Staging is the process of gathering all the diagnostic information to determine how far the lymphoma has spread. This helps the medical team determine the best treatment and the outlook for cure. Many cancers are staged with a system called the TNM system developed by the American Joint Committee on Cancer. But lymphomas are staged by other systems, developed by specialists in lymphoma diagnosis and treatment. The staging system most often used to describe the spread of non-Hodgkin lymphoma in children is called the St. Jude staging system.

Stage I:

Non-Hodgkin lymphoma starting in one place, either as a single tumor not in lymph nodes or in lymph nodes in one part of the body (the neck, groin, underarm, etc.). The lymphoma is not in the chest or abdomen.

Stage II:

In Stage II, the lymphoma is not in the chest. There is a single tumor mass not in lymph nodes that has spread to one nearby group of lymph nodes.

Or

The lymphoma started in the intestinal tract and all visible tumor masses have been removed.

Or

The lymphoma is growing as 2 separate tumors not in lymph nodes or in more than one group of lymph nodes where they are on the same side of (above or below) the diaphragm (the breathing muscle that separates the chest and abdomen). For example, this might mean nodes in the underarm and neck area are affected but not the combination of underarm and groin nodes.

Stage III:

This includes any non-Hodgkin lymphoma that starts in the chest (usually in the thymus or lymph nodes in the center of the chest or the lining of the lung)

Or

Lymphoma starting in the abdomen that has spread widely within the abdomen and cannot be completely removed by surgery

Or

Lymphoma located next to the spine

Or

The lymphoma is in 2 groups of lymph nodes on different sides of the diaphragm

Or

Two lymphoma tumors, not in lymph nodes, that are on different sides of the diaphragm

Stage IV:

This includes any non-Hodgkin lymphoma that has spread to the bone marrow (but less than 25% of the cells are lymphoma) or the central nervous system (brain or spinal fluid). Last Revised: 03/08/2007