From: Childhood Hodgkin Lymphoma Treatment (PDQ®)
PDQ Cancer Information Summaries [Internet].
Bethesda (MD): National Cancer Institute (US); 2002-.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Table 4. Lugano Classification Applicable for Pediatric Hodgkin Lymphomasa
| Stage | Description |
|---|---|
| Limited stage | |
| I | Involvement of a single lymphatic site (i.e., nodal region, Waldeyer's ring, thymus, or spleen). |
| IE | Single extralymphatic site in the absence of nodal involvement (rare in Hodgkin lymphoma). |
| II | Involvement of two or more lymph node regions on the same side of the diaphragm. |
| IIE | Contiguous extralymphatic extension from a nodal site with or without involvement of other lymph node regions on the same side of the diaphragm. |
| II bulky b | Stage II with disease bulk. c |
| Advanced stage | |
| III | Involvement of lymph node regions on both sides of the diaphragm; or nodes above the diaphragm with spleen involvement. |
| IV | Diffuse or disseminated involvement of one or more extralymphatic organs, with or without associated lymph node involvement; or noncontiguous extralymphatic organ involvement in conjunction with nodal stage II disease or any extralymphatic organ involvement in nodal stage III disease. Stage IV includes any involvement of the bone marrow, liver, or lungs (other than by direct extension in stage IIE disease). |
| Designations applicable to any stage | |
| A | No symptoms. |
| B | Fever (temperature >38.0ºC), drenching night sweats, unexplained loss of >10% of body weight within the preceding 6 months. |
| E | Involvement of a single extranodal site that is contiguous or proximal to the known nodal site. |
| S | Splenic involvement. |
Note: Hodgkin lymphoma uses A or B designation with stage group.
bStage II bulky may be considered either early or advanced stage based on lymphoma histology and prognostic factors.
cThe definition of disease bulk varies according to lymphoma histology. In the Lugano classification, bulk in Hodgkin lymphoma is defined as a mass greater than one third of the thoracic diameter on CT of the chest or a mass >10 cm.