Diagnosing

Pediatric Non-Hodgkin Lymphoma (NHL)


Diagnosing Pediatric Non-Hodgkin Lymphoma

If your child has symptoms that point to non-Hodgkin lymphoma, our pediatric specialists in the Hemato-Oncology Division at Sheba Medical Center will perform various exams and tests to diagnose or rule out the disease. These tests will also help us to determine the precise type of NHL. We bring years of professional experience and the latest technologies to diagnosing each individual patient as quickly and efficiently as possible. The diagnostic procedures may include:

 

Blood Tests

Specific blood tests provide information about the amounts of different types of cells and chemicals in your child’s blood.

 

Biopsy

If your child has an enlarged lymph node, a sample of tissue will be removed from the node and examined under a microscope for the presence of cancer cells. This test is required to confirm a diagnosis of NHL.

 

Chest x-rays

This imaging procedure may be used to check for swollen lymph nodes in the chest.

 

CT scan

We may use CT scans, which are more detailed than general x-rays, to look for swollen lymph nodes or inflammation in other body parts.

 

PET scan

A PET scan is useful for accurately seeing where NHL has spread throughout the body.

 

MRI scan

MRIs enable our physicians to check the brain and spinal cord for any signs that NHL has spread to these regions. It may also be used if the results of the CT scan or x-ray are not clear enough.

 

Ultrasound

This imaging technique can be used to view internal organs as they function, as well as to evaluate blood flow through various vessels.

 

Bone marrow aspiration and biopsy

When NHL has been diagnosed, a bone marrow aspiration and biopsy may be done to determine whether the diseased cells have reached the bone marrow.

 

Lumbar puncture

A small amount of cerebrospinal fluid (CSF) is removed from the spinal canal (the area around the spinal cord) to assess the central nervous system for cancer cells.

 

Staging

which refers to the spread or extent of the disease, is a significant part of diagnosing NHL, and it is necessary for designing the most appropriate treatment program. Our doctors will use the information learned from the above tests to assign a “stage” to the NHL. In childhood NHL, the most common system of staging is outlined as follows:

  1. Stage I – tumor is located in only place, but not in the chest, abdomen, next to the spine or brain
  2. Stage II – tumor is at two or more places in the body, all either in the upper half or the lower half of the body, but not in the chest, next to the spine or brain, or in the abdomen
  3. Stage III – refers to when the tumor is at two or more places in the body, in both the upper and lower halves of the body, located in the chest, located in the abdomen, or located next to the spinal cord or brain, but does not involve the bone marrow or the central nervous system
  4. Stage IV – tumor is at any place in the body and cancer is also found in the bone marrow and/or central nervous system. Stage IV is subdivided depending on the number of cancer cells present in the bone marrow. If there are more than 25% lymphoma cells in the bone marrow, the cancer is generally considered to be leukemia and not lymphoma.

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