Hello,
In short
lymphoma can be considered as cancer of lymphatic glands. It has different types and treatment is different as per different type.Also there are many conditions that can mimic lymphoma. Most common and most prevalent in Indian setting is
Tuberculosis. So getting a appropriate diagnosis is most important when we are suspecting lymphoma.
In a 18 year old girl with long history(as per your doctor), high
ESR and CRP and lung shadows there are 2 most important possibilities.
1. Hodgkins Lymphoma
2. Tuberculosis
In such cases what I do is to
1. Take proper history regarding duration of symptoms and TB contacts
2. Good general examination
3. Lymphnode bipsy with PCR/Staining for AFB as well as IHC for lymphoma
Once a lymphoma is confirmed on
biopsy. Treatment will depend on its type and how advance it is (Stage)
So in your daughters case if we take it as hodgkins lymphoma,It is one of the most curable lymphomas in children. Though it will be stage IV as she has lung nodules. The initial
chemotherapy for hodgkins is standard all over the word which is ABVD (4 chemotherapy drugs). What I do is give 2 cycles of chemotherapy and assess response with PET after 2 cycles. And then decide whether to give 6 or 8 cycles.
I hope this answers your query. If you have any other questions I am happy to answer.
Thank you