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Ann Arbor Staging Classification for Ni Made Wahyu Surya Aryantini

Hodgkin Disease I Gusti Ngurah Agung Ari Nugraha

Intan Nurani Indrajanu
Made Mahamita Gandari
Stage or Description
Designation*
I Involvement of a single lymph node region or a lymphoid structure (eg, spleen, thymus, Waldeyer ring) or
involvement of a single extralymphatic site (IE)
II Involvement of two or more lymph node regions on the same side of the diaphragm (hilar nodes, when
involved on both sides, constitute stage II disease) or localized contiguous involvement of only one extranodal
organ or site and lymph node region on the same side of the diaphragm (IIE); the number of anatomic sites
should be indicated by a subscript (eg, II2)
III Involvement of lymph node regions on both sides of the diaphragm (III), which may be accompanied by
involvement of the spleen (IIIs) or by localized contiguous involvement of only one extranodal organ site
(IIIE) or both (IIISE)
III1 With or without involvement of splenic, hilar, celiac, or portal nodes
III2 With involvement of paraaortic, iliac, and mesenteric nodes
IV Diffuse or disseminated involvement of one or more extranodal organs or tissues, with or without associated
lymph node involvement
A* No symptoms
B* Fever (temperature38°C), drenching night sweats, unexplained loss of10% of body weight within the
preceding 6 mo
E* Involvement of a single extranodal site that is contiguous to the known nodal site
X* Bulky disease (widening of the mediastinum by more than one-third or presence of a nodal mass with a
maximum size10 cm)
CS* Clinical stage
PS* Pathologic stage (as determined with laparotomy)
*These designations are applicable to any disease stage
 I Putu Agus Wijaya Putra
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St Jude Children’s Research Hospital Staging Ni Made Wahyu Surya Aryantini

I Gusti Ngurah Agung Ari Nugraha
Classification for Non-Hodgkin Lymphomas
Intan Nurani Indrajanu
Made Mahamita Gandari

Stage Description
I A single tumor or nodal area of involvement outside the abdomen and
mediastinum
II A single tumor with regional node involvement, two or more tumors or
nodal areas of involvement on one side of the diaphragm, or a primary
gastrointestinal tract tumor (resected) with or without regional node
involvement
III Tumors or nodal areas of involvement on both sides of the diaphragm,
any primary intrathoracic or extensive intraabdominal disease, or any
paraspinal or epidural tumors
IV Bone marrow disease*or CNS disease† regardless of other sites of
involvement
*Defined as 5% malignant cells in otherwise normal bone marrow with normal peripheral blood cell counts and smears.
Patients with lymphoblastic lymphoma with more than 25% malignant cells in bone marrow are usually considered to have
leukemia and may be appropriately treated in leukemia clinical trials.† CNS disease in lymphoblastic lymphoma is defined
with criteria similar to those used for acute lymphocytic leukemia (ie, white blood cell count 5/L or greater with malignant
cells). For small noncleaved cell or large cell lymphoma, however, the definition of CNS disease is the presence of any
malignant cell regardless of cell count