Pediatric lymphoma may develop by 'one-step' cell transformation of a lymphoid cell

Lymphomas are a large group of neoplasms developed from lymphoid cells (LCs) in lymph nodes (LNs) or lymphoid tissues (LTs). Some forms of lymphomas, including Burkitt lymphoma (BL), ALK+ anaplastic large cell lymphoma (ALK+-ALCL), and T-cell lymphoblastic lymphoma/leukemia (T-LBL), occur mainly in children and teenagers. Hodgkin’s lymphoma (HL) has a peak incidence at age 20s. To understand pediatric lymphoma, we have recently proposed two hypotheses on the causes and the mechanism of cell transformation of a LC. Hypothesis A is: repeated bone-remodeling during bone-growth and bone-repair may be a source of cell injuries of marrow cells including hematopoietic stem cells (HSCs), myeloid cells, and LCs, and thymic involution may be a source of damage to the developing T-cells in thymus. Hypothesis B is: a LC may have three pathways on transformation: a slow, a rapid, and an accelerated. In this paper, we discuss pediatric lymphomas by this hypothesis. Having a peak incidence at young age, BL, T-LBL, ALK+-ALCL, and HL develop more likely as a result of rapid transformation of a LC. In BL, ALK+-ALCL, and HL, the cell transformations may be triggered by severe viral infections. In T-LBL, the cell transformation may be related to thymic involution. Occurring in both adults and children, diffuse large B-cell lymphoma (DLBCL) may develop via slow or accelerated pathway. In conclusion, pediatric lymphoma may develop as a result of “one-step” cell transformation of a LC, and severe viral infections may be the main trigger for the rapid transformation of a LC in a LN/LT.