Fast Five Quiz: Test Your Knowledge on Key Aspects of Non-Hodgkin Lymphoma

Emmanuel C. Besa, MD


August 20, 2018

The Ann Arbor staging system is the most commonly used staging system for patients with NHL. This system divides NHL into four stages, as follows:

  • Stage I NHL involves a single lymph node region (I) or localized involvement of a single extralymphatic organ or site (IE)

  • Stage II NHL involves two or more lymph node regions on the same side of the diaphragm (II) or localized involvement of a single associated extralymphatic organ in addition to criteria for stage II (IIE)

  • Stage III involves lymph node regions on both sides of the diaphragm (III) that also may be accompanied by localized involvement of an extralymphatic organ or site (IIIE), spleen (IIIS), or both (IIISE)

  • Stage IV represents disseminated or multifocal involvement of one or more extralymphatic sites with or without associated lymph node involvement or isolated extralymphatic organ involvement with distant (nonregional) nodal involvement

The stages can also be appended by A or B designations. Patients with A disease do not have systemic symptoms. The B designation is applied in patients with any of the following symptoms:

  • Unexplained loss > 10% of body weight in the 6 months before diagnosis

  • Unexplained fever with temperature > 100.4°F (> 38°C)

  • Drenching night sweats

The IPI for NHL is as follows:

  • Age > 60 years

  • ECOG grade of 2 or greater

  • Elevated LDH value

  • Two or more extranodal sties

  • Ann Arbor stage III or IV

The FLIPI score is as follows:

  • Five or more nodal sites

  • Elevated LDH value

  • Age ≥ 60 years

  • Ann Arbor stage III or IV

  • Hemoglobin value < 12 g/dL

For more on the workup of NHL, read here.


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