Ann Arbor staging
Oncology, staging and radiology
Also known as: Lugano classification · Ann-Arbor-Klassifikation (Lugano-Modifikation) · Lugano-Klassifikation · Ann Arbor evrelemesi · Lugano sınıflaması · Ann Arbor staging with the Lugano 2014 modification (lymphoma)
What it is for
Anatomical staging of primary nodal Hodgkin and non-Hodgkin lymphoma. In the Lugano modification extent is assessed with positron emission tomography–computed tomography (PET-CT) for FDG-avid lymphomas and with CT for non-avid types; tonsils, Waldeyer's ring and spleen count as nodal tissue.
Classification
| Category | Description |
|---|---|
| Stage I | one node or a group of adjacent nodes; or a single extranodal lesion without nodal involvement (IE). |
| Stage II | two or more nodal groups on the same side of the diaphragm; or stage I/II nodal extent with limited contiguous extranodal involvement (IIE). |
| Stage II bulky | stage II with bulky disease; whether it is grouped as limited or advanced depends on histology and prognostic factors. |
| Stage III | nodes on both sides of the diaphragm, or nodes above the diaphragm with spleen involvement. |
| Stage IV | additional non-contiguous extralymphatic involvement. |
| Limited vs advanced | stages I–II (non-bulky) are called limited disease; stages III–IV advanced disease. |
| A / B | B symptoms are fever above 38 °C, drenching night sweats or unexplained loss of more than 10% of body weight within 6 months; under Lugano the A/B suffix is used only for Hodgkin lymphoma. |
| Bulk | the X designation is dropped; the largest tumour diameter is recorded instead (for Hodgkin lymphoma bulk remains a single mass ≥10 cm or more than one third of the thoracic diameter). |
| E | applies only to limited extranodal disease (IE, or stage II with contiguous extranodal extension), not to advanced stages. |
Source
Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification
J Clin Oncol 2014;32:3059–3068 (Cheson BD et al.)
PMID: 25113753
- Edition
- Lugano classification 2014 (modified Ann Arbor staging); Ann Arbor 1971, Cotswolds modification 1989
- Checked on
Summary of the published classification in our own words. Not a substitute for the original publication.
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