Ann Arbor Staging System

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A staging system used for Hodgkin's and Non-Hodgkin's lymphoma

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The stage is determined by tumour site:

• Stage I: the cancer is located in a single area, e.g. one lymph node and the surrounding area.

• Stage II: the cancer is situated in two separate regions, e.g. affected lymph node or lymphatic organ and a second affected area, and that both affected areas are confined to one side of the diaphragm—i.e. both are above the diaphragm, or both are below the diaphragm.

• Stage III: the cancer has spread above and below the diaphragm, including one organ or area near the lymph nodes or the spleen.

• Stage IV: diffuse or disseminated involvement, including disease progressing into the liver, bone marrow, or nodular cancerous change in the lungs.

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There may be other letters to further describe the staging process

• A: Lack of "B" sympyoms

• B: The presence of "B" symptoms

• E: There is extranodal disease

• X: Bulky disease e.g. a mediastinum >1/3 of the thorax, or tumour deposits of 10sm+

• CS: Clinical staging - as per clinical examination

• PS: Pathological staging e.g. via laporotomy, though this is rarely undertaken