Staging is the process of finding out how far cutaneous lymphoma has spread. Mycosis fungoides and Sézary syndrome are staged differently from other cutaneous lymphomas. They are grouped into overall stages I (1) through IV (4).
When your Fred Hutch Cancer Center team designs your treatment plan, they will take into account the stage of your cancer along with many other factors. The stage is an important part of choosing which treatments are right for you. Physical exams, imaging tests, biopsies and blood tests are used to determine stage.
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Stages for Mycosis Fungoides and Sézary Syndrome
Some of the stages are divided into substages A and B based on specific patterns of skin, blood, lymph node and organ involvement.
Stage I (1)
Thin patches or plaques on the skin; there are no tumors and no involvement of the lymph nodes.
Stage II (2)
There are few or no tumors. Lymph nodes may be normal or enlarged but are not cancerous.
Stage III (3)
Skin lesions cover at least 80% of the body. Lymph nodes may be normal or enlarged but are not cancerous.
Stage IV (4)
Skin lesions may cover any amount of skin. Stage IV disease may involve the blood, lymph nodes or other organs such as the liver or spleen.
Staging for Other Cutaneous Lymphomas
A TNM staging system is used for other cutaneous lymphomas, including primary cutaneous follicle center lymphoma. This system is more complex and this system is used for many other types of cancer. The letters stand for:
- Tumor (T): The size of the main tumor and any spread of cancer into nearby tissue
- Nodes (N): The number of nearby lymph nodes where cancer has spread
- Metastasis (M): If cancer has spread (metastasized) to other parts of the body
In the TNM system, there will be a symbol after each letter to give details; for example, T1N0M0. In T1, the 1 indicates the size of the tumor (small). In N0, the 0 means there’s no sign of cancer in nearby lymph nodes. In M0, the 0 means cancer hasn’t spread to distant parts of the body.
Your Fred Hutch care team will explain what your stage means for you and how it guides your treatment plan and follow‑up.