Purpose or Case Report: Lymphoma (including both Hodgkin’s and non-Hodgkin’s) is the third most common pediatric malignancy. Treatment requires distinct definitions of bulky disease, response to therapy, and organ involvement. In this way, pediatric radiologists form a center role in the medical care of affected children. This educational exhibit examines pediatric lymphoma diagnosis and response to therapy by detailing the varying classification systems, including the newer PET-related Deauville and Lugano classification systems.

The Ann Arbor staging classification system for Hodgkin’s lymphoma was initially developed in the 1970’s and anatomically classifies lymphoma by site and number of lymph nodes affected, cross-diaphragmatic disease, and extralymphatic organ dissemination. More recently, after the introduction of PET/CT, newer classification systems which incorporated tumor metabolism were developed - including Deauville and Lugano. Notably, these systems are commonly applied to both Hodgkin’s and non-Hodgkin’s lymphoma. This educational exhibit includes a discussion of these various systems as well as annotated examples. Additionally, risk stratification is discussed using strata defined by the Children’s Oncology Group (COG), EuroNet, and Pediatric Hodgkin Consortium.

After review, the pediatric radiologist should feel more comfortable staging and classifying response to treatment of lymphoma using PET assessment principles.
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