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Last update: 02/13/2008

Staging | Extranodal notations | Ann Arbor notations | About Stage IV

Staging defines how widespread the disease is and the locations of the disease in the body.  

Above illustration adapted from Favrille patient education material.

Click to enlarge illustration

Anne Arbor staging for Hodgkin's disease - Virginia.edu
 

	Stage I - disease in single lymph node or lymph node region.
	Stage II - disease in two or more lymph node regions on same  side of diaphragm.  Note: Stage II contiguous means two or more lymph nodes in close proximity (side by side).
	Stage III - disease in lymph node regions on both sides of the  diaphragm are affected.
	Stage IV - disease is wide spread, including multiple involvement at  one or more extranodal (beyond the lymph node) sites, such as the bone marrow.

Also see Extranodal and Ann Arbor notations  below, which may be added to the above staging designations.

Also see Staging - Oncologychannel.com

Extranodal notations 

Extranodal means 'beyond nodal' -  sites are identified by the following notation: 

N	= lymph nodes
H	= liver (hepatic)
L	= lung
M	= bone marrow
S	= spleen
P	= pleura (lung)
O	= bone
D	= skin (dermis)

You can click the image on the right to enlarge it.

Disease Staging may also be accompanied by local involvement of an extranodal organ or site.

Example involving spleen: Stage IIIS

ANN ARBOR notations 

Ann Arbor staging further classifies patients with lymphoma into A or B categories:

A = without symptoms

B = with symptoms including unexplained weight loss (10% in 6 months prior to diagnosis,  unexplained fever, and drenching night sweats.) 

Disease Staging may also be accompanied by local involvement of an extranodal organ or site.

Example involving spleen and Ann Arbor notation: Stage IIIS A

About STAGE IV:  

It is common for b-cell lymphomas to be diagnosed at stage IV, and with bone marrow involvement.  While dependant on the cell type and other factors, successful treatment is often possible for stage IV disease and bone marrow involvement is reversible!