Cancer of the lymphatic system, caused by the Epstein–Barr virus


  • Abdominal swelling.
  • Distortion of facial bones.
  • Night sweats.
  • Intestinal obstruction.
  • An enlarged thyroid.
  • enlarged tonsils
  • Nausea and vomiting
  • Loss of appetite, change in bowel habits, or both
  • Gastrointestinal bleeding
  • Signs and symptoms of acute abdomen
  • Intestinal perforation
  • Renal failure
  • drenching sweats, especially at night
  • tiredness or fatigue
  • fever and flu-like symptoms, and
  • loss of appetite and weight loss
  • anemia, causing shortness of breath and tiredness


  • Genetics
  • Exposure to viral infections
  • Non-Hodgkin’s lymphoma
  • Epstein-Barr virus (EBV)

Risk factors:

  • vary according to geographic location
  • most common childhood cancer
  • regions where there is a high incidence of malaria (Africa)
  • greatest risk factors are HIV and AIDS
  • incidence is higher: North Africa,the Middle East, South America
  • Gender: more common in males

Diagnostic tests:

  • Bone marrow biopsy
  • Chest x-ray
  • CT scan of the chest, abdomen, and pelvis
  • Complete blood count (CBC)
  • Examination of the spinal fluid
  • Lymph node biopsy
  • PET scan
  • MRI

Differential diagnostics

  • Lymphoblastic lymphoma
  • Blastic mantle cell lymphoma
  • Prolymphocytic SLL/CLL
  • Acute Lymphoblastic Leukemia (ALL)
  • Diffuse Large Cell Lymphoma
  • Follicular Lymphoma
  • Lymphoblastic Lymphoma
  • Mantle Cell Lymphoma
  • Neuroblastoma
  • Pediatric Neuroblastoma
  • Wilms Tumor


  • Intravenous chemotherapy
  • combination chemotherapy
  • Radiation treatment used with chemotherapy
  • Intrathecal chemotherapy
  • The monoclonal antibody rituximab along with chemotherapy
  • Bone marrow transplant
  • Preventing complications such as tumour lysis syndrome
  • Autologous stem cell transplantation
  • Radiation therapy
  • Steroid therapy


Drugs used in various combinations:

  • Cyclophosphamide (Cytoxan)
  • cytarabine (Cytosar-U, Tarabine PFS)
  • doxorubicin (Adriamycin)
  • etoposide (Etopophos, Toposar, VePesid)
  • methotrexate (Rheumatrex)
  • vincristine (Oncovin)
  • Rituximab (Rituxan)
  • Other medications:
  • Glucocorticoids (eg, prednisone)
  • Urate-oxidase enzymes (eg, rasburicase)

Lifestyle Management:

  • Supportive therapy
  • Factors that increase the risk of HIV infection- to be lowered
  • Genetic counseling