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Published on: June 14, 2020
Clinical manifestations in children with tonsillar lymphoma: A systematic review
Alexandre Caixeta Guimarães1, Guilherme Machado de Carvalho1, Lucas Ricci Bento1
1Department of Otolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Brazil.
Insights
Pediatric tonsillar lymphoma often presents as unilateral tonsil enlargement, altered tonsil appearance, and neck lymph nodes. Early recognition of these signs is crucial for better outcomes in childhood head and neck cancers.
Area of Science:
- Pediatric Oncology
- Head and Neck Surgery
- Hematology
Background:
- Childhood lymphoma is a common head and neck malignancy.
- Waldeyer's ring lymphomas account for 15% of pediatric head and neck lymphomas.
- Early diagnosis and treatment are critical for tonsillar lymphoma prognosis.
Purpose of the Study:
- To systematically review the literature on clinical manifestations of tonsillar lymphoma in pediatric patients at diagnosis.
Main Methods:
- Systematic literature review of articles published in English, Spanish, or Portuguese within the last 15 years.
- Databases searched include PubMed/Medline, LILACS, IBECS, Cochrane, SCIELO, BIREME, and Scopus.
- Included studies focused on pediatric patients (up to 18 years) with tonsillar lymphoma, detailing clinical presentation at diagnosis.
Main Results:
- 18 articles and 66 cases of palatine tonsil lymphoma in children were analyzed.
- Most common findings: unilateral tonsillar enlargement (72.7%), altered tonsil appearance (45.4%), and cervical lymphadenopathy (30.3%).
- B symptoms were present in only 16% of cases; Burkitt lymphoma was the most frequent type.
Conclusions:
- Key clinical signs of pediatric tonsillar lymphoma include tonsil asymmetry, altered mucosal appearance, and cervical lymphadenopathy.
- Detailed case reporting and standardized criteria for tonsillar asymmetry are needed for future research.
Background:
The lymphoma is the most common childhood malignancy in the head and neck. Approximately 15% of head and neck lymphomas in children affect the Waldeyer's ring. Early diagnosis and treatment are of great importance in the prognosis of tonsillar lymphoma patients.
Objectives:
To realize a systematic review of the literature on the clinical manifestations present at diagnosis of tonsillar lymphoma in pediatric patients.
Date Source:
Articles in English, Spanish or Portuguese in the last 15 years about lymphoma in palatine tonsil in children from PubMed/Medline, LILACS, IBECS, Cochrane, SCIELO, BIREME and Scopus.
Study Eligibility Criteria:
It was included articles and case reports that covered the pediatric age group, up to 18 years old and that contained information of the clinical manifestations of tonsillar lymphoma at diagnosis.
Results:
We found 87 articles of which 18 were included; there were 66 cases of lymphoma of palatine tonsils. The most common clinical manifestations found in children with lymphoma in palatine tonsils were unilateral tonsillar enlargement (72.7%), alteration in appearance of the tonsil (45.4%) and cervical lymphadenopathy (30.3%). The presence of B symptoms occurred in only 16% of the patients. Burkitt was the most common type of lymphoma found.
Conclusion:
The most common clinical manifestations of lymphoma in palatine tonsil are the tonsils asymmetry, alteration in the appearance of the mucous and cervical lymphadenopathy. A detailed description of cases of lymphoma in palatine tonsils and the use of criteria for classification of tonsillar asymmetry are important for future revisions.
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