What Are The Stages Of Hodgkin’s Lymphoma?

Lymphoma originates from the lymphocytes. The symptoms of lymphoma are enlarged lymph nodes especially in the neck, under the arm or in the groin region, night sweats and high fever. The patient also experiences weight loss. The primary cause of lymphoma is the viral infection. The treatment for lymphoma is chemotherapy and radiotherapy. In some cases, stem cell transplant may also be used. The treatment depends upon the stage at which the disease is diagnosed.

Once the lymphoma is diagnosed on the basis of imaging techniques and biopsy, the doctor has to design the treatment strategy for the patient. For deciding this, the doctor should know about the extent of the disease in the body. If the disease is spread in the body i.e. if the cancer is metastasized, more aggressive treatment is required. This process of determining the extent of impact of disease is known as staging. The staging is also used to figure out the prognosis of the disease.

The present classification of the stages of lymphoma is the Lugano classification which is derived from the older Ann Arbor staging with the Cotswolds modification. For stage I and II of the Hodgkin’s lymphoma, letter “E” is added as suffix to depict the presence of lymphoma outside lymph node. Following are the stages of Hodgkin’s Lymphoma:

The lymphoma is said to be in stage I:

• When the lymphoma is found only in 1 lymph node or the disease is present in 1 lymphoid organ such as thymus or
• If the cancer is found only in a single area present on a single organ (IE).

The Hodgkin’s Lymphoma is said to be in stage II if:

• More than two lymph nodes are involved, and both these nodes are on the same side (above or below) of diaphragm or,
• If the single lymph node and its nearby organ is involved.
• The number of anatomical regions involving lymph nodes is indicated by number in suffix such as Stage II-3.

Stage III Hodgkin’s Lymphoma has the following characteristic:

• The lymph nodes above and below the diaphragm and the involvement of lymphoid organ.
• If the spleen, celiac or portal nodes are involved, the stage is termed as Stage III-1, while involvement of paraaortic, inguinal, iliac, or mesenteric nodes is termed as stage III-2.

• Stage IV of the Hodgkin’s Lymphoma is characterized by the involvement of at least one extranodal organ such as liver, bone marrow or lungs.
• Further, the stages are also having certain other characteristics.

1. Bulky Disease: If a single nodal mass is at least 10 cm or is greater than or equal to one-third of the transthoracic diameter, it is termed as bulky stage of Hodgkin’s lymphoma. Thus, the stage with bulky disease is depicted as Stage II bulky where in the mass of 10cm or more in diameter or more than one-third of the thoracic region is present along with the typical characteristic of stage II lymphoma.

2. Systemic Symptoms: The stages of the lymphoma are further classified in to A or B on the basis of presence of systemic symptoms. Following are the (B) symptoms:

   Loss of more than 10% of the weight within 6 months without following any weight loss strategy,

   1. Unexplained fever greater than 38° C or Pel-Ebstein Fever
   2. Night sweats
   3. If the above symptoms are not present, the patient is given (A) classification.

3. Relapsed Lymphoma: The disease may either relapse at the previous site or may originate at some other site. The term RS is added to the stage to designate the stage at which the disease has been relapsed.

Staging is a process of determining the extent of disease. In case of cancer, the staging is almost essential as this will determine the spread of the disease in the body and the strategy for the treatment of the disease. Further, this will help the oncologists in evaluating the prognosis of the disease.

Also Read:

• Hodgkin’s Lymphoma Vs Non-Hodgkin’s Lymphoma: Differences Worth Knowing
• Is Hodgkin’s Lymphoma A Blood Cancer?
• What Are The Lifestyle Changes For Hodgkin’s Lymphoma?