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PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-.

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PDQ Cancer Information Summaries [Internet].

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Table 4. Lugano Classification Applicable for Pediatric Hodgkin Lymphomasa

Stage Description
Limited stage
I Involvement of a single lymphatic site (i.e., nodal region, Waldeyer's ring, thymus, or spleen).
IESingle extralymphatic site in the absence of nodal involvement (rare in Hodgkin lymphoma).
II Involvement of two or more lymph node regions on the same side of the diaphragm.
IIEContiguous extralymphatic extension from a nodal site with or without involvement of other lymph node regions on the same side of the diaphragm.
II bulky b Stage II with disease bulk. c
Advanced stage
III Involvement of lymph node regions on both sides of the diaphragm; or nodes above the diaphragm with spleen involvement.
IV Diffuse or disseminated involvement of one or more extralymphatic organs, with or without associated lymph node involvement; or noncontiguous extralymphatic organ involvement in conjunction with nodal stage II disease or any extralymphatic organ involvement in nodal stage III disease. Stage IV includes any involvement of the bone marrow, liver, or lungs (other than by direct extension in stage IIE disease).
Designations applicable to any stage
A No symptoms.
B Fever (temperature >38.0ºC), drenching night sweats, unexplained loss of >10% of body weight within the preceding 6 months.
E Involvement of a single extranodal site that is contiguous or proximal to the known nodal site.
SSplenic involvement.

Note: Hodgkin lymphoma uses A or B designation with stage group.

aAdapted from AJCC: Pediatric Hodgkin and non-Hodgkin lymphomas. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp. 959–65.[23,26]

bStage II bulky may be considered either early or advanced stage based on lymphoma histology and prognostic factors.

cThe definition of disease bulk varies according to lymphoma histology. In the Lugano classification, bulk in Hodgkin lymphoma is defined as a mass greater than one third of the thoracic diameter on CT of the chest or a mass >10 cm.

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