Paziente con linfoma di Hodgkin con coinvolgimento massivi della milza e’

Patients with Hodgkin lymphoma (HL) and extensive splenic involvement are classified as having stage IV disease according to the Ann Arbor staging system and its derived clinical practice guidelines. The Ann Arbor classification—which forms the basis of standard lymphoma staging used widely in both UK clinical guidelines and international practice—defines stage IV disease as dissemination to one or more extralymphatic organs including the spleen, liver, bone marrow or lung, beyond regional lymph nodes NICE CKS. Extensive involvement of the spleen, which is considered an extranodal organ in this system, therefore places a HL patient into stage IV disease rather than stage III or lower.

This standard remains the cornerstone of Hodgkin lymphoma staging internationally and is integrated into UK guidelines, supporting a classification of any HL patient with significant splenic involvement as stage IV NICE CKS. Recent pediatric and adult HL clinical research and classifications, including adaptations of the Lugano and Cotswold modifications to Ann Arbor staging, also reflect this principle, extending the consistent use of these staging criteria to both children and adults in contemporary lymphoma management Stoevesandt et al. 2025. In pediatric-specific consensus efforts, splenic involvement is also recognized as defining advanced stage disease Stoevesandt et al. 2025.

In summary, a patient with Hodgkin lymphoma who has extensive splenic involvement is classified as having stage IV disease according to current UK guidelines and international lymphoma staging systems NICE CKS Stoevesandt et al. 2025. This classification guides treatment intensity and prognosis and remains the prevailing standard in clinical practice.