Staging allows an understanding of how much lymphoma is present and where it is located in the body. The Ann Arbor staging system is used to stage most types of lymphoma. The exceptions are CLL, which is staged using either the Rai or Binet system, and cutaneous lymphomas which are staged using the Tumour, Node, Metastasis and Blood (TNMB) Classification. Waldenstrom’s Macroglobulinemia is not staged but is given a risk level.
Ann Arbor Staging System
The whole body must be examined to find all the lymphoma. This is done with a whole-body computed tomography (CT) scan, or a positron emission tomography (PET)/CT scan. A bone marrow biopsy may be done to look for lymphoma cells in the bone, and sometimes a spinal tap (lumbar puncture) is done to look for lymphoma cells in the spinal cord and brain. The results of these tests will be used to assess the stage of the lymphoma.
Eastern Cooperative Oncology Group (ECOG) Performance Status:
Lymphomas may also be given a designation of A or B, with A meaning there are no B symptoms and B indicating the presence of the B symptoms of lymphoma (unexplained fever>38°C, drenching night sweats, or unexplained loss of >10% body weight within 6 months).