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Lymphoma staging

A commonly adopted staging system for Hodgkin lymphoma is the Cotswold's modification of the original Ann arbor staging system. Non-Hodgkin lymphoma also uses the same classification 1. However, contiguous nodal spread is common with Hodgkin lymphoma whereas multifocal nodal involvement and extranodal spread is common with non-Hodgkin lymphoma 1.

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

  • stage I: one nodal group or lymphoid organ (e.g. spleen or thymus)
    • stage IE: one extranodal site
  • stage II: two or more nodal groups, same side of diaphragm
    • stage IIE: localized extranodal site with stage II criteria, both on the same side of the diaphragm
  • stage III: nodal groups on both sides of the diaphragm
    • stage IIIS(1): with splenic involvement
    • stage IIIE(2): with localized extranodal site
  • stage IV: disseminated involvement of 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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