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Based on the Swiss Pediatric Oncology Group (SPOG) cancer registry data during 1981–1991, a high average incidence of 8 new NHL per million children younger than 15 years per year was found. Of 162 children with NHL registered in 1976–1991, 120 were study patients, i.e., officially registered and treated according to SPOG or Pediatric Oncology Group (POG) protocols, while 42 were non-study patients, i.e., patients not officially enrolled on protocols. Overall, 91 of 120 (76%) study patients remained alive. Seventy-nine study patients were treated according to older SPOG protocols, and 53 (67%) of these survived, while 38 of 41 (93%) study patients treated according to newer POG protocols remained alive (P = 0.0068). Only 22 (52%) of the 42 non-study patients survived (P = 0.0001). There was no improvement if the survival of non-study patients before and since 1986 was compared. Population-based treatment results in Switzerland were similar to those in the United Kingdom. They provided an important base for the development of future treatment strategies. © 1995 Wiley-Liss, Inc.

Data pertaining to primary and secondary osseous involvement in pediatric non-Hodgkin's lymphoma (NHL) are scarce in English literature. Fifty-nine cases of childhood NHL over a period of 3·5 years were reviewed out of which eight had bone involvement, the incidence of skeletal involvement being 13·6%. There were seven males (87·5%) and mean age was 9·9 years (range: 1–15 years). Two patients (25%) had primary bone lymphoma and six cases (75%) were classified as secondary bone lymphoma. Six patients who opted for treatment received chemotherapy; 4/6 (67%) patients are in complete remission at a median follow-up of 41 months (range 19–44 months). Bone involvement was more common in relapsed cases in comparison to de novo presentations.

In this study an attempt is made to propose a working clinical classification and staging of adult non-Hodgkin's lymphoma (NHL) which brings out both primary site and extent of disease. Unlike childhood NHL, where histopathology is uniformly of unfavourable type, this clinical staging system seems to have a prognostic value when applied with reference to different histology groups of working formulation. Based on the experience of staging of childhood NHL as proposed earlier, 304 cases of adult NHL above 14 years of age seen at Kidwai Memorial Institute of Oncology, Bangalore, India, over a period of 5 years (1981-1985) are first categorized according to primary site (initial bulky site at presentation): (1) peripheral nodal (n = 181; (2) extranodal (excluding gastrointestinal tract; n = 48); (3) abdominal (including gastrointestinal tract; n = 46), and (4) mediastinal (n = 29). Each group is further staged according to the extent of the disease. Once categorized into various clinical groups, the Ann Arbor Clinical staging fits very well only with the peripheral nodal group, the major group, although not suitable for other clinical groups.

The types of childhood non-Hodgkin lymphoma (NHL) differ considerably from Hodgkin lymphoma and NHL seen in adults, both pathologically and clinically. Essential to understanding these differences is a knowledge of the three major histologic subtypes (undifferentiated, lymphoblastic, and large cell) that account for the vast majority of cases of pediatric NHL. Each of these subtypes has typical imaging and clinical features. The most common subtype, undifferentiated NHL, usually shows intraabdominal disease. Lymphoblastic tumors most frequently manifest as a mediastinal mass, perhaps with respiratory or circulatory compromise. Large cell tumors show heterogeneous clinical and imaging features but tend to spare the anterior mediastinum. Knowledge of the appropriate imaging modality to be used in evaluation of these tumors is also important. Computed tomography (CT) is the primary imaging modality for staging childhood NHL. Magnetic resonance imaging is best for examination of the central nervous system and bone involvement. Ultrasonography may be useful as a complementary study to abdominal CT; gallium scintigraphy also plays an adjunctive role to CT. Familiarity with typical and atypical patterns of tumoral behaviors and optimal imaging methods aid in the diagnosis and appropriate follow-up of these tumors.

Twenty-five children with previously untreated stage IV non-Hodgkin's lymphoma (NHL) were studied. At the time of evaluation 16 patients were disease-free (64%), with a median observation time of 23 months. Intensive chemotherapy for childhood NHL provides a better outlook for these patients, including those who would be considered high-risk acute lymphoblastic leukemia (ALL).

The histopathologic classification of non-Hodgkin’s lymphoma (NHL) is discussed in relation to age and sex of 62 children under the age of 15 yr. NHL was less common than Hogkin’s lymphoma in the ratio of 6:7. Male patients were six times commoner than female patients. This male preponderance was seen in all histologic subtypes. The youngest child was 6 months of age The peak incidence was in 6–10 yr age group. Nodular lymphomas were rare constituting only 3.2% of total NHL Diffuse poorly differentiated lymphocytic lymphcma was the commonest subtype in all age groups. Childhood NHL showed greater male preponderance and diffuse pattern as compared to adult NHL Starry-sky appearance in non-Burkitt NHL was noted and was related to soft tissue infiltration.