Doctors use physical examinations, imaging tests, blood test and, sometimes, bone marrow tests to determine the extent of the disease. This determination is called "staging." Staging provides important information for treatment planning.
Staging for Hodgkin lymphoma is based on the Lugano classification, which is derived from the Ann Arbor staging system.
HL cells found in a single lymph node region (this can include one node or a group of adjacent nodes), OR
HL cells found in one organ or site outside the lymphatic system.
HL cells found in two or more lymph node regions on the same side of the diaphragm (the thin muscle below the lungs and heart that separates the chest from the abdomen), either above the diaphragm or below the diaphragm, OR
HL cells found in a lymph node area and a nearby organ outside the lymphatic system, on the same side of the diaphragm
|Stage III||HL cells found in lymph node regions on both sides of the diaphragm (above and below), possibly with localized involvement of an organ outside the lymphatic system or the spleen|
|Stage IV||HL cells have spread widely into one or more organs outside the lymphatic system|
In addition to the stage number, the letters A, B, E or S may be used to further classify the stage of HL.
- Category A: The patient does not have B symptoms (fever, weight loss or night sweats).
- Category B: The patient has B symptoms.
- Category E: The patient has HL cells in organs or tissues outside the lymphatic system.
- Category S: The patient has HL cells in the spleen.
For example, stage IIB would indicate that the patient has
- Involvement of two lymph node sites near each other (for example, enlarged lymph nodes in the neck and collarbone area or in the neck and the armpit)
- Fever, excessive sweating and/or weight loss
Patients in the B category sometimes require more aggressive treatments. It is important to note that even patients with stage IV (advanced stage) HL are frequently cured with treatment, despite having lymphoma in many areas of the body.
- Download or order The Leukemia & Lymphoma Society's free booklet, Hodgkin Lymphoma.