How is Hodgkin lymphoma (Hodgkin disease) staged?

Updated: Sep 12, 2018
  • Author: Bradley W Lash, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Clinical staging involves assessment of disease extent by clinical examination, history, and imaging techniques. The Ann Arbor classification (1971) is used most often for Hodgkin lymphoma. It classifies cases into the following four stages, principally on the basis of lymph node involvement:

  • Stage I - A single lymph node area or single extranodal site

  • Stage II - Two or more lymph node areas on the same side of the diaphragm

  • Stage III - Lymph node areas on both sides of the diaphragm

  • Stage IV - Disseminated or multiple involvement of the extranodal organs

Involvement of the liver or the bone marrow is considered stage IV disease. For staging classifications, the spleen is considered to be a lymph node area. Involvement of the spleen is denoted with the S suffix (ie, IIBS).

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