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Non-hodgkin Lymphoma

Stages of Adult Non-Hodgkin Lymphoma

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Stages of adult non-Hodgkin lymphoma may include E and S.

Adult non-Hodgkin lymphoma may be described as follows:

  • E: "E" stands for extranodal and means the cancer is found in an area or organ other than the lymph nodes or has spread to tissues beyond, but near, the major lymphatic areas.
  • S: "S" stands for spleen and means the cancer is found in the spleen.

The following stages are used for adult non-Hodgkin lymphoma:

Stage I

Stage I adult non-Hodgkin lymphoma; drawing shows cancer in one lymph node group above the diaphragm. An inset shows a lymph node with a lymph vessel, an artery, and a vein. Lymphoma cells containing cancer are shown in the lymph node.
Stage I adult non-Hodgkin lymphoma. Cancer is found in one lymphatic area (lymph nodes, tonsils, thymus, or spleen). In stage IE (not shown), cancer is found in one organ or area outside the lymph nodes.

Stage I adult non-Hodgkin lymphoma is divided into stage I and stage IE.

Stage II

Stage II adult non-Hodgkin lymphoma is divided into stage II and stage IIE.

  • Stage IICancer is found in two or more lymph node groups either above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
    Stage II adult non-Hodgkin lymphoma; drawing shows cancer in lymph node groups above and below the diaphragm. An inset shows a lymph node with a lymph vessel, an artery, and a vein. Lymphoma cells containing cancer are shown in the lymph node.
    Stage II adult non-Hodgkin lymphoma. Cancer is found in two or more lymph node groups, and both are either above (a) or below (b) the diaphragm.
  • Stage IIE: Cancer is found in one or more lymph node groups either above or below the diaphragm. Cancer is also found outside the lymph nodes in one organ or area on the same side of the diaphragm as the affected lymph nodes.
    Stage IIE adult non-Hodgkin lymphoma; drawing shows cancer in one lymph node group above the diaphragm and in the left lung. An inset shows a lymph node with a lymph vessel, an artery, and a vein. Lymphoma cells containing cancer are shown in the lymph node.
    Stage IIE adult non-Hodgkin lymphoma. Cancer is found in one or more lymph node groups either above or below the diaphragm and outside the lymph nodes in an organ or area on the same side of the diaphragm as the lymph nodes with cancer (a).

Stage III

Stage III adult non-Hodgkin lymphoma; drawing shows cancer in lymph node groups above and below the diaphragm, in the left lung, and in the spleen. An inset shows a lymph node with a lymph vessel, an artery, and a vein. Lymphoma cells containing cancer are shown in the lymph node.
Stage III adult non-Hodgkin lymphoma. Cancer is found in one or more lymph node groups above and below the diaphragm (a). In stage IIIE, cancer is found in lymph node groups above and below the diaphragm and outside the lymph nodes in a nearby organ or area (b). In stage IIIS, cancer is found in lymph node groups above and below the diaphragm (a) and in the spleen (c). In stage IIIE plus S, cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area (b), and in the spleen (c).

Stage III adult non-Hodgkin lymphoma is divided into stage III, stage IIIE, stage IIIS, and stage IIIE+S.

Stage IV

Stage IV adult non-Hodgkin lymphoma; drawing shows cancer in the liver, the left lung, and in one lymph node group below the diaphragm. The brain and pleura are also shown. One inset shows a close-up of cancer spreading through lymph nodes and lymph vessels to other parts of the body. Lymphoma cells containing cancer are shown inside one lymph node. Another inset shows cancer cells in the bone marrow.
Stage IV adult non-Hodgkin lymphoma. Cancer is found throughout one or more organs that are not part of a lymphatic area (lymph nodes, tonsils, thymus, or spleen) (a); or in one organ that is not part of a lymphatic area and has spread to lymph nodes far away from that organ (b); or cerebrospinal fluid (not shown), the liver, bone marrow, or lungs.

In stage IV adult non-Hodgkin lymphoma, the cancer:

  • is found throughout one or more organs that are not part of a lymphatic area (lymph node group,tonsils and nearby tissuethymus, or spleen), and may be in lymph nodes near those organs; or
  • is found in one organ that is not part of a lymphatic area and has spread to organs or lymph nodes far away from that organ; or
  • is found in the liverbone marrowcerebrospinal fluid (CSF), or lungs (other than cancer that has spread to the lungs from nearby areas).

Adult non-Hodgkin lymphomas are also described based on how fast they grow and where the affected lymph nodes are in the body.

Indolent or aggressive:

Contiguous or noncontiguous:

There is no standard staging system for Waldenström macroglobulinemia.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with Waldenström macroglobulinemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI Web site.

Adapted from the National Cancer Institute's Physician Data Query (PDQ(r)) Cancer Information Summaries (http://www.cancer.gov/cancertopics/pdq). Last Modified: April 25, 2014

 

 

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Last Reviewed: Apr 07, 2015