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Your doctor will perform a thorough diagnostic screening to determine what type of non-Hodgkin lymphoma you have and its stage. Diagnostic testing can include:
UCHealth follows the World Health Organization (WHO) classification system for the many types of non-Hodgkin lymphoma. Treatment for NHL depends on the type, so it’s critical that we determine the exact type of lymphoma you have.
The WHO system groups lymphomas based on:
Your lymph system is made up mainly of lymphocytes, a type of white blood cell that helps the body fight infections. The first criteria for WHO classification is the type of lymphocyte involved. There are two main types of lymphocytes:
Some types of lymphoma, like mantle cell lymphoma, don’t fit neatly into either of these categories.
Regardless of how quickly they grow, all non-Hodgkin lymphomas can spread to other parts of the lymph system if not treated. Eventually, they can also spread to other parts of the body, such as the liver, brain, or bone marrow.
UCHealth follows the Lugano classification for staging NHL in adults, which uses Roman numerals I through IV (1-4). Limited stage (I or II) lymphomas that affect an organ outside the lymph system have an E added.
The lymphoma is in only one lymph node area or lymphoid organ such as the tonsils (I).
The cancer is found only in one area of a single organ outside of the lymph system (IE).
The lymphoma is in two or more groups of lymph nodes on the same side of (above or below) the diaphragm (the thin band of muscle that separates the chest and abdomen). For example, this might include nodes in the underarm and neck area (II) but not the combination of underarm and groin nodes (III).
The lymphoma is in a group of lymph nodes) and in one area of a nearby organ (IIE). It may also affect other groups of lymph nodes on the same side of the diaphragm.
The lymphoma is in lymph node areas on both sides of (above and below) the diaphragm.
The lymphoma is in lymph nodes above the diaphragm, as well as in the spleen.
The lymphoma has spread widely into at least one organ outside the lymph system, such as the bone marrow, liver, or lung.