Table 9.3-3. Lugano (2014) staging system for primarily nodal lymphomas

Clinical stage (CS)



One node or a group of adjacent nodes, or single extranodal lesions without nodal involvement


≥2 nodal groups on the same side of the diaphragm, or CS I/II by nodal extent with limited contiguous extranodal involvement


Nodes on both sides of the diaphragm, or nodes above the diaphragm with spleen involvement


Additional noncontiguous extralymphatic involvement

The tonsils, Waldeyer ring, and spleen are considered nodal tissue.

Additionally in Hodgkin lymphoma: A, no general symptoms; B, general symptoms: unexplained fever (>38°C), drenching night sweats, or weight loss >10% of body weight in the prior 6 months.

a CS II bulky: CS II as above and bulky disease (a single nodal mass of ≥10 cm or >1/3 of the transthoracic diameter at any level of thoracic vertebrae as determined by computed tomography).

Based on J Clin Oncol. 2014;32(27):3059-68.