# Ann Arbor — Ann Arbor staging of lymphoma (Cotswolds/Lugano-modified)

> Stages lymphoma by anatomic distribution of nodal and extranodal involvement, with A/B/E/S/X modifiers.

**Situação:** vigente · **Órgão:** Oncologia · **Órgão emissor:** Lymphoma staging consensus · **Versão:** current · **Ano:** 1971

## Procedência e vigência
- Família: algoritmo
- Tipo de lógica: flat
- Modalidade: CT, PET
- Fonte primária: Wikipedia contributors. Ann Arbor staging (2026) — https://en.wikipedia.org/wiki/Ann_Arbor_staging
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| I | Stage I | Disease confined to a single lymph node region or lymphoid structure, or a single extranodal site (IE). Modifiers (all stages): A = no B symptoms; B = B symptoms (unexplained fever, drenching night sweats, or >10% body-weight loss); E = limited contiguous extension into one adjacent extranodal site; S = splenic involvement; X = bulky disease (mass >10 cm, or a mediastinal mass exceeding one-third of the internal transverse thoracic diameter). | Early-stage (I-II) favorable disease is treated with combined-modality therapy: a short course of ABVD chemotherapy (e.g. 2 cycles) followed by involved-site/involved-field radiotherapy. | Early stage (I-IIA) carries an excellent prognosis, with roughly 90% 5-year overall survival. | Wikipedia 'Ann Arbor staging', Principal stages (Stage I) + Modifiers (A/B, E, S, X). Management and survival from StatPearls NBK499969, Treatment/Prognosis ('two cycles of ABVD ... followed by ... involved-field radiation therapy'; early stages I-IIA ~90% 5-year overall survival). | ✓ |
| II | Stage II | Involvement of two or more lymph node regions on the same side of the diaphragm (or localized contiguous extranodal extension, IIE). | Early-stage (I-II) disease is treated with combined-modality therapy (ABVD chemotherapy plus involved-site radiotherapy); unfavorable features (bulky/X disease, elevated ESR, extranodal extension) prompt more chemotherapy cycles (4-6) and higher-dose radiation. | Early favorable stage I-IIA disease has roughly 90% 5-year overall survival; unfavorable features worsen the outlook. | Wikipedia 'Ann Arbor staging', Principal stages (Stage II); corroborated by StatPearls NBK499969, Staging ('2 or more lymph node regions on the same side of the diaphragm'). Management/prognosis from NBK499969 Treatment (combined modality; 4-6 cycles for unfavorable features) and Prognosis (~90% early-stage OS). | ✓ |
| III | Stage III | Lymph node regions or lymphoid structures involved on both sides of the diaphragm; may include splenic (S) or limited contiguous extranodal (E) involvement. | Advanced-stage disease is treated mainly with multi-agent chemotherapy (ABVD for most; escalated BEACOPP or Stanford V in selected higher-risk patients per IPS); radiotherapy is generally not beneficial. | Advanced stage carries a less favorable prognosis than early stage; risk is further stratified by the International Prognostic Score. | Wikipedia 'Ann Arbor staging', Principal stages (Stage III); corroborated by StatPearls NBK499969, Staging ('both sides of the diaphragm'). Management from NBK499969 Treatment (advanced-stage chemotherapy 'ABVD for most patients'; 'radiation, in general, is not beneficial'); IPS stratification noted. | ✓ |
| IV | Stage IV | Diffuse or disseminated involvement of one or more extralymphatic (extranodal) organs or tissues (e.g. liver, bone marrow), beyond limited contiguous E-type extension, with or without associated nodal involvement. | Treated as advanced-stage disease with multi-agent chemotherapy (ABVD for most; escalated BEACOPP or Stanford V in selected higher-risk patients); radiotherapy is generally not beneficial. | Most extensive stage with the least favorable outlook; stage IV disease has roughly 60% 5-year overall survival. | Wikipedia 'Ann Arbor staging', Principal stages (Stage IV); corroborated by StatPearls NBK499969, Staging ('extranodal sites beyond those designated as E'). Management/prognosis from NBK499969 Treatment (advanced-stage chemotherapy) and Prognosis ('stage IV disease ... approximately 60%' 5-year OS). | ✓ |

### Citações por categoria
- **I**: Wikipedia contributors. Ann Arbor staging (2026) — https://en.wikipedia.org/wiki/Ann_Arbor_staging · Wikipedia 'Ann Arbor staging', Principal stages (Stage I) + Modifiers (A/B, E, S, X). Management and survival from StatPearls NBK499969, Treatment/Prognosis ('two cycles of ABVD ... followed by ... involved-field radiation therapy'; early stages I-IIA ~90% 5-year overall survival).
- **II**: Wikipedia contributors. Ann Arbor staging (2026) — https://en.wikipedia.org/wiki/Ann_Arbor_staging · Wikipedia 'Ann Arbor staging', Principal stages (Stage II); corroborated by StatPearls NBK499969, Staging ('2 or more lymph node regions on the same side of the diaphragm'). Management/prognosis from NBK499969 Treatment (combined modality; 4-6 cycles for unfavorable features) and Prognosis (~90% early-stage OS).
- **III**: Wikipedia contributors. Ann Arbor staging (2026) — https://en.wikipedia.org/wiki/Ann_Arbor_staging · Wikipedia 'Ann Arbor staging', Principal stages (Stage III); corroborated by StatPearls NBK499969, Staging ('both sides of the diaphragm'). Management from NBK499969 Treatment (advanced-stage chemotherapy 'ABVD for most patients'; 'radiation, in general, is not beneficial'); IPS stratification noted.
- **IV**: Wikipedia contributors. Ann Arbor staging (2026) — https://en.wikipedia.org/wiki/Ann_Arbor_staging · Wikipedia 'Ann Arbor staging', Principal stages (Stage IV); corroborated by StatPearls NBK499969, Staging ('extranodal sites beyond those designated as E'). Management/prognosis from NBK499969 Treatment (advanced-stage chemotherapy) and Prognosis ('stage IV disease ... approximately 60%' 5-year OS).

## Referências cruzadas
- _caracteriza_ → [Deauville 5PS — Deauville five-point FDG-PET scale for lymphoma](https://radcommons.laudos.ai/systems/deauville.md) — Deauville assesses metabolic response within the Ann Arbor / Lugano staging framework.
- _fronteira compartilhada_ → [Lugano — Lugano classification for lymphoma response](https://radcommons.laudos.ai/systems/lugano.md) — The Lugano classification refines Ann Arbor staging and response assessment for lymphoma.


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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