TOPICS
Staging
| Extranodal notations |
Ann
Arbor notations |
About Stage IV
| In the News
Staging
defines how widespread the disease is and the locations of the
disease in the body.
Above illustration adapted from Favrille patient education
material.
Click to enlarge illustration
Ann Arbor
staging for Lymphoma:
NOTE: The staging does not take into account the
grade (growth rate) of the tumor tissue, or prognostic factors,
such as bulky disease, LDH, age, symptomatic. See FLIPI
Bone marrow involvement and other so-called
extranodal involvement is not
unexpected for lymphoma can be reversed with treatment.
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Stage
I - disease in single lymph node or lymph node region.
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Stage
II - disease in two or more lymph node regions
on same
side of diaphragm.
Note: Stage II contiguous
means two or more lymph nodes in close proximity (side by
side). |
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Stage III -
disease
in lymph node regions on both sides of the
diaphragm are
affected. |
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Stage
IV - disease is wide spread, including multiple
involvement at
one or more extranodal (beyond the lymph node) sites, such as the
bone marrow (which is involved commonly), liver, pleura
(thin lining of the lungs). |
Also see Extranodal
and Ann Arbor notations
below,
which may be added to the above staging designations.
Also see
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Prognostic Factors (FLIPI, IPI, MIPI)
PAL |
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CLL Staging (Rai |
Binet)
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CLL
Staging (Rai |
Binet)
MALT Staging and Workup -
PAL
Extranodal
notations
Extranodal means 'beyond nodal'
- sites are identified by the following notation:
| N |
= lymph nodes |
| |
|
| E |
= extranodal |
| H |
= liver (hepatic) |
| L |
= lung |
| M |
= bone marrow |
| S |
= spleen |
| P |
= pleura (lung) |
| O |
= bone |
| D |
= skin (dermis) |
You can click the image on the right
to enlarge it.
Disease Staging may also be accompanied by local
involvement of an extranodal organ or site.
Example involving spleen: Stage
IIIS
ANN ARBOR notations
Ann Arbor staging further classifies
patients with lymphoma into A or B categories
A
= without symptoms
B
= with symptoms including unexplained weight loss (10% in 6 months
prior to diagnosis, unexplained fever, and drenching night
sweats.)
E
= Extranodal means 'beyond nodal' (see above)
Disease Staging may also be accompanied by local
involvement of an extranodal organ or site.
Example involving spleen and Ann Arbor notation: Stage
IIIS A
About STAGE IV
It is common for b-cell lymphomas to
be diagnosed at stage IV, and with bone marrow involvement.
While dependant on the cell type and other factors, successful
treatment is often possible for stage IV disease and bone marrow
involvement is reversible!
