The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

Non-Hodgkin lymphoma stages

The grade and stage of adult non-Hodgkin lymphoma are important factors in evaluating treatment options. Staging helps to determine how far the disease has spread and whether it has invaded tissues and organs outside the lymph system. Grading non-Hodgkin lymphoma is important in helping to understand the growth pattern and aggressiveness of the cancer cells.

Grading non-Hodgkin lymphoma

Doctors will determine whether the lymphoma is low grade (indolent or slow growth rate), intermediate grade (moderate growth rate) or high grade (aggressive or rapid growth rate). While aggressive non-Hodgkin lymphoma often requires a more immediate and intensive treatment plan, many types of the disease typically respond well to treatment.

Staging non-Hodgkin lymphoma

Non-Hodgkin lymphoma staging is the process of identifying the location of the cancer, the number of lymph nodes affected by the cancer and whether the disease has spread from the original site to other parts of the body, including organs outside the lymphatic system, such as the liver or lungs. Doctors also look for affected lymph nodes near the diaphragm, the breathing muscle beneath the lungs. In earlier stages of non-Hodgkin lymphoma, affected lymph nodes are found only on one side of the diaphragm. In more advanced stages of non-Hodgkin lymphoma, the disease may be found on both sides of the diaphragm.

Additional staging factors for non-Hodgkin lymphoma

Stages of non-Hodgkin lymphoma are identified using the numbers 1 through 4. Doctors may also use the letters A, B, E and S to help describe the cancer:

A and B: The letter B indicates the presence of one or more of the following symptoms: drenching night sweats, fever or unexplained weight loss. The letter A is used if there is no evidence of B symptoms.

E and S: The letter E indicates the disease affects tissues or organs outside the lymphatic system. The letter S is used if the disease has spread to the spleen.

If the disease is considered “bulky” (greater than 10 cm in size), it is designated with an X.

The stages of non-Hodgkin lymphoma are:

Stage 1 non-Hodgkin lymphoma: The cancer is found in a single region or organ, usually one lymph node and the surrounding area.

Stage 2 non-Hodgkin lymphoma: The cancer is found in two or more lymph node regions on the same side of the diaphragm, either above or below it.

Stage 3 non-Hodgkin lymphoma: The cancer is found in lymph nodes on both sides of the diaphragm.

Stage 4 non-Hodgkin lymphoma: The cancer has spread to one or more tissues or organs outside the lymph system, such as the liver, lungs or bones, and may be found in lymph nodes near or far away from those organs.

Next topic: What are the types of non-Hodgkin lymphoma?