Ann Arbor Staging System for Lymphoma

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Ann Arbor staging classification for Hodgkin and non-Hodgkin lymphomas

Stage I

Involvement of a single lymph node region (I) or of a single extralymphatic organ or site (IE)*

Stage II

Involvement of two or more lymph node regions or lymphatic structures on the same side of the diaphragm alone (II) or with involvement of limited, contiguous extralymphatic organ or tissue (IIE)

Stage III

Involvement of lymph node regions on both sides of the diaphragm (III) which may include the spleen (IIIS) or limited, contiguous extralymphatic organ or site (IIIE) or both (IIIES)

Stage IV

Diffuse or disseminated foci of involvement of one or more extralymphatic organs or tissues, with or without associated lymphatic involvement

All cases are subclassified to indicate the absence (A) or presence (B) of the systemic ("B") symptoms of significant unexplained fever, night sweats, or unexplained weight loss exceeding 10 percent of body weight during the six months prior to diagnosis.


Clinical stage refers to the extent of disease determined by diagnostic tests following a single diagnostic biopsy. If a second biopsy of any kind is obtained, even if negative, the term pathologic stage is used.


* The designation "E" generally refers to extranodal contiguous extension (ie, proximal or contiguous extranodal disease) that can be encompassed within an irradiation field appropriate for nodal disease of the same anatomic extent. A single extralymphatic site as the only site of disease should be classified as IE, rather than stage IV.


Modified to become the COTSWOLD Staging System for Lymphoma, or modified Ann Arbor System - only for Hodgkin's Lymphoma however.


Prognostics is done using: International Prognostic Index for the aggressive non-Hodgkin's lymphomas or IPI