Which substage in Ann Arbor staging indicates the presence of constitutional symptoms?

Constitutional symptoms in the context of lymphoma staging refer to systemic manifestations such as fever, night sweats, and unexplained weight loss. These symptoms are classified as "B symptoms" and are crucial in the Ann Arbor staging system, which is used to categorize the extent of lymphomas.

Substage B specifically denotes the presence of these constitutional symptoms. The presence of B symptoms signifies a potentially more aggressive disease and influences treatment decisions and prognosis. In contrast, Substage A indicates the absence of these systemic symptoms, suggesting a potentially more favorable prognosis.

Stages I and II refer broadly to the extent of the disease rather than the specific presence of constitutional symptoms. Therefore, while those stages convey important information about the localization of the disease, they do not directly address the presence of B symptoms as Substage B does. This distinction is critical in lymphoma management and understanding patient prognosis.