Lymphoma occurs when a lymphocyte mutates at some point in its development. This cell starts multiplying rapidly, crowding out healthy immune system cells.

The two types of lymphocytes that can turn into lymphoma are:

• T cells, which help the immune system respond to disease and directly kill abnormal cells.
• B cells, which produce antibodies that recognize and attack foreign substances like bacteria and viruses.

Parts of the lymphatic system

The lymphatic system plays a key role in the development and spread of lymphoma. There are several parts of this system. They include:

Lymph: A fluid that carries lymphocytes throughout the body via lymph vessels.

Lymph vessels: Tiny vein-like structures found throughout the body. They carry lymph from place to place and connect to the lymph nodes.

Lymph nodes: Tiny, bean-shaped masses found throughout the body, including in the underarm, pelvis, neck, abdomen and groin. They filter lymph and store white blood cells to help the body fight disease. Lymphoma cells gather in lymph nodes, causing them to swell.

Spleen: An organ on the left side of the abdomen that makes lymphocytes, stores blood cells and gets rid of old blood cells.

Thymus: Located in the chest, this tiny organ stores lymphocytes.

Tonsils: Nodes in back of throat that produce lymphocytes.

Bone marrow: A spongy material in bones that produces blood cells.

Lymphoma types

Lymphoma is classified by how the cells appear under a microscope. There are two main categories: Hodgkin lymphoma and non-Hodgkin lymphoma.

Hodgkin lymphoma

Hodgkin lymphoma is defined by the presence of Reed-Sternberg cells. These are large cells that can have more than one nucleus. These cells grow and divide more quickly and live longer than normal cells.

Reed-Sternberg cells also produce substances that encourage more healthy cells to gather in the lymph nodes. These healthy cells then produce substances that encourage the growth of Reed-Sternberg cells.

There are several subtypes of Hodgkin lymphoma, but the vast majority are classical Hodgkin lymphoma. The five-year survival rate for Hodgkin lymphoma patients under age 20 is about 98%.

Non-Hodgkin lymphoma

Non-Hodgkin lymphoma (NHL) does not have Reed-Sternberg cells. There are several subtypes of NHL, including:

• Burkitt's lymphoma (BL). This disease affects B cell lymphocytes. It is one of the fastest-growing cancers.
• Lymphoblastic lymphoma (LBL). LBL mostly affects T cell lymphocytes and is similar to acute lymphoblastic leukemia (ALL). It makes up about one-third of all childhood NHL, and is more common in boys.
• Large cell lymphoma (LCL), which includes two subtypes: diffuse large B-cell lymphoma (DLBCL) mostly affects pre-adolescent and teens; and anaplastic large cell lymphoma (ALCL) is more common in adolescents.

Doctors also classify NHL by how fast it spreads. Nearly all cases of pediatric NHL are an aggressive form of the disease. Despite this, the five-year survival rate for children and adolescents with NHL is about 90%.

Childhood lymphoma risk factors

A risk factor is anything that increases the chances of a person developing a disease. 

There are many different types of lymphoma, so not every risk factor applies to every type. Most pediatric lymphoma patients don't have any of the risk factors listed here (other than race and sex). Nonetheless, the disease's risk factors include:

• Sex: Hodgkin lymphoma is more predominant in males than females.
• Race: White people are more likely to contract the disease than other groups.
• Infections including Epstein-Barr virus (which causes mononucleosis), and HIV
• Immune system diseases, including lupus and rheumatoid arthritis
• Immune deficiency syndromes, including:
  • Ataxia-telangiectasia
  • Bloom syndrome
  • Common variable immunodeficiency
  • Severe combined immunodeficiency syndrome (SCID)
  • Wiskott-Aldrich syndrome
• Taking immunosuppressants due to organ transplant
• Having a parent or sibling with the disease

Some cases of lymphoma can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.

Why come to MD Anderson for childhood lymphoma  care?

Selecting a hospital is the first big choice a family makes after a cancer diagnosis. MD Anderson’s Children’s Cancer Hospital offers childhood lymphoma patients the most advanced treatments from an expert team, along with support services designed to help the entire family through their cancer journey.

This journey starts with a highly detailed diagnosis of each patient’s lymphoma. Through the skills of our leading pathologists, MD Anderson is able to quickly pinpoint alterations in the cancer cells. This information can be used to develop treatment plans tailored to each individual patient.

These treatment plans are created by our multidisciplinary team of physicians working together to benefit each patient. Among these physicians are leading medical oncologists who focus exclusively on treating childhood lymphoma and related conditions, and specialists from one of the largest stem cell transplantation services in the country.

While here, pediatric lymphoma patients have access to clinical trials for children, teens and even adults. In addition, the Children’s Cancer Hospital offers supportive care services designed to improve your child’s quality of life, such as counseling and symptom management. Patients also have access to support programs like our arts in medicine activities, summer camps and support groups. We even have an accredited, in-hospital school that helps patients meet their academic goals while in treatment.