Lymphoma & related disorders

Topic Completed: 1 February 2011

Minor changes: 5 July 2020

Copyright: 2001-2020,, Inc.

PubMed Search: staging pediatric lymphoma

Nikhil Sangle, M.D.
Page views in 2019: 136
Page views in 2020 to date: 101
Cite this page: Sangle N. Staging-pediatric. website. Accessed July 7th, 2020.
St. Jude Staging System
Stage I:
  • A single tumor (extranodal) or single anatomic area (nodal), with the exclusion of mediastinum or abdomen

Stage II:
  • A single tumor (extranodal) with regional node involvement
  • Two or more nodal areas on the same side of the diaphragm
  • Two single (extranodal) tumors with or without regional node involvement on the same side of the diaphragm
  • A primary gastrointestinal tumor, usually in the ileocecal area, with or without involvement of associated mesenteric nodes only

Stage III:
  • Two single tumors (extranodal) on opposite sides of the diaphragm
  • Two or more nodal areas above and below the diaphragm
  • All primary intrathoracic tumors (mediastinal, pleural, thymic)
  • All extensive primary intra-abdominal disease
  • All paraspinal or epidural tumors, regardless of other tumor site(s)

Stage IV:
  • Any of the above with initial CNS or bone marrow involvement

  • Stage III intra-abdominal disease typically exhibits spread to paraaortic and retroperitoneal areas by implants and plaques in mesentery or peritoneum, or by direct infiltration of structures adjacent to the primary tumor; ascites may be present, and complete resection of all gross tumor is not possible
  • Stage II GI tract lymphoma typically is limited to one segment of the gut plus or minus the associated mesenteric nodes only and the primary tumor can be completely removed grossly by segmental excision
  • If marrow involvement is present initially, the number of abnormal cells must be 25% or less in an otherwise normal marrow aspirate with a normal peripheral blood picture
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