How is Hodgkin Lymphoma Staged and Classified?

Hodgkin lymphoma is staged using the Ann Arbor staging system. This system is based on the number of lymph node regions involved and whether the disease has spread beyond the lymph nodes or not. The stages are as follows:

• Stage I: The cancer is limited to one lymph node region or a single organ.
• Stage II: The cancer is in two or more lymph node regions on the same side of the diaphragm or the cancer has extended from a single lymph node region into a nearby organ.
• Stage III: The cancer is in lymph node regions on both sides of the diaphragm.
• Stage IV: The cancer has spread widely into at least one organ outside of the lymph system.

Each stage can also be classified as A or B. 'A' means the patient does not have any significant symptoms. 'B' is added if the patient has significant symptoms such as fever, night sweats, or weight loss.

Classification of Hodgkin Lymphoma

Hodgkin Lymphoma is classified into two main types based on the presence of a specific type of cell, known as the Reed-Sternberg cell:

• Classical Hodgkin lymphoma: This is the most common type and is characterized by the presence of Reed-Sternberg cells. There are four subtypes of classical Hodgkin lymphoma:
  • Nodular sclerosis: This type accounts for 70% of all classical Hodgkin lymphoma cases. It is most common among young adults. The involved lymph nodes contain elements of fibrous tissues. B symptoms are found in approximately 40% of cases and it is highly curable.
  • Mixed cellularity: This type is most prevalent in children, older adults and patients with HIV. It is associated with the Epstein–Barr virus. The affected lymph nodes contain Reed-Sternberg cells and several other cell types. Most people will experience B symptoms which include fever, night sweats and weight loss.
  • Lymphocyte-rich: This type is usually diagnosed at an early stage. The involved lymph nodes contain many normal-appearing lymphocytes and Reed-Sternberg cells. B symptoms are rare.
  • Lymphocyte-depleted: This is the rarest type of classical Hodgkin lymphoma. The involved lymph nodes contain few normal lymphocytes but many Reed-Sternberg cells. It is most often found in older adults and people with an HIV infection. It is associated with the Epstein-Barr virus. B symptoms are common. 
• Nodular lymphocyte-predominant Hodgkin lymphoma: This is a rare type and is characterized by the presence of a different abnormal cell, known as the "popcorn cell". This type of Hodgkin lymphoma tends to grow more slowly and is often diagnosed at an earlier stage. This type of most common in 30 to 50 year olds ad is highly curable. There is a small risk of this type transforming to aggressive non-Hodgkin's lymphoma. 

What are the Phases of Hodgkin Lymphoma?

The phases of Hodgkin Lymphoma refer to the progression of the disease and are often associated with the stages. The phases include:

• Initial phase: This is when the disease is localized to one area. It corresponds to Stage I of the disease.
• Locally advanced phase: The disease has spread to nearby lymph nodes or tissues. This corresponds to Stage II of the disease.
• Advanced phase: The disease has spread to lymph nodes on both sides of the diaphragm or to other parts of the body. This corresponds to Stages III and IV of the disease.

Want to Learn More About Hodgkin Lymphoma?

Keep reading HealthTree for Hodgkin Lymphoma's 101 pages!

• What Is Hodgkin Lymphoma?
• How Is Hodgkin Lymphoma Diagnosed?
• How Long Will I Live With Hodgkin Lymphoma?
• What Are The Signs And Symptoms Of Hodgkin Lymphoma?
• What Are Treatments For Hodgkin Lymphoma?