Thymoma staging: Difference between revisions
Jump to navigation
Jump to search
Amr Marawan (talk | contribs) No edit summary |
Gerald Chi- (talk | contribs) No edit summary |
||
Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
== | Staging of thymic epithelial tumors was initially proposed by Bergh and his colleagues in 1978,<ref name="Bergh-1978">{{Cite journal | last1 = Bergh | first1 = NP. | last2 = Gatzinsky | first2 = P. | last3 = Larsson | first3 = S. | last4 = Lundin | first4 = P. | last5 = Ridell | first5 = B. | title = Tumors of the thymus and thymic region: I. Clinicopathological studies on thymomas. | journal = Ann Thorac Surg | volume = 25 | issue = 2 | pages = 91-8 | month = Feb | year = 1978 | doi = | PMID = 626543 }}</ref> modified by Wilkins and Castleman in 1979,<ref name="Wilkins-1979">{{Cite journal | last1 = Wilkins | first1 = EW. | last2 = Castleman | first2 = B. | title = Thymoma: a continuing survey at the Massachusetts General Hospital. | journal = Ann Thorac Surg | volume = 28 | issue = 3 | pages = 252-6 | month = Sep | year = 1979 | doi = | PMID = 485626 }}</ref> and advanced by Masaoka et al. in 1981.<ref name="Masaoka-1981">{{Cite journal | last1 = Masaoka | first1 = A. | last2 = Monden | first2 = Y. | last3 = Nakahara | first3 = K. | last4 = Tanioka | first4 = T. | title = Follow-up study of thymomas with special reference to their clinical stages. | journal = Cancer | volume = 48 | issue = 11 | pages = 2485-92 | month = Dec | year = 1981 | doi = | PMID = 7296496 }}</ref><ref name="Kondo-2005">{{Cite journal | last1 = Kondo | first1 = K. | title = Invited commentary. | journal = Ann Thorac Surg | volume = 80 | issue = 6 | pages = 2000-1 | month = Dec | year = 2005 | doi = 10.1016/j.athoracsur.2005.08.053 | PMID = 16305832 }}</ref> Modified Masaoka staging grouped with TNM classification is the most widely adopted system for thymic epithelial tumors currently in use. | ||
: | |||
==Masaoka | ==Modified Masaoka Clinical Staging of Thymoma== | ||
== | {| style="border: 2px solid #696969;" align="center" | ||
|+ <SMALL>''Modified Masaoka Clinical Staging of Thymoma (1994)''<ref name="Masaoka-1994">{{Cite journal | last1 = Masaoka | first1 = A. | last2 = Yamakawa | first2 = Y. | last3 = Niwa | first3 = H. | last4 = Fukai | first4 = I. | last5 = Saito | first5 = Y. | last6 = Tokudome | first6 = S. | last7 = Nakahara | first7 = K. | last8 = Fujii | first8 = Y. | title = Thymectomy and malignancy. | journal = Eur J Cardiothorac Surg | volume = 8 | issue = 5 | pages = 251-3 | month = | year = 1994 | doi = | PMID = 8043287 }}</ref></SMALL> | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 15px;" | '''Stage''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 600px;" | '''Description''' | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''I''' || Macroscopically and microscopically completely encapsulated | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''II''' || A. Microscopic transcapsular invasion <BR> B. Macroscopic invasion into surrounding fatty tissue or grossly adherent to but not through <BR> mediastinal pleura or pericardium | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''III''' || Macroscopic invasion into neighboring organs (ie, pericardium, great vessels, lung) <BR> A. Without invasion of great vessels <BR> B. With invasion of great vessels | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''IV''' || A. Pleural or pericardial dissemination <BR> B. Lymphogenous or hematogenous metastasis | |||
|- | |||
|} | |||
==TNM Classification of Thymic Epithelial Tumors== | |||
{| style="border: 2px solid #696969;" align="center" | |||
|+ <SMALL>''TNM Classification of Thymic Epithelial Tumors by Yamakawa and Masaoka (1991)''<ref name="Yamakawa-1991">{{Cite journal | last1 = Yamakawa | first1 = Y. | last2 = Masaoka | first2 = A. | last3 = Hashimoto | first3 = T. | last4 = Niwa | first4 = H. | last5 = Mizuno | first5 = T. | last6 = Fujii | first6 = Y. | last7 = Nakahara | first7 = K. | title = A tentative tumor-node-metastasis classification of thymoma. | journal = Cancer | volume = 68 | issue = 9 | pages = 1984-7 | month = Nov | year = 1991 | doi = | PMID = 1913546 }}</ref></SMALL> | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px;" colspan=2 | '''T/N/M Stage''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 520px;" | '''Description''' | |||
|- | |||
| style="background: #F0F0F0; width:75px;" rowspan=4 align=center | '''T factor''' || style="background: #F0F0F0; width: 50px;" align=center | '''T1''' || Macroscopically completely encapsulated and microscopically no capsular invasion | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''T2''' || Macroscopically adhesion or invasion into surrounding fatty tissue or mediastinal pleura, <BR> or microscopic invasion into capsule | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''T3''' || Invasion into neighboring organs, such as pericardium, great vessels, and lung | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''T4''' || Pleural or pericardial dissemination | |||
|- | |||
| style="background: #F0F0F0;" rowspan=4 align=center | '''N factor''' || style="background: #F0F0F0;" align=center | '''N0''' || No lymph node metastasis | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''N1''' || Metastasis to anterior mediastinal lymph nodes | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''N2''' || Metastasis to intrathoracic lymphnodes except anterior mediastinal lymph nodes | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''N3''' || Metastasis to extrathoracic lymphnodes | |||
|- | |||
| style="background: #F0F0F0;" style="background: #F0F0F0;" rowspan=4 align=center | '''M factor''' || style="background: #F0F0F0;" align=center | '''M0''' || No hematogenous metastasis | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''M1''' || Hematogenous metastasis | |||
|- | |||
|} | |||
{| style="border: 2px solid #696969;" align="center" | |||
|+ <SMALL>''Combined Masaoka Staging/TNM Classification (1994)''<ref name="Tsuchiya-1994">{{Cite journal | last1 = Tsuchiya | first1 = R. | last2 = Koga | first2 = K. | last3 = Matsuno | first3 = Y. | last4 = Mukai | first4 = K. | last5 = Shimosato | first5 = Y. | title = Thymic carcinoma: proposal for pathological TNM and staging. | journal = Pathol Int | volume = 44 | issue = 7 | pages = 505-12 | month = Jul | year = 1994 | doi = | PMID = 7921194 }}</ref></SMALL> | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 150px;" | '''Masaoka Stage''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 150px;" | '''T factor''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 150px;" | '''N factor''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 150px;" | '''M factor''' | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''Stage I''' ||align=center| T1 ||align=center| N0 ||align=center| M0 | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''Stage II''' ||align=center| T2 ||align=center| N0 ||align=center| M0 | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''Stage III''' ||align=center| T3 ||align=center| N0 ||align=center| M0 | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''Stage IVa''' ||align=center| T4 ||align=center| N0 ||align=center| M0 | |||
|- | |||
| style="background: #F0F0F0;" align=center rowspan=2 | '''Stage IVb''' ||align=center| Any T ||align=center| N1, N2, or N3 ||align=center| M0 | |||
|- | |||
|align=center| Any T ||align=center| Any N ||align=center| M1 | |||
|- | |||
|} | |||
==Previously Reported Staging System== | |||
{| style="border: 2px solid #696969;" align="center" | |||
|+ <SMALL>''Masaoka Staging (1981)''<ref name="Masaoka-1981">{{Cite journal | last1 = Masaoka | first1 = A. | last2 = Monden | first2 = Y. | last3 = Nakahara | first3 = K. | last4 = Tanioka | first4 = T. | title = Follow-up study of thymomas with special reference to their clinical stages. | journal = Cancer | volume = 48 | issue = 11 | pages = 2485-92 | month = Dec | year = 1981 | doi = | PMID = 7296496 }}</ref></SMALL> | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 15px;" | '''Stage''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 600px;" | '''Description''' | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''I''' || Macroscopically completely encapsulated and microscopically no capsular invasion | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''II''' || 1. Macroscopic invasion into surrounding fatty tissue or mediastinal pleura <BR> 2. Microscopic invasion into capsule | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''III''' || Macroscopic invasion into neighboring organ (ie, pericardium, great vessels, or lung) | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''IVa''' || Pleural or pericardial dissemination | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''IVb''' || Lymphogenous or hematogenous metastasis | |||
|- | |||
|} | |||
{| style="border: 2px solid #696969;" align="center" | |||
|+ <SMALL>''Clinical Staging by Bergh (1978) and Wilkins (1979)''<ref name="Bergh-1978">{{Cite journal | last1 = Bergh | first1 = NP. | last2 = Gatzinsky | first2 = P. | last3 = Larsson | first3 = S. | last4 = Lundin | first4 = P. | last5 = Ridell | first5 = B. | title = Tumors of the thymus and thymic region: I. Clinicopathological studies on thymomas. | journal = Ann Thorac Surg | volume = 25 | issue = 2 | pages = 91-8 | month = Feb | year = 1978 | doi = | PMID = 626543 }}</ref><ref name="Wilkins-1979">{{Cite journal | last1 = Wilkins | first1 = EW. | last2 = Castleman | first2 = B. | title = Thymoma: a continuing survey at the Massachusetts General Hospital. | journal = Ann Thorac Surg | volume = 28 | issue = 3 | pages = 252-6 | month = Sep | year = 1979 | doi = | PMID = 485626 }}</ref></SMALL> | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 100px;" | '''Author''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 15px;" | '''Stage''' | |||
! style="background: #F0F0F0; border: 0px solid #696969; padding: 0 5px; width: 500px;" | '''Description''' | |||
|- | |||
| style="background: #F0F0F0;" rowspan=3 align=center | Bergh et al. || style="background: #F0F0F0;" align=center | '''I''' || Intact capsule or growth within the capsule | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''II''' || Pericapsular growth into the mediastinal fat tissue | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''III''' || Invasive growth into the surrounding organs and/or intrathoracic metastases | |||
|- | |||
| style="background: #F0F0F0;" rowspan=3 align=center | Wilkins et al. || style="background: #F0F0F0;" align=center | '''I''' || Intact capsule or growth within the capsule | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''II''' || Pericapsular growth into the mediastinal fat tissue or adjacent pleura or pericardium | |||
|- | |||
| style="background: #F0F0F0;" align=center | '''III''' || Invasive growth into the surrounding organs and/or intrathoracic metastases | |||
|- | |||
|} | |||
==References== | ==References== | ||
{{ | |||
{{reflist|2}} | |||
[[Category:Oncology]] | [[Category:Oncology]] | ||
Line 44: | Line 128: | ||
[[Category:Rare diseases]] | [[Category:Rare diseases]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Revision as of 17:37, 2 March 2014
Thymoma Microchapters |
Diagnosis |
---|
Case Studies |
Thymoma staging On the Web |
American Roentgen Ray Society Images of Thymoma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]
Overview
Staging of thymic epithelial tumors was initially proposed by Bergh and his colleagues in 1978,[1] modified by Wilkins and Castleman in 1979,[2] and advanced by Masaoka et al. in 1981.[3][4] Modified Masaoka staging grouped with TNM classification is the most widely adopted system for thymic epithelial tumors currently in use.
Modified Masaoka Clinical Staging of Thymoma
Stage | Description |
---|---|
I | Macroscopically and microscopically completely encapsulated |
II | A. Microscopic transcapsular invasion B. Macroscopic invasion into surrounding fatty tissue or grossly adherent to but not through mediastinal pleura or pericardium |
III | Macroscopic invasion into neighboring organs (ie, pericardium, great vessels, lung) A. Without invasion of great vessels B. With invasion of great vessels |
IV | A. Pleural or pericardial dissemination B. Lymphogenous or hematogenous metastasis |
TNM Classification of Thymic Epithelial Tumors
T/N/M Stage | Description | |
---|---|---|
T factor | T1 | Macroscopically completely encapsulated and microscopically no capsular invasion |
T2 | Macroscopically adhesion or invasion into surrounding fatty tissue or mediastinal pleura, or microscopic invasion into capsule | |
T3 | Invasion into neighboring organs, such as pericardium, great vessels, and lung | |
T4 | Pleural or pericardial dissemination | |
N factor | N0 | No lymph node metastasis |
N1 | Metastasis to anterior mediastinal lymph nodes | |
N2 | Metastasis to intrathoracic lymphnodes except anterior mediastinal lymph nodes | |
N3 | Metastasis to extrathoracic lymphnodes | |
M factor | M0 | No hematogenous metastasis |
M1 | Hematogenous metastasis |
Masaoka Stage | T factor | N factor | M factor |
---|---|---|---|
Stage I | T1 | N0 | M0 |
Stage II | T2 | N0 | M0 |
Stage III | T3 | N0 | M0 |
Stage IVa | T4 | N0 | M0 |
Stage IVb | Any T | N1, N2, or N3 | M0 |
Any T | Any N | M1 |
Previously Reported Staging System
Stage | Description |
---|---|
I | Macroscopically completely encapsulated and microscopically no capsular invasion |
II | 1. Macroscopic invasion into surrounding fatty tissue or mediastinal pleura 2. Microscopic invasion into capsule |
III | Macroscopic invasion into neighboring organ (ie, pericardium, great vessels, or lung) |
IVa | Pleural or pericardial dissemination |
IVb | Lymphogenous or hematogenous metastasis |
Author | Stage | Description |
---|---|---|
Bergh et al. | I | Intact capsule or growth within the capsule |
II | Pericapsular growth into the mediastinal fat tissue | |
III | Invasive growth into the surrounding organs and/or intrathoracic metastases | |
Wilkins et al. | I | Intact capsule or growth within the capsule |
II | Pericapsular growth into the mediastinal fat tissue or adjacent pleura or pericardium | |
III | Invasive growth into the surrounding organs and/or intrathoracic metastases |
References
- ↑ 1.0 1.1 Bergh, NP.; Gatzinsky, P.; Larsson, S.; Lundin, P.; Ridell, B. (1978). "Tumors of the thymus and thymic region: I. Clinicopathological studies on thymomas". Ann Thorac Surg. 25 (2): 91–8. PMID 626543. Unknown parameter
|month=
ignored (help) - ↑ 2.0 2.1 Wilkins, EW.; Castleman, B. (1979). "Thymoma: a continuing survey at the Massachusetts General Hospital". Ann Thorac Surg. 28 (3): 252–6. PMID 485626. Unknown parameter
|month=
ignored (help) - ↑ 3.0 3.1 Masaoka, A.; Monden, Y.; Nakahara, K.; Tanioka, T. (1981). "Follow-up study of thymomas with special reference to their clinical stages". Cancer. 48 (11): 2485–92. PMID 7296496. Unknown parameter
|month=
ignored (help) - ↑ Kondo, K. (2005). "Invited commentary". Ann Thorac Surg. 80 (6): 2000–1. doi:10.1016/j.athoracsur.2005.08.053. PMID 16305832. Unknown parameter
|month=
ignored (help) - ↑ Masaoka, A.; Yamakawa, Y.; Niwa, H.; Fukai, I.; Saito, Y.; Tokudome, S.; Nakahara, K.; Fujii, Y. (1994). "Thymectomy and malignancy". Eur J Cardiothorac Surg. 8 (5): 251–3. PMID 8043287.
- ↑ Yamakawa, Y.; Masaoka, A.; Hashimoto, T.; Niwa, H.; Mizuno, T.; Fujii, Y.; Nakahara, K. (1991). "A tentative tumor-node-metastasis classification of thymoma". Cancer. 68 (9): 1984–7. PMID 1913546. Unknown parameter
|month=
ignored (help) - ↑ Tsuchiya, R.; Koga, K.; Matsuno, Y.; Mukai, K.; Shimosato, Y. (1994). "Thymic carcinoma: proposal for pathological TNM and staging". Pathol Int. 44 (7): 505–12. PMID 7921194. Unknown parameter
|month=
ignored (help)