After adult non-Hodgkin lymphoma has been diagnosed, tests are done to find out
if cancer cells have spread within the lymph
system or to other parts of the body.
There are three ways that cancer spreads in the body.
Stages of adult non-Hodgkin lymphoma may include
E and S.
The following stages are used for adult non-Hodgkin
lymphoma:
Stage I
Stage II
Stage III
Stage IV
Adult non-Hodgkin lymphomas may be grouped for treatment according to whether the cancer is indolent or aggressive and whether affected lymph nodes are next to each other in the body.
After adult non-Hodgkin lymphoma has been diagnosed, tests are done to find out
if cancer cells have spread within the lymph
system or to other parts of the body.
The process used to find out the type of cancer
and if cancer cells
have spread within the lymph system
or to other parts of the body is called staging. The
information gathered from the staging process determines the stage
of the
disease. It is important to know the stage of the disease in order to plan treatment. The results of the tests and procedures done to diagnosenon-Hodgkin lymphoma
are used to help make decisions about treatment.
The following tests and procedures may also be used in the staging
process:
The portion of the blood sample made up of red blood cells.
Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs
and tissues
in the body. An unusual (higher or lower than normal) amount of a substance can be a sign
of disease.
CT scan
(CAT scan):
A procedure that makes a series of detailed pictures of areas inside the body, such as the lung, lymph nodes, and liver, taken from different angles. The pictures are made by a computer linked to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
PET scan
(positron
emission tomography scan): A procedure to find malignanttumor
cells in the body. A small amount of radioactiveglucose
(sugar) is injected into a vein. The PET scanner
rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
MRI
(magnetic
resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Lumbar puncture: A procedure used to collect cerebrospinal fluid
(CSF) from the spinal column. This is done by placing a needle between two bones in the spine
and into the CSF around the spinal cord
and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that the cancer has spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.
Lumbar puncture. A patient lies in a curled position on a table. After a small area on the lower back is numbed, a spinal needle (a long, thin needle) is inserted into the lower part of the spinal column to remove cerebrospinal fluid (CSF, shown in blue). The fluid may be sent to a laboratory for testing.
For pregnant
women with non-Hodgkin lymphoma, staging tests and procedures that protect the baby from the harms of radiation
are used. These tests and procedures include MRI, bone marrow aspiration and biopsy, lumbar puncture, and ultrasound. An ultrasound exam is a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
There are three ways that cancer spreads in the body.
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels
to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels
to other parts of the body.
Stages of adult non-Hodgkin lymphoma may include
E and S.
Adult non-Hodgkin lymphoma may be described as
follows:
E: "E" stands for extranodal
and means the cancer is found in an area or organ other than the lymph nodes or has spread to tissues beyond, but near, the major lymphatic
areas.
S: "S" stands for spleen
and means the cancer is found in the spleen.
The following stages are used for adult non-Hodgkin
lymphoma:
Stage I
Stage I adult non-Hodgkin lymphoma. Cancer is found in one lymphatic area (lymph nodes, tonsils, thymus, or spleen). In stage IE (not shown), cancer is found in one organ or area outside the lymph nodes.
Stage II
: Cancer is found in two or more lymph node
groups either above or below the diaphragm
(the thin muscle below the lungs
that helps breathing and separates the chest
from the abdomen).
Stage II adult non-Hodgkin lymphoma. Cancer is found in two or more lymph node groups, and both are either above (a) or below (b) the diaphragm.
Stage IIE
: Cancer is found in one or more lymph node
groups either above or below the diaphragm. Cancer is also found outside the lymph nodes in one organ
or area on the same side of the diaphragm as the affected lymph nodes.
Stage IIE adult non-Hodgkin lymphoma. Cancer is found in one or more lymph node groups either above or below the diaphragm and outside the lymph nodes in an organ or area on the same side of the diaphragm as the lymph nodes with cancer (a).
Stage III
Stage III adult non-Hodgkin lymphoma. Cancer is found in one or more lymph node groups above and below the diaphragm (a). In stage IIIE, cancer is found in lymph node groups above and below the diaphragm and outside the lymph nodes in a nearby organ or area (b). In stage IIIS, cancer is found in lymph node groups above and below the diaphragm (a) and in the spleen (c). In stage IIIE plus S, cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area (b), and in the spleen (c).
Stage III
: Cancer is found in lymph node
groups above and below the diaphragm
(the thin muscle below the lungs
that helps breathing and separates the chest from the abdomen).
Stage IV adult non-Hodgkin lymphoma. Cancer is found throughout one or more organs that are not part of a lymphatic area (lymph nodes, tonsils, thymus, or spleen) (a); or in one organ that is not part of a lymphatic area and has spread to lymph nodes far away from that organ (b); or cerebrospinal fluid (not shown), the liver, bone marrow, or lungs.
is found in one organ that is not part of a lymphatic area and has spread to organs or lymph nodes far away from that organ; or
is found in the liver, bone marrow, cerebrospinal fluid (CSF), or lungs
(other than cancer that has spread to the lungs from nearby areas).
Adult non-Hodgkin lymphomas may be grouped for treatment according to whether the cancer is indolent or aggressive and whether affected lymph nodes are next to each other in the body.
See the General Information section for more information on the types of indolent
(slow-growing) and aggressive
(fast-growing) non-Hodgkin lymphoma.
