Neck lumps and night sweats in a 26-year-old
History
26-year-old woman with 3 months of drenching night sweats, 8 kg weight loss and painless neck lumps. Core biopsy of a left supraclavicular node: classical Hodgkin lymphoma, nodular sclerosis. Chest radiograph: widened mediastinum. Haemoglobin 108 g/L, ESR 64 mm/h. Request: staging FDG PET/CT before chemotherapy; please give the stage.
Step 1 · Staging scan
Besides the neck, supraclavicular and mediastinal nodes, there are three foci in the spleen and three in the skeleton (right ilium, L2, left femur). What is the stage?