A 62-year-old man with known CLL has a hemoglobin of 9.5 g/dL and platelet count of 210,000/µL. Examination shows cervical nodes up to 2 cm and spleen palpable 4 cm below costal margin. According to the Rai staging system, his disease is stage:
- A Stage I
- B Stage III ✓
- C Stage II
- D Stage IV
Correct answer: B. Stage III
Explanation
Rai staging progresses from lymphocytosis alone (0), to lymphadenopathy (I), splenomegaly (II), anemia (III), and thrombocytopenia (IV). This patient has anemia with normal platelets, placing him at stage III regardless of node size or spleen size, since higher stages are defined by the cytopenia. Stage IV requires thrombocytopenia. Binet staging, used more in Europe, groups node-bearing areas and uses hemoglobin and platelet cutoffs instead.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.