Ann Arbor staging

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Ann Arbor staging is the staging system for lymphomas, both in Hodgkin's lymphoma (formerly designated 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 TNM staging in solid tumors.

Contents

The stage depends on both the place where the malignant tissue is located (as located with biopsy, CT scanning, gallium scan and increasingly positron emission tomography) and on systemic symptoms due to the lymphoma ("B symptoms": night sweats, weight loss of >10% or fevers).

Principal stages

The principal stage is determined by location of the tumor:[ citation needed ]

Modifiers

These letters can be appended to some stages:[ citation needed ]

Type of staging

The nature of the staging is (occasionally) expressed with:[ citation needed ]

Limitations

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". [1]

History

The Ann Arbor classification is named after Ann Arbor, Michigan, where the Committee on Hodgkin's Disease Staging Classification met in 1971; [2] it consisted of experts from the United States, UK, Germany and France, and replaced the older Rye classification from a 1965 meeting. [3] The Cotswolds modification followed after a 1988 meeting in the UK Cotswolds. [4]

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References

  1. Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, et al. (November 1989). "Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting". Journal of Clinical Oncology. 7 (11): 1630–1636. doi:10.1200/JCO.1989.7.11.1630. PMID   2809679.
  2. Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M (November 1971). "Report of the Committee on Hodgkin's Disease Staging Classification". Cancer Research. 31 (11): 1860–1861. PMID   5121694.
  3. Rosenberg SA (June 1966). "Report of the committee on the staging of Hodgkin's disease". Cancer Research. 26 (6 Part 1): 1310.
  4. Mauch P, Armitage J, Diehl V, Hoppe R, Weiss L (1999). Hodgkin's Disease. Lippincott Williams & Wilkins. pp. 223–228. ISBN   978-0-7817-1502-7.

Further reading