Twelve Cases of Lymphoblastomata

The primary purpose of this paper is to illustrate the protean symptomatology of a group of growths known collectively as the malignant lymphomata or lymphoblastomata. Much discussion centres on the exact nomenclature of these conditions, and no attempt is made here to elucidate this matter. Gall and Mallory (1942) discuss the problems involved, and suggest a cytological basis for subdivision; Custer and Bernhard (1948) point out that the cellular structure of lymphatic tumours is extremely labile, and that transition from one apparently distinct type to another is frequently seen, so that an absolute cytological diagnosis by biopsy may be very difficult. From the descriptive standpoint, with the exception perhaps of Hodgkin's disease, these conditions are relegated to small sections of the average paediatric textbook, emphasis generally being placed on enlargement of lymph nodes in the symptomatology. Arey (1949) does not discuss Hodgkin's disease or lymphosarcoma, stating that they have their counterparts in adult life. Dargeon (1947) states that the physical signs and symptoms of lymphosarcoma will depend on the anatomical site of the affected structures, and says that the nasopharynx, the tonsil and the cervical, or any other group of nodes, may be involved. In a later study (1953), however, he describes more specific cases, and emphasizes the difficulty of diagnosis and management. Material The cases are drawn from the practice of the University hospitals of the University of Wisconsin. In all 12 cases the diagnosis was established by biopsy, at necropsy, or by both means. The cytological diagnosis was variously stated to be lymphoblastoma, lymphosarcoma or reticulum-cell sarcoma, each thus being included in the lymphomata as described by Gall and Mallory, or represented in the lymphoblastomata of Custer and Bernhard.