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Hematologic Malignancies Program

Patient and Family Education

AIDS-Related Lymphoma

Staging

Once AIDS-related lymphoma is found, more tests will be done to find out if the cancer has spread from where it started to other parts of the body. This testing is called staging. The stage of a disease, ranging from Stage I - Stage IV, gives an indication of how far the disease has spread. To plan treatment, a doctor needs to know the stage of the disease.

The doctor may determine the stage of the disease by conducting a thorough examination that may include blood tests and different kids of x-rays. This testing is called clinical staging. In some cases, a surgeon may need to do an operation called a laparotomy to determine the stage of the cancer. During this operation, the doctor cuts into the abdomen and carefully looks at the organs and lymph nodes to see if they contain cancer. The doctor will cut out (biopsy) small pieces of tissue and look at them under a microscope to see whether they contain cancer. This type of staging is called pathologic staging. Pathologic staging is usually done only when it is needed to help the doctor plan treatment. It is not necessary in most cases of AIDS-related lymphoma.

For treatment, AIDS-related lymphomas are grouped based on where they started, as follows:

• Systemic/Peripheral Lymphoma - Lymphoma that has started in lymph nodes or other organs of the lymph system. The lymphoma may have spread from where it started throughout the body, including to the brain or bone marrow. Treatments for this group of lymphomas may include standard- or low-dose systemic chemotherapy plus intrathecal chemotherapy, or a clinical trial involving a new type of chemotherapy. There is a high risk of brain or spinal fluid involvement with AIDS-related lymphoma so the doctor will likely do a spinal fluid evaluation.
  
  
• Primary Central Nervous System Lymphoma - Lymphoma that has started in the brain or spinal cord, both of which are part of the central nervous system. This type of lymphoma is called a "primary central nervous system lymphoma" because it starts in the central nervous system itself rather than starting somewhere else in the body and then spreading to the central nervous system. Treatment for this group of lymphomas will probably include cranial radiation therapy in addition to any other therapy considered appropriate. A clinical trial investigating new types of treatment may also be an option.

This page was last updated on: October 7, 2009.

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