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Lymphoma - B cell neoplasms

Non-Hodgkin Lymphoma

Staging Pediatric lymphoma

Reviewer: Nikhil Sangle, M.D., University of Utah and ARUP Laboratories (see Reviewers page)
Revised: 17 February 2011, last major update February 2011
Copyright: (c) 2001-2011, PathologyOutlines.com, Inc.

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 intraabdominal disease typically exhibits spread to para-aortic 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.

Additional references

J Clin Oncol 1989;7:186

End of Lymphoma - B cell neoplasms > Non-Hodgkin Lymphoma > Staging Pediatric lymphoma

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