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Hodgkin lymphoma stages

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Hodgkin lymphoma is diagnosed by stages and categories. The stages—I, II, III and IV—are determined by how much the disease has spread from a single lymph node region to the rest of the body. The categories—A, B, E, S and X—measure the presence of certain symptoms and to where in the body the disease may have spread.

Accurately diagnosing the stage and category of Hodgkin lymphoma is an important factor in evaluating treatment options. Our doctors use a variety of diagnostic tests to evaluate Hodgkin lymphoma and develop an individualized treatment plan tailored to each patient’s needs.

The stages of Hodgkin lymphoma are:

Stage I (stage 1 Hodgkin lymphoma): The cancer has only affected one lymph node region or organ.

Stage II (stage 2 Hodgkin lymphoma): Two or more lymph nodes are affected. The cancer is either above or below the diaphragm.

Stage III (stage 3 Hodgkin lymphoma): The cancer may affect lymph nodes on both sides of the diaphragm.

Stage IV (stage 4 Hodgkin lymphoma): Cancer cells have moved beyond the lymph system into other tissues and organs, such as the liver, lungs or bones.

Staging categories

In addition to stages, these letters are used to indicate the presence or absence of certain symptoms and/or how far the cancer has spread beyond the lymph nodes:

A indicates no symptoms have developed.

B is used when any of the following symptoms have developed: unexplained weight loss, drenching night sweats or fever.

X is used when the disease is considered “bulky,” with large tumors, greater than 10 cm in size, spanning the chest region.

E indicates extranodal cancers that have spread beyond the lymph nodes into other tissues or organs.

S is used when the cancer has spread to the spleen. Approximately 30 percent of Hodgkin lymphoma patients will develop an enlarged spleen (splenomegaly).

Next topic: How is Hodgkin lymphoma diagnosed?

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