Staging of Hodgkin lymphoma

The stage describes how many areas of the body are affected by lymphoma and where these are. This information helps doctors plan the right treatment for you. 

The stage of a lymphoma is usually described using numbers from 1 to 4:

  • Stage 1 – there is only one area of lymphoma. This may affect one group of lymph nodes or another part of the lymphatic system.
  • Stage 2 – there are two or more areas of lymphoma on the same side of the diaphragm (the sheet of muscle underneath the lungs).
  • Stage 3 – there are areas of lymphoma above and below the diaphragm.
  • Stage 4 – there are areas of lymphoma outside and separate from the lymphatic system. For example, this could be in organs such as the bone marrow, liver or lungs.

Stages 1 and 2 are also called early-stage, limited lymphoma. If stage 1 or 2 lymphoma has grown into nearby areas of tissue, this is called extra-nodal disease. The letter E may be added after the stage number to show it is extra-nodal disease.

Stages 3 and 4 are also called advanced lymphoma.

B symptoms

If you have any B symptoms, the letter B is added after the stage number, for example stage 1B. B symptoms are:

  • heavy, drenching night sweats
  • unexplained high temperatures
  • unexplained weight loss.

If you don’t have any of these symptoms, the letter A is used instead, for example stage 1A.

Bulky disease

If an area of lymphoma is 10cm (4 inches) or more in diameter, this is called ‘bulky’ disease. The letter X may be added after the stage number, for example stage 1X.

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