In children, non-Hodgkin's lymphomas most frequently occur in the bowel, particularly in the region adjacent to the appendix, and in the upper midsection of the chest, a site where Hodgkin's disease may also occur. An initial sign of disease in non-Hodgkin's lymphoma may be abdominal pain or swelling, breathing difficulties and sometimes difficulty in swallowing, or swelling of the face and neck. Non-Hodgkin's lymphomas may also occur in other organs, including the liver, spleen, bone marrow, lymph nodes, central nervous system, and bones. Lymphomas can be diagnosed definitively only through a biopsy, where a piece of tumor tissue is obtained surgically and examined under a microscope. Once the diagnosis is made, many tests must be done to determine the extent of the tumor, including special x-rays, CT scans, isotope scans, and ultrasound.
Blood tests are also necessary.
In the case of Hodgkin's disease, radiation therapy is highly effective for localized disease and has been the main form of treatment. However, it is believed that most lymphomas in young people are spread throughout the body, even though tumors may be detected in only one region. Because chemotherapy acts on cells throughout the body, it is the most important aspect of treatment. Surgery and radiation therapy are sometimes valuable in particular circumstances. Except in Hodgkin's disease, treatment is usually given to prevent the spread of disease to the brain and spinal column.