Staging of Non Hodgkin lymphoma

Staging is the way your doctors find out where the lymphoma is in your body, how many groups of lymph nodes are affected, and whether or not it has spread to other organs. A commonly used staging system divides NHL into the following 4 stages:

  • Stage 1 One group of lymph nodes is affected.
  • Stage 2 The lymphoma is in two or more groups of lymph nodes on the same side of the diaphragm (above or below). The diaphragm is a sheet of muscle under the lungs.
  • Stage 3 The lymphoma is on both sides of the diaphragm (both above and below it).
  • Stage 4 The lymphoma has spread beyond the lymph nodes to other organs, such as the bone marrow, liver or lungs.

Stages 1 and 2 are sometimes called early-stage, limited-stage or localised NHL.

Stages 3 and 4 are sometimes called advanced NHL.


As well as giving each stage a number, doctors also use a letter after the stage number – A or B. Thisdescribes whether or not you have the following symptoms:

  • An unexplained fever causing your temperature to rise above 38°C (100.4°F).
  • Drenching night sweats.
  • Unexplained weight loss.

The letter A means you don’t have these symptoms and the letter B means you do.This is why these symptoms are called B-symptoms.

Extranodal lymphoma

Sometimes lymphoma is found in parts of the body outside the lymph nodes. This is called extranodal lymphoma.

It’s described by adding the letter E (for extranodal) after the stage number.

  • started in an organ outside the lymph nodes (called primary extranodal NHL)
  • started in the lymph nodes then spread somewhere else.

If you have extranodal lymphoma, your doctor can explain to you how this affects the stage.

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