Signs and Symptoms of Lymphoma in Children

Lymph nodes in the neck, collarbone area, underarms, or groin

When lymph nodes in the neck, collarbone area, underarms, or groin are enlarged they may be seen or felt as lumps under the skin. They are often first noticed by the child, their parent, or a health care provider.

Enlarged lymph nodes in children are more often caused by infections than by lymphoma.

If a lymph node is enlarged because of an infection:

• It is called a reactive or hyperplastic node.
• When you touch it, it may be tender and will likely move around under your fingers and feel like rubber.
• It may be treated with antibiotics, if needed.
• It usually goes away within days or weeks.

If a lymph node is enlarged because of lymphoma:

• It is usually painless and hard.
• It may feel stuck or matted down when you touch it.
• It doesn’t go away with time.

Lymph nodes in other areas of the body

Lymph nodes are also found in the chest, belly, and pelvis. Enlarged lymph nodes in these areas often can’t be felt or seen, but they may cause other symptoms (see below).

When a child has lymphoma in their abdomen, it can cause some of these symptoms:

Swelling or pain in the abdomen. Lymphoma growing inside a child’s abdomen can cause swelling or pain. Lymphoma can also cause fluid to build up, resulting in even more swelling.

Low appetite and feeling full after only a small meal. This can happen if lymphoma causes an enlarged spleen, which presses on the stomach.

Belly pain, nausea, and vomiting. Lymphoma can cause swelling in or near a child’s stomach or intestines. This might block bowel movements (poop) and lead to belly pain, nausea, and vomiting. A blocked bowel is called an obstruction. It needs to be treated right away.

Low urine output. Lymphoma might also block urine. This can cause a child to urinate less than usual.

Lymphoma can develop in a child’s thymus, which is a small organ in the middle of the chest. It can also develop in lymph nodes in the chest. When lymphoma in the chest is large, it is called a mediastinal mass.

Mediastinal masses can be dangerous if they press on a child’s heart, nearby blood vessels, or trachea (windpipe). This can cause:

Swelling and redness of the head and neck (SVC syndrome). Lymphoma can block blood flow if it presses on the blood vessels and heart. In severe cases, a large vein called the superior vena cava may be blocked, resulting in superior vena cava (SVC) syndrome. 

This vein usually drains blood from the head and neck to the heart. When it is compressed, blood backs up in the veins, causing swelling in a child’s face, neck, arms, and upper chest. Sometimes the skin is a bluish-red color.

This backup of blood can cause fluid buildup on the heart and lungs, trouble breathing, headaches, dizziness, confusion, blurry vision, and fainting. SVC syndrome can be life-threatening, so it needs to be treated right away.

Trouble breathing or lying flat. Mediastinal masses can also press on a child’s trachea (windpipe) causing coughing, wheezing, shortness of breath, or difficulty breathing. If a child has a mediastinal mass, any anesthesia must be given with caution or avoided when possible. Anesthesia is medicine used to put you to sleep for procedures like surgery.

Some types of lymphoma can spread to the area around the brain and spinal cord. This can cause problems such as:

• Headache
• Nausea
• Vision changes 
• Facial numbness 
• Trouble talking
• Weakness, numbness, or loss of bowel and bladder control (spinal cord compression)

Spinal cord compression can be life-threatening and needs to be treated right away.

Some lymphomas can affect the skin itself. This can cause itchy, red or purple lumps or nodules under the skin.