Lymphomas, important malignancyin childhood, are classified as Non Hodgkin Lymphoma (NHL) and Hodgkin Disease (HD), and are distinct according to age, stage at diagnostic, organ involvement and histology particularity.
In children imaging modalities including conventional X-ray, Ultrasound (US), CT and MRI are excellent tools for evaluating the extent and sites of disease. We show here the spectrum of US imaging findings in lymphomas and its importance for biopsy guidance, complications, emergency situations, staging for optimal therapy and response evaluation.
In Children: HD present as painless lymphadenopathy in neck and chest. Mediastinal adenomegaly may cause respiratory problem. Abdomen is the most common site of NHL and B cell Lymphoma like Burkett Lymphoma. Palpable mass, weight loss or obstruction is frequent signs of presentation.
US shows visceral mass in the liver, spleen, pancreas, and hypo echoic lymph nodes, and involvement of the of the bowel wall. Intussusceptions may occur and may be demonstrated by US. Renal involvement when present appears as focal hypo echoic mass or diffuse infiltration. US is useful to show pelvic organs and superficial involvement: parotid, thyroid Brest, testis etc…
MRI should be used for evaluation of brain or spinal cord involvement Bone Radiographs are performed if any sign suspecting bone involvement exists. Chest X-ray will show mediastinal location which can be identified by US. Experience is limited in our countries of Isotope studies.
Chest X-ray, OR L examination, abdominal US and fine needle biopsy are sufficient in 90% of cases to start urgent treatment After initial staging, US allows the aassessment of treatment response, it is useful if any complication, release or relapse is suspected.