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Abdominal manifestations of non-Hodgkin's lymphomas
C M Kullendorff1, E Arnbjörnsson, T Wiebe
1Department of Pediatric Surgery, University Hospital, Lund, Sweden.
Insights
This study reviewed 25 pediatric non-Hodgkin
Area of Science:
- Pediatric Oncology
- Surgical Pathology
Background:
- Non-Hodgkin's Lymphoma (NHL) is a significant diagnosis in children.
- Intraabdominal NHL presents unique diagnostic challenges.
Purpose of the Study:
- To analyze the clinical presentation and diagnostic approaches for intraabdominal NHL in children.
- To evaluate the role of surgical interventions in diagnosing pediatric intraabdominal NHL.
Main Methods:
- Retrospective review of 25 pediatric non-Hodgkin's lymphoma cases diagnosed between 1982-1990.
- Detailed analysis of presenting symptoms, diagnostic procedures, and surgical findings in 6 patients with intraabdominal NHL.
Main Results:
- Six pediatric patients were diagnosed with intraabdominal NHL.
- Presenting symptoms included abdominal pain, nausea, distention, jaundice, and diarrhea.
- Laparotomy was performed in 4 cases prior to diagnosis, with conclusive NHL diagnosis in 4 of 6 cases via peroperative histology.
- Tumor locations varied, including porta hepatis and ovary, with peritoneal involvement in some cases.
Conclusions:
- Intraabdominal NHL in children requires careful diagnostic consideration.
- Peroperative histological examination is crucial for timely diagnosis.
- Staging laparotomy, palliative resection, and radical surgery should be avoided; adequate biopsy is paramount.
- Multidisciplinary management is essential for pediatric NHL patients.
Abstract:
25 children (18 boys and 7 girls) were treated for non-Hodgkin's lymphomas (NHL) during 1982-1990. The age at diagnosis was 2-15 years. Five of the 25 children died. Of the 25 children 6 patients had the diagnosis of intraabdominal NHL. The presenting abdominal symptoms for these 6 patients were abdominal pain in 4 cases, nausea 3, abdominal distention 2, icterus 1 and diarrhoea 1. Four of the 6 patients with abdominal NHL underwent laparotomy but the diagnosis was unknown before surgery. The indication for explorative laparotomy was in all cases a tumor of unknown etiology combined with ascites in 2 cases and icterus in 1 case. At surgery there was a tumor localized around the porta hepatitis in 1 case and in the right ovarium in 1 case. Furthermore, spread infiltrative growth of tumor was found in 3 cases, with infiltration of the peritoneum in 2 of these cases. A specimen for peroperative histological examination was taken and gave the conclusive diagnosis of NHL in 4 of 6 cases. Staging laparotomy, palliative tumor resection and radical surgery are preferably avoided. For proper treatment an adequate biopsy is important. The management of children with NHL is a multidisciplinary approach.