Seventeen children with non-Hodgkin's lymphoma observed recently at the Chaim Sheba Medical Center are described. Two clinical forms of the disease are apparent: poorly-differentiated lymphocytic lymphosarcoma presenting with mediastinal and peripheral nodal localization and occasional bone marrow infiltration, and Burkitt's lymphoma. I n the latter, predominantly affecting the Arab population, abdominal localization was, in most cases, the presenting symptom, with CNS and jaw involvement in some patients. The Burkitt's lymphoma patients deteriorated rapidly. No relationship was found between the EB virus antibody titer and the histopathologic or clinical features of the disease. The possible relationship between the high prevalence of childhood non-Hodgkin's lymphoma and abdominal lymphoma with malabsorption on the one hand, and the low prevalence of childhood acute lymphatic leukemia in the Arab population on the other warrants further regional studies.
Cancer 33:1411-1416, 1974.
HILDHOOD NON-HODGKIN'S LYMPHOMA usu-C ally manifests itself in one of two ways.
Firstly, there is Burkitt's lymphoma, with a fairly well defined histologic picture and a restricted geographic distribution; with isolated exceptions, it is extranodal. High titers of Epstein-Barr virus (EBV) antibodies were found in this gr0~p.4.6~733~28 Secondly, there is the usual childhood lymphosarcoma and reticulum cell sarcoma with a wider geographic distribution, nodal localization, and high incidence of transformation to acute
In recent years an increased incidence of Burkitt's lymphoma has been reported beyond the African Continent. These have presented chiefly as abdominal lesions.l~~~g~11~12~'6
We have previously described 16 cases of abdominal lymphoma affecting particularly Jewish children of Oriental origin and Arabs. In 6 of them the histology was indistinguishable from Burkitt's lymphoma.16 This communication describes the clinical picture, histology, and therapy of childhood non-Hodgkin's lymphomas as observed at the leukemia.