stage 2 lymphoma | Non-Hodgkin's lymphoma Stages

Non-Hodgkin's lymphoma Stages



After the diagnosis of non-Hodgkin's lymphoma, doctors will try to find out if it has spread and if so, how far. This process is called staging (or stage determination). The stage of a cancer describes how much cancer is in the body, and helps to know how serious cancer is, as well as the best way to treat it. Doctors also use the cancer stage when they talk about survival statistics.
Some tests used to obtain information and classify the disease by stages are:

Physical exam
Enlarged lymph node biopsies or other abnormal areas
Blood tests imaging studies such as PET and CT
Aspiration of bone marrow and biopsy (it is often done, but not always)
Lumbar puncture (This procedure may not be necessary)
In general, the results of imaging studies, such as PET or CT, are the most important when determining the stage of lymphoma.

Lugano classification
A staging or stage grading system is a method used by cancer specialists to summarize the extent of the spread of a cancer. The current system for non-Hodgkin's lymphoma in adults is known as the Lugano classification, and is based on the old Ann Arbor system.

The stages (stadiums) are usually classified with Roman numerals from I to IV (1-4). Limited-stage lymphomas (I or II) that affect an organ outside the lymphatic system (an extraganglionic organ) are added the letter E (e.g., stage IIE).

Stage I
Any of the following features means that the disease is in stage I:

The lymphoma is found only in an area of lymph nodes or a lymphatic organ, such as the Tonsils (I).
Cancer is found only in an area of an organ that is outside the lymphatic system (IE).
Stage II
Any of the following features means that the disease is in stage II:

The lymphoma is in two or more groups of lymph nodes on the same (upper or lower) side of the diaphragm (the fine band of the muscle that separates the thorax from the abdomen). For example, this may include the lymph nodes in the armpit and neck area, but not the combination of the armpit and groin lymph nodes (II).
The lymphoma is in a group of lymph nodes (s) and in an area of a nearby organ (IIE). It may also affect other lymph node groups on the same side of the diaphragm.
Stage III
Any of the following characteristics means that the disease is in stage III:

Lymphoma is found in lymph node areas on both sides (upper and lower) of the diaphragm.

The lymphoma is found in the lymph nodes above the diaphragm, as well as in the spleen.

Stage IV

Lymphoma has spread widely to at least one organ outside the lymphatic system, such as bone marrow, liver, or lung.

Bulky disease

This term is often used to describe large tumours in the chest. This is especially important for stage II lymphomas, as bulky disease may require more intensive treatment.

Staging of small-cell lymphocytic lymphoma (SLL) Chronic lymphocytic/leucemia (CLL)

The anterior system is mainly used to determine the stage of this lymphoma if it is found only in the lymph nodes. If the disease is affecting the blood or bone marrow, it is often graded in stages using CLL systems. See stages of chronic lymphocytic leukemia.

How stage classification affects treatment

The stage of a lymphoma is often important to determine a person's treatment options, but it is more important for some types of lymphoma than for others. For many of the most common types of non-Hodgkin lymphoma, treatment is based in part on whether the lymphoma is "limited" (stage I or non-voluminous stage II) or "Advanced" (stage III or IV). For bulky lymphomas in stages II, other factors (known as prognostic factors) are used to help determine whether lymphoma should be treated as limited or advanced. 

Determining the stage is less important for deciding the treatment of other types of non-Hodgkin lymphoma such as fast-growing lymphomas, such as Burkitt lymphoma. 

For more information on this topic, see Treatment of B-cell non-Hodgkin lymphomas and treatment of non-Hodgkin's T-cell lymphomas.