Hodgkin's lymphoma diagnostic study of choice: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnostic study of choice for Hodgkin's lymphoma is lymph node biopsy. In addition to light microscopy evaluation of the biopsy samples, the immunophenotypic analysis with immunohistochemistry helps to determine | The diagnostic study of choice for Hodgkin's lymphoma is lymph node biopsy. In addition to light microscopy evaluation of the biopsy samples, the immunophenotypic analysis with immunohistochemistry helps to determine Hodgkin's lymphoma subtypes and distinguish Hodgkin's lymphoma from T cell rich large B cell lymphoma. | ||
According to the Lugano classification and Cotswold's modification of the original Ann arbor staging system, there are four stages of Hodgkin's lymphoma based on the number of nodes and extranodal involvement. | According to the Lugano classification and Cotswold's modification of the original Ann arbor staging system, there are four stages of Hodgkin's lymphoma based on the number of nodes and extranodal involvement. | ||
Revision as of 15:02, 16 October 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Overview
The diagnostic study of choice for Hodgkin's lymphoma is lymph node biopsy. In addition to light microscopy evaluation of the biopsy samples, the immunophenotypic analysis with immunohistochemistry helps to determine Hodgkin's lymphoma subtypes and distinguish Hodgkin's lymphoma from T cell rich large B cell lymphoma.
According to the Lugano classification and Cotswold's modification of the original Ann arbor staging system, there are four stages of Hodgkin's lymphoma based on the number of nodes and extranodal involvement.
Staging
The diagnostic study of choice for Hodgkin's lymphoma is lymph node biopsy. In addition to light microscopy evaluation of the biopsy samples, the immunophenotypic analysis with immunohistochemistry helps to determine HL subtypes and distinguish HL and T cell rich large B cell lymphoma.
According to the Lugano classification[1] and Cotswold's modification of the original Ann arbor staging system,[2][3] there are four stages of Hodgkin's lymphoma based on the number of nodes and extranodal involvement.
Staging for Hodgkin's lymphoma is provided in the following tables:
| Stage | Involvement | Extra nodal (E) status |
|---|---|---|
| Limited | ||
| I | One node or a group of adjacent nodes | Single extra nodal lesions without nodal involvement |
| II | Two or more nodal groups on the same side of the diaphragm | Stage I or II by nodal extent with limited contiguous extra nodal involvement |
| II bulky* | II as above with "bulky" disease | Not applicable |
| Advanced | ||
| III | Nodes on both sides of the diaphragm; nodes above the diaphragm with spleen involvement | Not applicable |
| IV | Additional noncontiguous extra lymphatic involvement | Not applicable |
| Stage | Involvement | |
|---|---|---|
| stage I | ||
| I | One nodal group or lymphoid organ (e.g. spleen or thymus) | |
| IE | One extra nodal site | |
| stage II | ||
| II | Two or more nodal groups, same side of diaphragm | |
| II E | Localized extra nodal site with stage II criteria, both on the same side of the diaphragm | |
| stage III | ||
| III | Nodal groups on both sides of the diaphragm | |
| III S (1) | With splenic involvement | |
| III E (2) | With localized extra nodal site | |
| III SE | Both | |
| stage IV | ||
| IV | Disseminated involvement of one or more extra lymphatic organ (e.g. lung, bone) +/- any nodal involvement | |
| Additional staging variables | ||
| X | Bulky nodal disease: nodal mass >1/3 of intra thoracic diameter or 10 cm in dimension | |
| A | Asymptomatic | |
| B | Presence of B symptoms (fever, night sweats and weight loss) | |
| E | Extra nodal: other than the lymph nodes or spread to tissues beyond, but nearby, the lymphatic tissues | |
| S | Spleen | |
| N | Lymph nodes | |
| H | Liver | |
| L | Lung | |
| M | Bone marrow | |
| O | Bone | |
| D | Skin | |
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Stage 1 Hodgkin's lymphoma -
Stage 2 Hodgkin's lymphoma -
Stage 3 Hodgkin's lymphoma -
Stage 4 Hodgkin's lymphoma
References
- ↑ Cheson, Bruce D.; Fisher, Richard I.; Barrington, Sally F.; Cavalli, Franco; Schwartz, Lawrence H.; Zucca, Emanuele; Lister, T. Andrew; Alliance, Australasian Leukaemia and Lymphoma Group; Eastern Cooperative Oncology Group; European Mantle Cell Lymphoma Consortium; Italian Lymphoma Foundation; European Organisation for Research; Treatment of Cancer/Dutch Hemato-Oncology Group; Grupo Español de Médula Ósea; German High-Grade Lymphoma Study Group; German Hodgkin's Study Group; Japanese Lymphorra Study Group; Lymphoma Study Association; NCIC Clinical Trials Group; Nordic Lymphoma Study Group; Southwest Oncology Group; United Kingdom National Cancer Research Institute (2014-09-20). "Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification". Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 32 (27): 3059–3068. doi:10.1200/JCO.2013.54.8800. ISSN 1527-7755. PMID 25113753.
- ↑ Hodgkin lymphoma. Dr Amir Rezaee and Dr Frank Gaillard et al. Radiopaedia.org 2015.http://radiopaedia.org/articles/lymphoma-staging
- ↑ Hodgkin-lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/hodgkin-lymphoma/staging/?region=ab Accessed on September 11, 2015