Lugano Classification Staging System for Hodgkin Lymphoma
The staging system used for Hodgkin lymphoma is the Lugano classification. It has 4 stages, labeled I, II, III, and IV. For limited stage (I or II) HL that affects an organ outside of the lymph system, the letter E is added to the stage (for example, stage IE or IIE).
Stage
|
Area of Concern
|
I
|
- Involvement of a single lymph node region (I) or localized involvement of a single extralymphatic organ or site (IE).
|
II
|
- Involvement of two or more lymph node regions on the same side of the diaphragm (II) or localized involvement of a single associated extralymphatic organ or site and its regional lymph node(s), with or without involvement of other lymph node regions on the same side of the diaphragm (IIE).
|
III
|
- Involvement of lymph node regions on both sides of the diaphragm (III), which may also be accompanied by localized involvement of an associated extralymphatic organ or site (IIIE), by involvement of the spleen (IIIS), or by both (IIIE+S).
|
| IV |
- Disseminated (multifocal) involvement of one or more extralymphatic organs, with or without associated lymph node involvement, or isolated extralymphatic organ involvement with distant (nonregional) nodal involvement.
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Note: The number of lymph node regions involved may be indicated by a subscript (e.g., II3).
Each stage may also be assigned a letter (A or B). B is added (stage IIIB, for example) if a person has ANY of these B symptoms:
- Loss of more than 10% of body weight over the previous 6 months (without dieting); or
- Unexplained fever of at least 100.4°F (38°C); or
- Drenching night sweats.
If a person has any B symptoms, it usually means the lymphoma is more advanced, and more intensive treatment is often recommended. If no B symptoms are present, the letter A is added to the stage.
