Stage IV: The tumor may be any size, may have spread to the lymph nodes and has spread to distant parts of the body.Stage IVA: The tumor may be any size, may have spread to the lymph nodes and has spread to the fluid in the lungs.Stage IVB: The tumor may be any size, may have spread to the lymph nodes and has spread to distant parts of the body including the liver, spleen, organs outside of the abdomen and intestines.