Ann Arbor staging

Principal stages

• Stage I indicates that the cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms.
• Stage II indicates that the cancer is located in two separate regions, an affected lymph node or lymphatic organ and a second affected area, and that both affected areas are confined to one side of the diaphragm—that is, both are above the diaphragm, or both are below the diaphragm.
• Stage III indicates that the cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen.
• Stage IV indicates diffuse or disseminated involvement of one or more extralymphatic organs, including any involvement of the liver, bone marrow, or nodular involvement of the lungs.

  Modifiers

• A or B: the absence of constitutional symptoms is denoted by adding an "A" to the stage; the presence is denoted by adding a "B" to the stage.
• S: is used if the disease has spread to the spleen.
• E: is used if the disease is "extranodal" or has spread from lymph nodes to adjacent tissue.
• X: is used if the largest deposit is >10 cm large, or whether the mediastinum is wider than ⅓ of the chest on a chest X-ray.

  Type of staging

• CS: clinical stage as obtained by doctor's examinations and tests.
• PS: pathological stage as obtained by exploratory laparotomy with splenectomy. Note: exploratory laparotomy has fallen out of favor for lymphoma staging.

  Limitations

History