Childhood Lymphoma Diagnosis

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Childhood Lymphoma Diagnosis

Accurate and precise diagnosis of lymphoma helps doctors choose the best course of treatment for their patients.

At MD Anderson, our group of experts is among the most experienced and skilled in the nation in diagnosing lymphoma. In fact, we are one of the few cancer centers with hematopathologists, specialized doctors who focus on diagnosing lymphoma and other blood cancers. They use the most modern equipment to find out the precise extent of disease. This can make a huge difference in accurate diagnosis and successful treatment.

Lymphoma diagnostic tests

If a child has symptoms that may signal lymphoma, their doctor will perform a medical exam and gather information on their family��s medical history.

One or more of the following tests may be used to find out if the patient has cancer and if it has spread. These tests also may be used to find out if treatment is working.

Lymph node biopsy: The entire lymph node or a piece of lymph node is removed and examined under a microscope.
Imaging tests, which may include:
- X-rays
- CT or CAT (computed axial tomography) scans
- PET (positron emission tomography) scans
- MRI (magnetic resonance imaging) scans
Blood tests: These are conducted to determine if blood cells are normal in number and appearance, and if blood chemistry is normal.
Bone marrow aspiration and biopsy: During this procedure, doctors use a long needle to remove bone marrow from a large bone, usually the pelvic bone.
Liver and kidney function tests: These tests can help diagnose the disease and support the prognosis.
Echocardiogram and pulmonary function tests: These tell doctors how well the heart (echocardiogram) and lungs (pulmonary function tests) are working before treatment begins. This information tells doctors how intense a patient��s treatment can be.
Immunophenotyping: Immunophenotyping tests are carried out on blood or tissue samples taken from the patient. These tests help determine the patient��s exact type of lymphoma. Doctors use this information to plan the best possible treatment.

Some types of lymphoma can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.

Childhood Lymphoma Staging

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. Doctors use the stage to help plan treatment.

Childhood Hodgkin lymphoma stages

(Source: )

Stage I

Stage I childhood Hodgkin lymphoma. Cancer is found in one or more lymph nodes in a group of lymph nodes or, in rare cases, cancer is found in the Waldeyer��s ring, thymus, or spleen. In stage IE (not shown), cancer has spread to one area outside the lymph system.

Stage I is divided into stage I and stage IE.

Stage I: Cancer is found in one of the following places in the lymph system:
- One or more lymph nodes in one lymph node group.
- Waldeyer's ring.
- Thymus.
- Spleen.
Stage IE: Cancer is found outside the lymph system in one organ or area.

Stage II

Stage II is divided into stage II and stage IIE.

Stage II: Cancer is found in two or more lymph node groups either above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
Stage IIE: Cancer has spread from a group of lymph nodes to a nearby organ that is outside the lymph system. Cancer may have spread to other lymph node groups on the same side of the diaphragm.

Stage III

In stage III, the cancer is found:

in lymph node groups above and below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen); or
in lymph node groups above the diaphragm and in the spleen.

Stage IV

In stage IV, the cancer:

has spread throughout one or more organs outside the lymph system and may be in lymph nodes near those organs; or
is found in two or more groups of lymph nodes that are on the same side of the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen) and in an organ that is outside the lymph system and not near the affected lymph nodes; or
is found in groups of lymph nodes on both side of the diaphragm and in any organ that is outside the lymph system; or
has spread to the lungs, liver, or bone marrow from areas far away.

In addition to the stage number, the letters A, B, E, or S may be noted

The letters A, B, E, or S may be used to further describe the stage of childhood Hodgkin lymphoma.

A: The patient does not have B symptoms (fever, weight loss, or drenching night sweats).
B: The patient has B symptoms.
E: Cancer is found in an organ or tissue that is not part of the lymph system but which may be next to an area of the lymph system affected by the cancer.
S: Cancer is found in the spleen.

Childhood non-Hodgkin lymphoma stages

(Source: )

Stage I

In stage I childhood non-Hodgkin lymphoma, 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

In stage II childhood non-Hodgkin lymphoma, cancer is found:

in one area outside the lymph nodes and in nearby lymph nodes; or
in two or more areas either above or below the diaphragm, and may have spread to nearby lymph nodes; or
to have started in the stomach or intestines and can be completely removed by surgery. Cancer may have spread to certain nearby lymph nodes.

Stage III

In stage III childhood non-Hodgkin lymphoma, 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

In stage IV childhood non-Hodgkin lymphoma, cancer is found in the bone marrow, brain, or cerebrospinal fluid. Cancer may also be found in other parts of the body.

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