The stage of non-Hodgkin’s lymphoma (NHL) is a process that determines the number of lymph nodes affected, the location of cancer, and the organs or regions where cancer has spread from the original site such as the lungs or liver. However, there are four stages of NHL (Stage I, Stage II, Stage III and Stage IV). Besides, NHLs are often classified as low or high grade lymphomas.
Determining the stage of non-Hodgkin’s lymphoma (NHL) is a process that determines the number of lymph nodes affected, the location of cancer, and the organs or regions where cancer has spread from the original site, such as the lungs or liver. Doctors also look for the affected lymph nodes at the diaphragm, the breathing muscle under the lungs in the early stages of NHL. In fact, in more advanced stages of NHL, the disease can be on both sides of the diaphragm.
Stages of non-Hodgkin’s lymphoma
To identify the stages of non-Hodgkin’s lymphoma, numbers starting from 1 to 4 are used. However, doctors can also describe cancer using the letters A, B, E and S.
A and B: The letter B indicates one or more of the following symptoms such as fever, night sweats, or unexplained weight loss. If there is no symptom of symptom B, the letter A is used.
E and S: The letter E indicates that the disease affects tissues or organs outside the lymphatic system. However, the letter S is used if it has spread to the spleen.
X is used to denote if the disease is considered “severe” (greater than 10 cm)1.
The stages of non-Hodgkin lymphoma are:
- Stage I non-Hodgkin lymphoma: Stage I refers to NHL with one lymph node area (stage I) besides additional lymphoid organs or sites without lymph node involvement (stage IE). In other words, one lymph node region may have one node or a group of adjacent nodes.
- Stage II non-Hodgkin lymphoma: Stage II involves two or more affected lymph nodes besides additional lymphoid organs or sites on the same side of the diaphragm (stage IIE) (stage II).
- Non-Hodgkin lymphoma Stage III: The involvement of lymph nodes on both sides of the diaphragm comes under Stage III (stage III).
- Stage IV non-Hodgkin lymphoma: Stage IV involves one or more additional lymphoid organs, such as the liver, lungs or bone marrow. However, it exists with or without associated lymph node involvement2.
Grades of non-Hodgkin lymphoma
Lymphomas are often classified as low or high grade. The degree of lymphoma is also an important factor in treatment planning.
- Low-grade lymphomas
They grow very slowly and are sometimes called indolent lymphomas. They may need little or no treatment for months or possibly years. Some people will never need treatment. Follicular lymphoma (FL) is a common low-grade NHL.
- High-grade lymphomas
They grow faster and are sometimes called aggressive lymphomas. It usually causes symptoms and requires immediate treatment. Diffuse large B-cell lymphoma (DLBCL) is the most common type of advanced lymphoma3.
- 1.Non-Hodgkin lymphoma stages. Cancer Treatment-Centers of America. Published 2022. Accessed March 2022. https://www.cancercenter.com/cancer-types/non-hodgkin-lymphoma/stages#:~:text=The%20stages%20of%20non%2DHodgkin,either%20above%20or%20below%20it.
- 2.Sapkota S, Shaikh H. statpearls. Published online December 5, 2021. http://www.ncbi.nlm.nih.gov/books/NBK559328/
- 3.Stage and grade of non-Hodgkin lymphoma. Macmillan Cancer Support. Published 2021. Accessed March 2022. https://www.macmillan.org.uk/cancer-information-and-support/lymphoma/staging-and-grading-of-non-hodgkin-lymphoma-nhl