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Stages of Childhood Non-Hodgkin Lymphoma

Key Points

  • After childhood non-Hodgkin lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body.
  • There are three ways that cancer spreads in the body.
  • The following stages are used for childhood non-Hodgkin lymphoma:
    • Stage I
    • Stage II
    • Stage III
    • Stage IV

After childhood non-Hodgkin lymphoma has been diagnosed, 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 results of tests and procedures used to diagnose non-Hodgkin lymphoma may also be used for staging. See the General Information section for a description of these tests and procedures. 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.

The following procedure also may be used to determine the stage:

  • Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood :

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

The following stages are used for childhood non-Hodgkin lymphoma:

Stage I

Stage I childhood non-Hodgkin lymphoma; drawing shows cancer in one group of lymph nodes. An inset shows a lymph node with a lymph vessel, an artery, and a vein. Lymphoma cells containing cancer are shown in the lymph node.
Stage I childhood non-Hodgkin lymphoma. Cancer is found in one group of lymph nodes or one area outside the lymph nodes, but no cancer is found in the abdomen or mediastinum (area between the lungs).

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

Stage II childhood non-Hodgkin lymphoma; drawing shows cancer in lymph node groups above and below the diaphragm, in the liver, and in the appendix. The colon and small intestine are also shown.  An inset shows a lymph node with a lymph vessel, an artery, and a vein. Lymphoma cells containing cancer are shown in the lymph node.
Stage II childhood non-Hodgkin lymphoma. Cancer is found in one area outside the lymph nodes and in nearby lymph nodes (a); or in two or more areas above (b) or below (c) the diaphragm; or cancer started in the stomach, appendix, or intestines (d) and can be removed by surgery.

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

Stage III childhood non-Hodgkin lymphoma; drawing shows cancer in lymph node groups above and below the diaphragm, in the chest, and throughout the abdomen in the liver, spleen, small intestines, and appendix. The colon is also shown. An inset shows a lymph node with a lymph vessel, an artery, and a vein. Lymphoma cells containing cancer are shown in the lymph node.
Stage III childhood non-Hodgkin lymphoma. Cancer is found in at least one area above and below the diaphragm (a); or cancer started in the chest (b); or cancer started in the abdomen and spread throughout the abdomen (c); or in the area around the spine (not shown).

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; or
  • in the area around the spine.

Stage IV

Stage IV childhood non-Hodgkin lymphoma; drawing shows the brain, spinal cord, and cerebrospinal fluid in and around the brain and spinal cord. An inset shows cancer in the bone marrow.
Stage IV childhood non-Hodgkin lymphoma. Cancer is found in the bone marrow, brain, or cerebrospinal fluid (CSF). Cancer may also be found in other parts of the body.

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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