Obstructive jaundice secondary to lymphoma in childhood

In children, biliary obstruction secondary to lymphoma is rare. Previous re ports in adults and children suggest that these lymphomas are associated wi th a poor prognosis. The authors reviewed the medical records and imaging s tudies of 4 children treated for pancreaticobiliary lymphoma at our childre n's hospital over the past 10 years. All 4 presented with jaundice. Abdomin al ultrasound scan and computed tomography (CT) scans were helpful in defin ing the anatomy of the obstruction. In the cases of involvement of the port a hepatis, the diagnosis was made by biopsy. In one child a mass was in the head of the pancreas, and evaluation of frozen section biopsy results were not diagnostic for lymphoma, and a major resection was performed. All the lymphomas were of nonHodgkin's B-cell type and one was a Burkitt's lymphoma , All responded promptly to chemotherapy. One child had a testicular relaps e and currently is receiving additional therapy. Pancreaticobiliary lymphom as are an unusual cause of obstructive jaundice in children. Biopsy alone w ithout resection or biliary drainage is recommended surgical therapy. Long- term survival rate in children with this disorder appears to be more promis ing than previously reported. Copyright (C) 2001 by WB. Saunders Company.