Non-Hodgkin's lymphoma of the head and neck in childhood.

Non-Hodgkin's lymphomas (NHL) in childhood account for approximately 10% of solid tumors reported for this age group, and almost 10% of all these lymphomas arise in the head and neck. Most head and neck NHL is a B-cell phenotype (70%) and is characterized by diffuse involvement of anatomic structures. Analysis of the cell surface expression of specific molecules of interest, including immunoglobulins, T-cell receptor components, and antigens specific for immunoblastic cells at discrete points in ontogenic development, has resulted in a greater understanding of the origins and biological behavior of childhood lymphomas. This has significance for the surgeon because specialized studies including immunophenotyping, cytogenetics, and Southern analysis require adequate amounts of tissue that has been properly processed after removal from the patient. In addition, because chemotherapy is the mainstay of lymphoma treatment, the surgical oncologist must avoid the postoperative morbidity inherent in en-bloc resection of other malignancies of the head and neck and thereby facilitate initiation of therapy. This article discusses the clinical presentation, imaging, treatment, and outcome of NHL primary in the head and neck region. Individual characteristics peculiar to specific anatomic sites are reviewed.