Diagnosis and Stages of Pediatric Hodgkin’s Lymphoma

Diagnosis

Getting a proper diagnosis for any disease or illness is extremely important whenever any symptoms appear. If a doctor suspects the presence of cancer, they will take all the required steps to reach an accurate diagnosis.

Blood and Urine Tests

Testing a patient’s blood and urine is a necessary step in diagnosing a disease, and they’re always used to diagnose Hodgkin’s lymphoma. These tests allow the doctor to see whether certain cells, chemicals, and proteins are present in the patient’s body.

While these tests can’t diagnose Hodgkin’s lymphoma, they can show whether there are any abnormalities in the patient’s bloodstream and urine that might be an indication of cancer.

Imaging Tests

Imaging tests are another important part of diagnosing cancer, especially when there is a tumor present like there is in Hodgkin’s lymphoma. These imaging tests are used to determine where exactly the tumor is present and to see whether the cancer has spread through the rest of the body.

Computed Tomography (CT) Scan

A CT scan takes cross-sectioned 3D images of the body from multiple angles, and it does so with the use of X-ray technology. They help doctors visualize the tumor in terms of its size and location.

Magnetic Resonance Imaging (MRI)

An MRI also takes ross-sectioned 3D images, and it does this with the use of strong magnetic waves. With an MRI, the doctor can take images of the body’s internal structures and see whether there are cancerous growths on the patient’s organs or tumors.

Positron Emission Tomography (PET) Scan

PET scans are a type of imaging test that can be performed only after a patient is injected with a small amount of a slightly radioactive substance. After that substance, known as sugar, is absorbed into their bloodstream, a doctor will use a special camera to take pictures of the patient’s body.

This camera is able to detect which cells have absorbed more or less of the substance. Since cancerous areas absorb this material more than healthy ones, this is a great way to determine what areas of the body are cancerous.

X-ray Scan

X-ray scans take images of the patient’s body with a beam of X-rays that are directed throughout the body. Different tissues absorb these rays differently depending on their structure, and so this imaging test is good for detecting swollen lymph nodes.

Bone Marrow Aspiration and Biopsy

A bone marrow aspiration and biopsy are performed to stage a patient’s Hodgkin’s lymphoma. If this disease spreads throughout the body, one of the areas it can spread is to the bone marrow, and the best way to determine whether this happened is to perform a bone marrow biopsy.

During the aspiration stage, a medical professional will remove part of the bone marrow, and during the biopsy, a pathologist will examine it under the microscope to look for the presence of a tumor.

Lymph Node Biopsy>

The only way a doctor can confirm with certainty that the patient is suffering from Hodgkin’s lymphoma is to perform a lymph node biopsy. This is a procedure during which a small sample of cells is removed from an enlarged lymph node with a thin and hollow needle.

The removed sample is then analyzed in a lab by a pathologist under a microscope. This medical professional will be able to determine the presence of Hodgkin’s lymphoma and its staging.

Staging

Staging cancer is important because it allows the doctors in charge of the case to determine the patient’s prognosis, establish a treatment plan and monitor how the disease is progressing.

There are two different ways doctors look at staging for Hodgkin's lymphoma and they assign staging letters and staging numbers.

A vs. B vs. E vs. S Staging Letters

Staging letters are used to describe certain characteristics of the lymphoma and provide additional information about it. There are two categories of letters: A and B, and E and S.

• Stage A vs. B: Asymptomatic patients are characterized as being in stage A, while those with symptoms are in stage B. Some of the common symptoms those with stage B lymphoma experience include a high fever, night sweats and unexplained weight loss.


• Stage E vs. S: As already mentioned, Hodgkin's lymphoma can spread to other parts of the body or it can stay in the area where it first appeared. If it has the E marking, that means it has spread to an extranodal site near the original area. The S stage indicates that the cancer is localized to the patient’s spleen.

In addition, Hodgkin's lymphoma is divided into four stages, and the higher the number, the more severe the disease is and the more it’s spread throughout the body.

• Stage 1 Hodgkin's lymphoma: The lymphoma is still contained in the area where it first appeared, and it only affects one organ or site.


• Stage 2 Hodgkin's lymphoma: The lymphoma is located in two or more lymph node regions, but the tumor sites are still on one side of the diaphragm.


• Stage 3 Hodgkin's lymphoma: When the lymphoma enters stage 3, the lymph nodes can be found on both sides of the diaphragm (both above and below it).


• Stage 4 Hodgkin's lymphoma: In its final and most severe stage, Hodgkin's lymphoma has spread to one or more organs far from its original site. The areas where it can spread include the bone marrow, liver and lungs.

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