- Ann Arbor staging
Ann Arbor staging is the staging system for
lymphomas, both in Hodgkin's lymphoma(previously called Hodgkin's Disease) and Non-Hodgkin lymphoma(abbreviated NHL). It was initially developed for Hodgkin's, but has some use in NHL. It has roughly the same function as TNMstaging in solid tumors.
The stage depends on both the place where the malignant tissue is located (as located with
biopsy, CT scanning and increasingly positron emission tomography) and on systemic symptoms due to the lymphoma (" B symptoms": night sweats, weight lossof >10% or fevers).
The principal stage is determined by location of the tumor:
* "Stage I" indicates that the cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms.
* "Stage II" indicates that the cancer is located in two separate regions, an affected lymph node or organ within the lymphatic system and a second affected area, and that both affected areas are confined to one side of the diaphragm - that is, both are above the diaphragm, or both are below the diaphragm.
* "Stage III" indicates that the cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen.
* "Stage IV" indicates diffuse or disseminated involvement of one or more extralymphatic organs, including any involvement of the liver, bone marrow, or nodular involvement of the lungs.
These letters can be appended to some stages:
* "A" or "B:" the absence of constitutional (B-type) symptoms is denoted by adding an "A" to the stage; the presence is denoted by adding a "B" to the stage.
* "E:" is used if the disease is "extranodal" (not in the
lymph nodes) or has spread from lymph nodes to adjacent tissue.
* "X:" is used if the largest deposit is >10 cm large ("bulky disease"), or whether the
mediastinumis wider than 1/3 of the chest on a chest X-ray.
* "S:" is used if the disease has spread to the
Type of staging
The nature of the staging is (occasionally) expressed with:
* "CS" - clinical stage as obtained by doctor's examinations and tests.
* "PS" - pathological stage as obtained by exploratory laparotomy (surgery performed through an abdominal incision) with splenectomy (surgical removal of the spleen). Note: exploratory laparotomy has fallen out of favor for lymphoma staging.
The staging does not take into account the "grade" (biological behavior) of the tumor tissue. The prognostic significance of bulky disease, and some other modifiers, were introduced with the "Cotswolds modification" (Lister "et al" 1989).
The Ann Arbor classification is named after Ann Arbor,
Michigan, where the Committee on Hodgkin's Disease Staging Classification met in 1971; it consisted of experts from the USA, UK, Germanyand France, and replaced the older Rye classification from a 1965 meeting (Rosenberg 1966). The Cotswolds modification followed after a 1988 meeting in the UK Cotswolds. [ cite book | last=Mauch | first=Peter | coauthors=James Armitage, Volker Diehl, Richard Hoppe, Laurence Weiss | title=Hodgkin's Disease | publisher= Lippincott Williams & Wilkins| date= 1999| pages=223-228 | isbn=0-7817-1502-4 ]
* Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. "Report of the committee on Hodgkin’s disease staging classification." Cancer Res 1971;31:1860-1. PMID 5121694.
* Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, Rosenberg SA, Coltman CA, Tubiana M. "Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting." J Clin Oncol 1989 Nov;7(11):1630-6. PMID 2809679.
* Rosenberg SA. "Report of the committee on the staging of Hodgkin’s disease. Cancer Res." 1966;26:1310.
* [http://www.garfield.library.upenn.edu/classics1983/A1983RS45200001.pdf Citation classics] (PDF, Current Contents/Clinical Practice 1983;50:22) - Prof Paul P. Carbone commenting on the impact of the Ann Arbor classification (from the [http://garfield.library.upenn.edu/classics.html Citation Classics] library)
Wikimedia Foundation. 2010.
Look at other dictionaries:
intermediate; intermittent; internal; internal medicine; intervention; intestine; involvement of a single lymph node [Ann Arbor staging system for Hodgkin disease]; iodine; ionic current; ionic strength; iris; ischemia; isochromosome; isoleucine; isotope; isotropic; nuclear spin quantum number; regi — electric current; incisor [deciduous]; insoluble; isochromosome; optically inactive … Medical dictionary
Ann Arbor (disambiguation) — Ann Arbor is a city in Washtenaw County, Michigan, United States.Ann Arbor may also refer to: *Ann Arbor (automobile), a vehicle produced by Huron River Manufacturing Company (1911 1912) *Ann Arbor (Amtrak station), an Amtrak station in Ann Arbor … Wikipedia
Ann Arbor, Michigan — For other uses, see Ann Arbor (disambiguation). City of Ann Arbor City … Wikipedia
Cancer staging — The stage of a cancer is a description (usually numbers I to IV with IV having more progression) of the extent the cancer has spread. The stage often takes into account the size of a tumor, how deeply it has penetrated, whether it has invaded… … Wikipedia
Hodgkin's lymphoma — Hodgkin lymphoma Classification and external resources Micrograph showing Hodgkin s lymphoma (Field stain). ICD 10 C … Wikipedia
Lymphoma — This article is about lymphoma in humans. For the disease in dogs, cats, and ferrets, see lymphoma in animals. Lymphoma Classification and external resources Follicular lymphoma replacing a lymph node … Wikipedia
TNM — The TNM Classification of Malignant Tumours (TNM) is a cancer staging system that describes the extent of cancer in a patient’s body. T describes the size of the tumor and whether it has invaded nearby tissue, N describes regional lymph nodes… … Wikipedia
IE — involvement of a single extrahepatic organ or site [Ann Arbor staging system for Hodgkin disease] … Medical dictionary
II — carcinoma of the subvaginal tissue without involving the pelvic wall [International Federation of Gynecologists and Obstetricians (FIGO) classification]; endometrial carcinoma involving the corpus and cervix but no other tissues [International… … Medical dictionary
IIE — localized involvement of an extrahepatic organ or site [Ann Arbor staging system for Hodgkin disease] … Medical dictionary