Hodgkin Lymphoma Stages

Stage I

Either of the following means that the Hodgkin lymphoma is stage I:

• Hodgkin lymphoma is found in only 1 lymph node area or lymphoid organ, such as the thymus (I).
• The cancer is found only in 1 part of 1 organ outside the lymph system (IE).

Stage II

Either of the following means that the Hodgkin lymphoma is stage II:

• Hodgkin lymphoma is found in 2 or more lymph node areas on the same side of (above or below) the diaphragm, which is the thin muscle beneath the lungs that separates the chest and abdomen (II).
• The cancer extends locally from 1 lymph node area into a nearby organ (IIE).

Stage III

Either of the following means that the Hodgkin lymphoma is stage III:

• Hodgkin lymphoma is found in lymph node areas on both sides of (above and below) the diaphragm (III). It may extend locally from a lymph node into a nearby organ (IIIE).
• Hodgkin lymphoma is in the spleen (IIIS).

Stage IV

• Hodgkin lymphoma has spread widely into at least 1 organ outside of the lymph system, such as the liver, bone marrow, or lungs.

Other modifiers may also be used to describe the Hodgkin lymphoma stage:

Bulky disease

Bulky disease is usually labeled by adding the letter X to the stage. It describes:

• Tumors in the chest that are at least ⅓ as wide as the chest, or
• Tumors in other areas that are larger than 10 centimeters (about 4 inches) across

This is especially important for stage II lymphomas, because bulky disease may require more intensive treatment.

A vs. B

Each stage may also be assigned a letter (A or B). For example: IIIB.

B is added if a person has any of these B symptoms:

• Unexplained weight loss of more than 10% of body weight over the previous 6 months
• Unexplained fever of at least 100.4°F (38°C) lasting for several days to weeks
• Drenching night sweats

If a person has any B symptoms, it usually means the lymphoma is more advanced and more intensive treatment is often recommended.

A is added to the stage if no B symptoms are present. 

Resistant or recurrent Hodgkin lymphoma

Resistant or recurrent Hodgkin lymphoma is not part of the formal staging system, but your cancer care team might use these terms to describe what's going on with the lymphoma in some cases.

Resistant or progressive disease: These terms are used when the lymphoma doesn’t go away or progresses (grows) while you're being treated.

Recurrent or relapsed disease: These terms mean Hodgkin lymphoma went away with treatment, but it has now come back. If the lymphoma returns, it might be in the same place it started or in another part of the body. This can happen shortly after treatment or years later.