Lymphomas in childhood

Lymphomas are derived from precursor lymphocytes by oncogenic changes that induce deregulation of growth factors. Lymphomas consist of clonal cells which are prone to further oncogenic changes. Clonal neoplastic expansions are often apparent as discrete masses and therefore these settings are the most challenging to recognize as lymphoma. Approximately seven types of childhood’s lymphomas are most frequent with clearly defined diagnostic criterias: lymphoblastic leukemia/lymphoma, large B- cell lymphoma (DLBCL) of the mediastinum, Burkitt’s lymphoma (BL), Hodgkin’s lymphoma(HL) and anaplastic large cell lymphoma – CD30+/ALK+(ALCL/CD30+/ALK+). However, some rare entities, i.e. a small cell variant of ALCLK CD30+/ALK+, hepatospenic and natural killer cell T-like lymphomas, require early diagnosis because of their highly aggressive clinical course. Therefore the components of diagnostic interpretation in pediatric hematopathology should be to establish a diagnosis that is appropriate for clinical setting that is timely and holds over time. To achieve that it is necessary to optimize tissue processing. The sophisticated studies available require sophisticated initial selection of tissue samples based either on clinical or gross examination. Finally, the most important thing is to maintain a collegial and professional relationship with clinicians. Clinical interpretation of symptoms, the distribution of disease and course of illness are invaluable in diagnosis and should always be taken into account in consideration of diagnosis.

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