Editing Lymphoma (section)

===Staging===
[[File:DIagram showing where lymphoma can spread in the body CRUK 382.svg|thumb|Diagram showing common sites where lymphoma spreads]]
After a diagnosis and before treatment, cancer is [[cancer staging|staged]]. This refers to determining if the cancer has spread, and if so, whether locally or to distant sites. Staging is reported as a grade between I (confined) and IV (spread). The stage of a lymphoma helps predict a patient's prognosis and is used to help select the appropriate therapy.<ref name="Cheson">{{cite journal | vauthors = Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, Lister TA | title = Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification | journal = Journal of Clinical Oncology | volume = 32 | issue = 27 | pages = 3059–3068 | date = September 2014 | pmid = 25113753 | pmc = 4979083 | doi = 10.1200/JCO.2013.54.8800 }}</ref>

The [[Ann Arbor staging|Ann Arbor staging system]] is routinely used for staging of both HL and NHL. In this staging system, stage I represents localized disease contained within a lymph node group, II represents the presence of lymphoma in two or more lymph nodes groups, III represents spread of the lymphoma to lymph nodes groups on both sides of the [[Thoracic diaphragm|diaphragm]], and IV indicates spread to tissue outside the lymphatic system. Different suffixes imply the involvement of different organs, for example, S for the spleen and H for the liver. Extra-lymphatic involvement is expressed with the letter E. In addition, the presence of B symptoms (one or more of the following: unintentional loss of 10% body weight in the last 6 months, night sweats, or persistent fever of 38&nbsp;°C or more) or their absence is expressed with B or A, respectively.<ref>{{cite journal | vauthors = Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M | title = Report of the Committee on Hodgkin's Disease Staging Classification | journal = Cancer Research | volume = 31 | issue = 11 | pages = 1860–1861 | date = November 1971 | pmid = 5121694 }}</ref>

[[CT scan]] or [[PET scan]] imaging modalities are used to stage cancer. PET scanning is advised for [[fludeoxyglucose (18F)|fluorodeoxyglucose]]-avid lymphomas, such as Hodgkin lymphoma, as a staging tool that can even replace bone marrow biopsy. For other lymphomas, CT scanning is recommended for staging.<ref name="Cheson"/>

Age and poor [[performance status]] are other established poor prognostic factors.<ref>{{cite journal | title = A predictive model for aggressive non-Hodgkin's lymphoma | journal = The New England Journal of Medicine | volume = 329 | issue = 14 | pages = 987–994 | date = September 1993 | pmid = 8141877 | doi = 10.1056/NEJM199309303291402 | author1 = International Non-Hodgkin's Lymphoma Prognostic Factors Project | doi-access =free  }}</ref>  This means that people who are elderly or too sick to take care of themselves are more likely to be killed by lymphoma than others.

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File:Nodular Mantle Cell Lymphoma - high power view - by Gabriel Caponetti.jpg|Mantle cell lymphoma: Notice the irregular nuclear contours of the medium-sized lymphoma cells and the presence of a pink histiocyte. By immunohistochemistry, the lymphoma cells expressed CD20, CD5, and Cyclin D1 (high-power view, H&E)
File:Hodgkin lymphoma, nodular lymphocyte predominant - low power view - H&E - by Gabriel Caponetti.jpg|Hodgkin lymphoma, nodular lymphocyte predominant (low-power view): Notice the nodular architecture and the areas of "mottling". (H&E)
File:Hodgkin lymphoma, nodular lymphocyte predominant - high power view - H&E - by Gabriel Caponetti.jpg|Hodgkin lymphoma, nodular lymphocyte predominant (high-power view): Notice the presence of L&H cells, also known as "popcorn cells". (H&E)
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