Skip to content

Is your insurance policy changing in 2026? Let us know here.

Non-Hodgkin Lymphoma Staging

Request An Appointment
RMCC-lymphoma-web

If you have been diagnosed with non-hodgkin lymphoma, the next step will be to figure out if it has spread, and if so, how far. Your doctor will do this through a process called staging. The information gathered from the staging process determines the stage of the disease, which assists your doctor in understanding the seriousness of your cancer, providing an optimal treatment plan, identifying potential clinical trials for viable treatment options, and even providing chances of survival (prognosis).

Tests Used to Stage Non-Hodgkin Lymphoma

After a diagnosis, additional information is needed to determine the stage, or extent, of cancer. Some commonly used tests include the following. 

Blood Tests

A complete blood count (CBC) may be run to see if cell counts are low. This could mean lymphoma cells are growing in the bone marrow and affecting new blood cell formation. Other blood tests may be used to look at how well the kidneys and liver are working, and the lactate dehydrogenase (LDH) levels. 

Bone Marrow Biopsy

During this procedure, your doctor uses a thick needle to remove a small sample of bone and bone marrow from your hip bone or another large bone (local anesthesia can help control pain). After the sample is taken, a pathologist looks for lymphoma cells under a microscope.

Lymph Node Biopsy

If a lymph node is swollen or other area appears to be affected, a small sample will be taken to test for the presence of cancer cells. 

CT Scan

This type of scan takes a series of detailed pictures of your head, neck, chest, abdomen, or pelvis. To make it easier for the doctor to see swollen lymph nodes and other abnormal areas on the x-ray, you may receive an injection of contrast material and/or be asked to drink another type of contrast material.

PET Scan

This test involves receiving an injection of a small amount of radioactive sugar. A machine then makes computerized pictures of the sugar being used by cells in your body. Lymphoma cells use sugar faster than normal cells, and areas with lymphoma look brighter in the pictures.

Spinal Tap

During a spinal tap, the doctor uses a long, thin needle to remove fluid from the spinal column, after administering local anesthesia. You must lie flat for a few hours afterward so that you don’t get a headache. The lab checks the fluid for lymphoma cells or other problems.

Non-Hodgkin Lymphoma Stages

Over the years, there have been many different systems used for staging lymphomas. The current staging system, however, is known as the Lugano classification, which is based on the older Ann Arbor system. The stages are described by Roman numerals I through IV (1-4). 

The stages of non-hodgkin lymphoma are as follows:

Stage I

Either of the following means the disease is stage I:

The lymphoma is in only 1 lymph node area or lymphoid organ, such as the tonsils (I).

The cancer is found only in 1 area of a single organ outside of the lymph system (IE).

Stage II

Either of the following means the disease is stage II:

The lymphoma is in two or more groups of lymph nodes on the same side of (above or below) the diaphragm (the thin band of muscle that separates the chest and abdomen).

The lymphoma is in a group of lymph node(s) and in one area of a nearby organ (IIE). It may also affect other groups of lymph nodes on the same side of the diaphragm.

Stage III

Either of the following means the disease is stage III:

The lymphoma is in lymph node areas both above and below the diaphragm.

The lymphoma is in lymph nodes above the diaphragm and in the spleen.

Stage IV

The lymphoma has spread widely into at least one organ outside the lymph system, such as the bone marrow, liver, or lung. This is also referred to as distant, or metastatic disease.

Bulky Disease

This term is often used to describe large tumors in the chest. It is especially important for stage II lymphomas, as bulky disease might need more intensive treatment.

Additional Staging Factors for Non-Hodgkin Lymphoma 

In addition to these stage numbers, your doctor may also describe the stage as A,B, E, or S:

  • A: You have not had weight loss, drenching night sweats, or fevers.
  • B: You have had weight loss, drenching night sweats, or fevers.
  • E: Indicates the disease affects tissues or organs outside the lymphatic system. 
  • S: Used if the disease has spread to the spleen.

At Rocky Mountain Cancer Centers, we understand that a lymphoma diagnosis can be scary and overwhelming, which is why our expert oncologists are committed to providing you peace of mind by offering the most advanced treatments for all types of cancers of the blood, including lymphomas. Please find the Rocky Mountain Cancer Centers location that is most convenient for you and call to request an appointment.

CTA