Diagnosing Non-Hodgkin Lymphoma in Children
Non-Hodgkin lymphoma (NHL) in children is a type of blood cancer that develops when there is uncontrolled growth of lymphocytes, a type of white blood cell. Specialists who may be involved in diagnosing NHL in children include pediatric oncologists, radiologists and pathologists. Here are the examinations, tests, and procedures used to diagnose Non-Hodgkin Lymphoma in children:
- Medical history: The doctor will ask about the child's symptoms, medical history, medications, and family medical history.
- Physical exam: During a physical exam, the doctor will look for swollen lymph nodes in the neck, groin, and underarms. They will also check for swelling in the spleen and liver.
- Blood tests: Blood chemistry studies may be performed to measure the amounts of certain substances released into the blood by organs and tissues in the body. Liver function tests can also be done to measure specific substances released by the liver. Unusual amounts of these substances can be indicators of cancer.
- Computed tomography (CT): Detailed pictures of the body are taken from different angles to identify areas of concern, such as the neck, chest, abdomen, and pelvis.
- Biopsy (tissue sample): Biopsy may be performed to collect tissue samples to be examined under a microscope by a pathologist to look for cancer cells. Biopsies may collect tissue from a lymph node, tumor, or bone marrow. A biopsy is the only way to diagnose NHL.
Additional examinations, tests, and procedures may be performed based upon initial findings or individual factors, or to gather information needed to determine the stage of NHL. These may include:
- Imaging tests: Additional imaging studies, such as ultrasound, magnetic resonance imaging (MRI), or positron emission tomography (PET) scan may be used to assess the extent of disease throughout the body. These tests help determine how far the cancer has progressed and identify any spread to other parts of the body. This information is needed to determine the stage of NHL.
- MRI with gadolinium: This procedure uses a magnet, radio waves, and a computer to create detailed pictures of areas inside the body. Gadolinium is injected into a vein to highlight cancer cells.
- Bone marrow biopsy: In some cases, a bone marrow biopsy may be performed to examine the bone marrow for signs of cancer involvement.
- Lumbar puncture: Cerebrospinal fluid is collected from the spinal column using a needle. It is then examined under a microscope to check for cancer spread to the brain and spinal cord.
The stages of NHL are based upon the location and spread of NHL. The stages are:
- Stage 1 NHL is found:
- In one area (a single tumor)
- Stage 2 NHL is all found on one side of the diaphram:
- In one area (a single tumor) and a nearby lymph node
- In two or more lymph nodes either above or below the diaphragm
- In the digestive tract and limited enough to be removed by surgery
- Stage 3 NHL is found:
- In more than one area (more than a single tumor)
- In lymph nodes on both sides of the diaphragm
- In the chest
- In the abdomen (digestive tract) with too much spread to be removed by surgery
- Next to the spine
- In a bone
- Stage 4 NHL is found in the bone marrow, spinal cord, or brain
These examinations, tests, and procedures help identify factors or indicators of the type and stage of non-Hodgkin lymphoma in children. Remember that it's important to consult with a pediatric oncologist and other healthcare professionals for an accurate diagnosis and personalized treatment plan for NHL in children.