Staging Flashcards
St Jude (Murphy) for NHL
Stage 1: single nodal or extranodal tumor (not mediastinum or abd)
Stage 2: single tumor (extranodal) with regional node involvement, OR 2+ nodal areas same side of diaphragm, OR 2 single (extranodal) tumors +/- regional LD on same side diaphragm, OR primary resectable GI +/- mesenteric nodes
Stage 3: 2single tumors or 2+ nodal areas opposite side diaphragm, OR any intrathoracic disease, OR extensive abd primary, OR all paraspinal or epidural dz
Stage 4: bone marrow and/or CNS involvement
B symptoms in NHL aren’t used for staging
Ann Arbor staging Hodgkin lymphoma
Stage 1: single node or single extranodal organ site
Stage 2: 2+ node regions same side diaphragm, OR 1nodal + localized extranodal on same side
Stage 3: node regions on both sides diaphragm, OR with localizing extranodal sites, OR spleen involvement
Stage 4: diffuse or disseminated more than 1 extranodal site, liver, bone marrow
E lesions: extranodal sites contiguous with nodes (lung, pleural, pericardial, chest wall infiltrate (not effusions)
Substage A = asymptomatic dz.
Substage B = presence of B symptoms
Bulky dz is not included in Ann Arbor, but included in COG
Types of Hodgkin Dz
Classic:
- mixed cellularity (30%), more common <10yrs, assoc with EBV (LMP1), diffuse inflammatory background, prominent eos
- nodular sclerosis: most common (80% adolescents), nodules with RS cells and inflammatory cell’s surrounded by bands of sclerotic collagen
- lymphocyte depleted: rare in peds
- lymphocyte rich: rare in peds
Nodular lymphocyte predominant:
-more common in boys, popcorn cells (convoluted nuclei with multiple lobes and basophilic nucleoli). Neg CD15, neg CD 30, pos CD45
Rarely assoc with EBV
Rhabdomyosarcoma staging
Group1: localized, complete resection, LN radiographic (not extremity or paratesticular)
Group 2: micro residual OR regional dz which is resected
Group 3: gross residual
Group 4; distant mets
Stage:
1
2 extremity, bladder, prostate, parameningeal <5cm, no nodes
3 <5cm bladder/prostate
>5cm
4 - mets