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Hodgkin lymphoma staging

A commonly adopted staging system for Hodgkin lymphoma is the Cotswold's modification of the original Ann arbor staging system. 

Accurate CT staging has been shown to have a significant impact on treatment and eventual clinical outcome

  • stage I : one nodal group
    • stage IE : one extra nodal site
  • stage II : two or more nodal groups, same side of diaphragm
    • stage IIE : one nodal group and one extranodal site, both on the same side of the diaphragm
  • stage III : nodal groups on both sides of the diaphragm
    • stage IIIS(1) : nodal groups above diaphragm and splenic involvement
    • stage IIIE(2) : nodal groups above diaphragm and extra nodal site below diaphragm
  • stage IV : one or more extra lymphatic organ (e.g lung, bone) + / - any nodal involvement 
Additional staging variables
  • X : bulky nodal disease : nodal mass > 1/3 of intra thoracic diameter or 10 cm in dimension
  • A : asymptomatic
  • B : presence of B symptoms (fever, night sweats and weight loss)

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