Risk Groups In addition to staging, Hodgkin lymphoma is divided into risk groups based on information obtained during staging, the size and location of the tumor, and whether the patient has “B” symptoms. Once the risk group is determined, the treatment team will use this information to decide which type of treatment is needed.
n WHICH TESTS AND PROCEDURES WILL MY CHILD NEED? Several tests are necessary to diagnose Hodgkin lymphoma and determine the extent of your child’s disease. The lymph nodes, chest, and abdomen will be examined. An enlarged spleen or liver may indicate Hodgkin lymphoma is present in those organs. The presence of small, soft lymph nodes in children may be misleading because only lymph nodes that have been increasing in size or that are significantly enlarged are a concern. To determine the best treatment possible, it is very important to identify the exact type of Hodgkin lymphoma and where it is located in the body. Your child’s physician will decide which tests and procedures are needed.
Most Commonly Performed Tests and Procedures
TISSUE BIOPSY The removal of all or part of a lymph node or other tissue is necessary to diagnose Hodgkin lymphoma. A lymph node tissue biopsy can be performed either in an operating room or in the hospital’s radiology department. Your child’s comfort and anxiety level always will be considered when planning procedures that involve needles. Once the biopsy sample is obtained, a pathologist will examine the tissue under a microscope to look for cancer cells, specifically Hodgkin Reed-Sternberg cells, which are common abnormal lymphocytes in Hodgkin lymphoma.
X-RAY EXAMINATION A chest X-ray, which takes a picture of the organs and bones inside the chest, may be necessary to determine whether Hodgkin lymphoma is present in the upper middle area of the chest (the mediastinum). This is the area just above the heart but below the neck, and it is a common site for Hodgkin lymphoma. A chest X-ray also can help determine if the lungs are affected. CT SCAN A computerized axial tomography (CT) scan is a computer-assisted X-ray that provides very detailed images of areas inside the body from different angles. The scan is painless and quick, but your child must be able to lie completely still during the scan. Younger children may require sedation to help them lie still. Your child may not be allowed to eat or drink for several hours before the exam. To make the CT images clearer, it also may be nec - essary for your child to have a small amount of dye injected into a vein or to drink a liquid containing a flavorless dye. Typically, side effects do not occur from either type of dye, although allergic reactions are possible. These scans are obtained at the time of diagnosis and at different times during treatment to determine how your child is responding to it.
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