n WHAT IS STAGING? Staging is the process of determining the location and amount of the disease at the time of diagnosis. This helps to determine the best treat- ment. The staging system usually used for children with non-Hodgkin lymphoma is called the “St. Jude Staging System” and is divided into four stages. STAGE I There is only one tumor or involved lymph node in one part of the body (such as the neck or underarm). The tumor is not in the chest or the belly. There is no metastasis, and it has not spread to other areas.
STAGE II There is one tumor that has spread to nearby lymph nodes. Another possibility is two or more lymph nodes or tumors located on the same side of the diaphragm (the breathing muscle that separates the chest and belly areas). For example, there might be a lymph node in the neck and one in the underarm but not one in the neck and one in the groin (opposite sides of the diaphragm). Another area of involve- ment may be the intestine. STAGE III There is tumor in the chest or belly that cannot be completely removed by surgery, or there are two or more lymph nodes on both sides of the diaphragm that are affected. Sometimes the tumor may be located near the spine. For example, a lymph node may be located in the neck and groin area. STAGE IV The tumor has spread from its original location to the bone marrow or central nervous system (brain or spinal fluid). n WHAT TESTS AND PROCEDURES WILL MY CHILD NEED? In order to diagnose non-Hodgkin lymphoma and determine the extent of your child’s disease, a number of tests and procedures are necessary. The first step will be a complete history of the illness and a physical examination. Any previous illnesses or organ transplants, as well as immune system problems, should be discussed with the healthcare team. The following tests may be needed. CHEST X RAY A chest X ray is taken to look for enlarged lymph nodes inside the chest or lungs. Efforts will be made to minimize your child’s exposure to X rays. CT SCAN The computed tomography (CT) scan is a computer-assisted X ray that shows detailed pictures of internal organs and tumors. It is a very important and useful test for looking at non-Hodgkin lymphoma in the chest, belly, and pelvis. It is a painless test, but your child must be able to lie still during the scan. Some children require sedation to help them lie still. If your child is having a CT scan of the belly, he or she will be asked to drink a special dye that makes the pictures clearer. Some children may require a small amount
3
Powered by FlippingBook