Cotswolds-modified Ann Arbor classification
The Cotswolds-modified Ann Arbor classification is a lymphoma staging classification system for both Hodgkin lymphoma and non-Hodgkin lymphoma. They came about in 1988 following recommended modifications to the Ann Arbor staging system after a meeting in Cotswold, England.
This classification has since been updated and modified, with the currently used criteria being the Lugano classification and the LYRIC classification.
Staging system
- stage I: one nodal group or lymphoid organ (e.g. spleen or thymus)
- stage IE: one extranodal site
- stage II: two or more nodal groups, same side of the diaphragm
- stage IIE: localized extranodal site with stage II criteria, both on the same side of the diaphragm
- stage III: nodal groups on both sides of the diaphragm
- stage IIIS(1): with splenic involvement
- stage IIIE(2): with localized extranodal site
- stage IIISE: both
- stage IV: disseminated involvement of one or more extralymphatic organ (e.g. lung, bone) with or without any nodal involvement
Additional sub-staging variables:
- A: asymptomatic
- B: presence of B symptoms (including fever, night sweats and weight loss of over 10% of body weight over 6 months)
- X: bulky nodal disease: nodal mass >1/3 of intrathoracic diameter or 10 cm in dimension