Cotswold’s modification of Ann Arbor staging of Hodgkin’s disease

StageClassification
Iinvolvement of single lymph node region (I) or a single extralymphatic organ or site (IE)
IIinvolvement of two or more lymph node regions on the same side of the diaphragm (II) or on one or more lymph node regions plus an extralymphatic site (IIE)
IIIinvolvement of lymph node regions on both sides of the diaphragm (III) (spleen is included here)
subdivided into:
III(1): involvement of spleen and/or splenic hilar, coeliac and portal nodes
III(2): with para-aortic, iliac or mesenteric nodes
IVinvolvement of one or more extralymphatic organs (lung, liver, bone, bone marrow) with or without lymph node involvement
Additional qualifiersA: asymptomatic
B: fever, night sweats, weight loss >10% body weight
X: bulky disease (defined as lymph node mass > 10 cm in diameter or, if involving mediastinum, a mass greater than 1/3 of intrathoracic diameter at level of T5)
E: involvement of a single extranodal site, contiguous with a known nodal site