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Diagnosing Childhood Lymphoma

A lymph node biopsy is a procedure that removes a piece of lymph node or a whole lymph node for examination under a microscope. Using various tests, the pathologist can determine the type of lymphoma so that the appropriate treatment can be chosen.

Because childhood lymphomas can be difficult to characterize, several tests may have to be done. If the lymph node is superficial (close to the surface of the skin), the biopsy can be done with a local anesthetic, meaning that the biopsy area is numbed, but the patient remains awake. Surgery, in which the patient is put to sleep, may be required if the suspicious lymph node is deeper in the body.

Other tests are conducted to determine the stage of disease. These tests may include:

  • X-rays
  • Ultrasound
  • PET scan
  • MRI
  • CT scan
  • Bone marrow biopsy

If your child has been diagnosed with lymphoma, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.

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  • The Children’s Cancer Hospital is within one of the top-ranked cancer centers in America
  • Access to novel therapies and state-of-the-art technologies before most children’s hospitals
  • We see more types of cancer than any other children’s hospital in Texas
  • Family-centered care that actively involves parents in their child’s treatment
  • A strong cancer research program focused on developing new therapies for pediatric patients
  • Comprehensive support services such as an accredited school program, creative arts, child life and career counseling
  • An Adolescent and Young Adult Program that specializes in the unique medical and psychological needs of patients aged 15-25

Childhood Lymphoma Knowledge Center

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Childhood Lymphoma Staging

(source: National Cancer Institute)

Following a diagnosis of childhood lymphoma, various tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body. The process used to find out if cancer has spread within the lymph system or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

Non-Hodgkin's Lymphoma Staging

The following stages are used for childhood non-Hodgkin's lymphomas, which include Burkitt's lymphoma, lymphoblastic lymphoma and large-cell lymphomas.

Stage I: Cancer is found:

  • In one group of lymph nodes; or
  • In one area outside the lymph nodes.

No cancer is found in the abdomen or mediastinum (area between the lungs).

Stage II: Cancer is found:

  • In one area outside the lymph nodes and in nearby lymph nodes; or
  • In two or more areas above or below the diaphragm, and may or may not have spread to nearby lymph nodes; or
  • To have started in the stomach or intestines and can be completely removed by surgery. Cancer may or may not have spread to certain nearby lymph nodes.

Stage III: Cancer is found:

  • in at least one area above the diaphragm and in at least one area below the diaphragm; or
  • to have started in the chest; or
  • to have started in the abdomen and spread throughout the abdomen, and cannot be completely removed by surgery; or
  • in the area around the spine.

Stage IV: Cancer is found in the bone marrow, brain or cerebrospinal fluid. Cancer may also be found in other parts of the body.

Treatment for childhood non-Hodgkin's lymphoma is based on whether the cancer is low-stage or high-stage: 

  • Low-stage lymphoma has not spread beyond the area in which it began. Stage I and stage II are usually considered low-stage.
  • High-stage lymphoma has spread beyond the area in which it began. Stage III and stage IV are usually considered high-stage.

Recurrent childhood non-Hodgkin's lymphoma is cancer that has recurred (come back) after it has been treated. It may come back in the lymph system or in other parts of the body.

Hodgkin's's Lymphoma Staging

Stages of childhood Hodgkin's lymphoma may include A, B, E, and S:

  • A: The patient has no symptoms.
  • B: The patient has symptoms such as fever, weight loss or night sweats.
  • E: Cancer is found in an organ or tissue that is not part of the lymph system but which may be next to an involved area of the lymph system.
  • S: Cancer is found in the spleen.

Stage I is divided into stage I and stage IE: 

  • Stage I: Cancer is found in one or more lymph nodes in one lymph node group.
  • Stage IE: Cancer is found outside the lymph nodes in one organ or area.

Stage II is divided into stage II and stage IIE: 

  • Stage II: Cancer is found in two or more lymph node groups above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
  • Stage IIE: Cancer is found in one or more lymph node groups above or below the diaphragm and outside the lymph nodes in a nearby organ or area.

Stage III is divided into stage III, stage IIIE, stage IIIS, and stage IIIE+S: 

  • Stage III: Cancer is found in one or more lymph node groups above and below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
  • Stage IIIE: Cancer is found in lymph node groups above and below the diaphragm and outside the lymph nodes in a nearby organ or area.
  • Stage IIIS: Cancer is found in lymph node groups above and below the diaphragm, and in the spleen.
  • Stage IIIE+S: Cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area, and in the spleen.

Stage IV: the cancer:

  • is found outside the lymph nodes throughout one or more organs, and may be in lymph nodes near those organs; or
  • is found outside the lymph nodes in one organ and has spread to lymph nodes far away from that organ; or
  • is found in the lung, liver or bone marrow.

If your child has been diagnosed with lymphoma, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.


© 2014 The University of Texas MD Anderson Cancer Center