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 is divided into stage I and stage IE.
Stage II
Stage II adult non-Hodgkin lymphoma is divided into stage II and stage IIE.
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Stage II: Cancer 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).
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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 III
Stage III adult non-Hodgkin lymphoma is divided into stage III, stage IIIE, stage IIIS, and stage IIIE+S.
- Stage III: Cancer is found in lymph node groups above and below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
- 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.
- Stage IIIS: Cancer is found in lymph node groups above and below the diaphragm, and in the spleen.
- Stage IIIE+S: Cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area, and in the spleen.
Stage IV
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 tissue, thymus, 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 liver, bone marrow, cerebrospinal 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:
- Indolent lymphomas: These tend to grow and spread slowly and have few symptoms.
- Aggressive lymphomas: These grow and spread quickly and have severe symptoms. Lymphoblastic lymphoma, diffuse small noncleaved cell lymphoma /Burkitt lymphoma, andmantle cell lymphoma are three types of aggressive adult non-Hodgkin lymphoma. Aggressive lymphomas are seen more often in patients who are HIV -positive (AIDS -related lymphoma).
- Contiguous lymphomas: Lymphomas in which the lymph nodes with cancer are next to each other.
- Noncontiguous lymphomas: Lymphomas in which the lymph nodes with cancer are not next to each other, but are on the same side of the diaphragm.
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/
For more information:
Go to the Non-hodgkin Lymphoma health topic.