neck (see: Lymph node swelling neck).

These swellings are hard to feel and not painful. In the course of the disease, a persistent fever, night sweats and a high, unwanted weight loss occur frequently and often simultaneously. The children complain about tiredness, listlessness and about getting out of breath quickly even with the smallest effort.

Some affected children also suffer from itching all over their bodies. If the degenerated cells have settled in the area of organs such as the lungs or in the abdominal cavity, the growth of the former can cause breathing problems and coughing, and the latter can lead to visible swelling of the abdomen, but also to digestive problems such as diarrhoea or constipation. Since the spleen is one of the lymphatic organs in which the degenerated lymphoma cells are preferentially located and settled, swelling of the organ also occurs here in the course of the disease.

The spleen is unnaturally palpable below the left costal arch. In healthy individuals, the spleen is not palpable. Since the blood is backed up in the liver due to this swelling, the liver is also enlarged after some time.

If the bone marrow is infiltrated, the children often complain of bone pain. The displacement of the remaining blood production leads to a lack of red blood cells, among other things, which is called anemia and is one of the reasons for fatigue and the loss of performance of the children. As a result, the skin appears pale.

The symptoms typically do not appear suddenly, but gradually within weeks to months. The therapy is planned on site after the diagnosis, which is usually done in a specialized hospital. The current symptoms, the condition of the sick child, the current tumor stage and the lymphoma subtype are all taken into account in the planning.

Non-Hodgkin lymphomas are caused by degeneration of B- or T-lymphocytes. These cells form part of the immune system of healthy people. B-cell lymphomas are proportionally much more common than T-cell lymphomas.

As in Hodgkin’s lymphoma, the degenerated cells settle preferentially in the lymph nodes, which swell as a result and sometimes massively increase in size. Non-Hodgkin’s lymphomas (NHL), which occur in children, are often very aggressive, i.e. highly malignant. Untreated, the disease would quickly lead to death.

The symptoms of non-Hodgkin’s lymphoma are similar to those described for Hodgkin’s lymphoma. However, due to the mostly aggressive growth of NHL cancer cells, the course of symptoms is often faster than in Hodgkin’s lymphoma. In addition, existing symptoms worsen faster.

A very rapid increase in tumor-related swelling in various parts of the body is also frequently observed.Common to both diseases is the typical, painless enlargement of lymph nodes in different parts of the body. In non-Hodgkin’s lymphomas, in addition to the organ-related symptoms that also occur in Hodgkin’s lymphoma, a “colonization” of the meninges by the malignant lymphoma cells can occur. The affected children complain of severe headaches.

In the course of the disease, the pressure in the brain can increase, which can lead to vomiting on an empty stomach and visual disturbances. A final differentiation between Hodgkin’s and non-Hodgkin’s lymphoma is only possible by histological-microscopic examination of affected tissue, despite the faster symptomatic course of NHL.