Staging of Hodgkin’s disease is important as for best results Hodgkin’s disease has to be treated differently depending on what stage it is found in at the time of diagnosis.
This is why lymphoma staging by a hematologist is a very important step before treatment can be started.
The common staging system used for Hodgkin’s disease and non-Hodgkin’s disease is the Ann Arbor system or one of its modifications. Below is an abridged version of it.
In order to come to accurate staging, the physician will have to order such tests as CT scans of the thorax and a CT scan of the abdomen and pelvis. Tumors of intermediate or high grade will take up gallium, and gallium scan may be useful in certain cases. Bone lesions anywhere in the skeleton can be picked up by a regular bone scan.
Ann Arbor staging of Hodgkin’s disease and non-Hodgkin’s lymphoma
Stage: Comments:
I : presentation in one lymph gland only
II : two or more lymph glands are affected on the same side of the diaphragm
III : disease present in lymph nodes and/or spleen and on both sides of the diaphragm
IV : involvement of tissues outside of lymph nodes (for instance bone marrow, lung or liver tissue)
Staging Of Hodgkin’s Disease (Location Of Diaphragm)
References:
1. N Engl J Med 329(14):987-994,1997.
2. The Merck Manual of Diagnosis and Therapy. 17th edition, editors M.Beers and R.Berkow. Whitehouse Station, N.J., 1999.
3. Cancer: Principles & Practice of Oncology. 4th edition, edited by V.T. DeVita et al., Lippincott Co., Philadelphia, 1993. Chapters 51 and 52.
4. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter 44,Lymphomas.
5. HY Dong et al. Mod Pathol 2001 May;14(5):472-481.
6. NL Kobrinsky et al. J Clin Oncol 2001 May 1;19(9):2390-2396.
7. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
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