Childhood Lymphoma Diagnosis

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. 

(Source: National Cancer Institute)

Non-Hodgkin lymphoma staging

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

Stage 1: 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 2: 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 3: 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 4: 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 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 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 lymphoma staging

Stages of childhood Hodgkin 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 1 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 2 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 3 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 4: 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