Stages of childhood Hodgkin lymphoma
Staging is a way of describing or classifying a cancer based on the extent, or amount, of cancer in the body. The most common staging system for Hodgkin lymphoma (HL) is the Cotswold system, which is a modification of the older Ann Arbor Staging System. This system divides HL into 4 stages that describe how much the disease has spread. Each stage may be further described by a letter.
- E stands for extranodal spread, which means that the disease has spread to an organ or tissue other than the lymph nodes.
- S is added if the lymphoma has spread to the spleen.
- X may be added to the stage if there is bulky disease. Bulky disease means there are tumours in the chest that are at least one-third as wide as the chest, or there are tumours in other areas that are at least 10 cm across.
Each stage is also further classified as either A or B depending on symptoms. The A classification refers to children who don’t have B symptoms. The B classification refers to children who have B symptoms. B symptoms include:
- fever over 38°C
- drenching night sweats
- weight loss of at least 10% of body weight over 6 months
Cancer is found in only 1 area of lymph nodes.
Cancer is found in 1 organ or tissue other than the lymph nodes.
Cancer is found in 2 or more areas of lymph nodes on the same side of the diaphragm (either above or below, but not both).
Cancer is found in 1 or more areas of lymph nodes on the same side of the diaphragm (either above or below) and has spread to a nearby organ or tissue.
Cancer is found in areas of lymph nodes both above and below the diaphragm.
Cancer is found in areas of lymph nodes on both sides of the diaphragm and in a nearby tissue or organ.
Cancer is found in areas of lymph nodes on both sides of the diaphragm and in the spleen.
Cancer is found in areas of lymph nodes on both sides of the diaphragm. It is also in the spleen and a tissue or an organ near the areas of lymph nodes.
Cancer has spread to 1 or more organs or tissues outside of the lymphatic system. Cancer cells may or may not be found in lymph nodes near these organs.
Recurrent Hodgkin lymphoma
Recurrent Hodgkin lymphoma means that the cancer has come back after it has been treated. It may recur in the same place that cancer first started or it may recur in another part of the body.
Primary progressive Hodgkin lymphoma
Primary progressive, or resistant, HL is lymphoma that continues to grow or spread during treatment.
The thin muscle below the lungs and heart that separates the chest cavity from the abdomen.
When the diaphragm contracts, the lungs expand and take in air. When it relaxes, the lungs deflate and push air out.