title: Clinical manifestations in children with tonsillar lymphoma: A systematic review.
abstract: BACKGROUND
  The lymphoma is the most common childhood malignancy in the head and neck. Approximately 15% of head and neck lymphomas in children affect the Waldeyer's ring. Early diagnosis and treatment are of great importance in the prognosis of tonsillar lymphoma patients.
  
  
  OBJECTIVE
  To realize a systematic review of the literature on the clinical manifestations present at diagnosis of tonsillar lymphoma in pediatric patients.
  
  
  METHODS
  Articles in English, Spanish or Portuguese in the last 15 years about lymphoma in palatine tonsil in children from PubMed/Medline, LILACS, IBECS, Cochrane, SCIELO, BIREME and Scopus.
  
  
  METHODS
  It was included articles and case reports that covered the pediatric age group, up to 18 years old and that contained information of the clinical manifestations of tonsillar lymphoma at diagnosis.
  
  
  RESULTS
  We found 87 articles of which 18 were included; there were 66 cases of lymphoma of palatine tonsils. The most common clinical manifestations found in children with lymphoma in palatine tonsils were unilateral tonsillar enlargement (72.7%), alteration in appearance of the tonsil (45.4%) and cervical lymphadenopathy (30.3%). The presence of B symptoms occurred in only 16% of the patients. Burkitt was the most common type of lymphoma found.
  
  
  CONCLUSIONS
  The most common clinical manifestations of lymphoma in palatine tonsil are the tonsils asymmetry, alteration in the appearance of the mucous and cervical lymphadenopathy. A detailed description of cases of lymphoma in palatine tonsils and the use of criteria for classification of tonsillar asymmetry are important for future revisions.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Brazil. Electronic address: alecgxl2@hotmail.com.
authors.forename: Alexandre Caixeta
authors.initials: AC
authors.lastname: Guimarães
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Brazil.
authors.forename: Guilherme Machado
authors.initials: GM
authors.lastname: de Carvalho
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Brazil.
authors.forename: Lucas Ricci
authors.initials: LR
authors.lastname: Bento
authors.affiliation: Department of Public Health, University of Campinas (UNICAMP), Brazil.
authors.forename: Carlos
authors.initials: C
authors.lastname: Correa
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Brazil.
authors.forename: Reinaldo Jordão
authors.initials: RJ
authors.lastname: Gusmão
mesh_terms: D002648:Child; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D014067:Tonsillar Neoplasms / Q000473:pathology*
keywords: Adolescent; Children; Lymphoma; Tonsil; Tonsillar neoplasm