Libre Pathology - User contributions [en]

Cancer staging systems

2014-11-20T20:02:57Z

Lik: /* Systems */

[[Image:Diagram showing the T stages of bladder cancer CRUK 372.svg|thumb|right|180px|Schematic showing the T stages in bladder cancer. (WC/CRUK)]]
'''Cancer staging systems''' are used to prognosticate cancer and determine treatment. They classify cancers based on the extent of tumour or the location of the tumour in relation to where it arose.

=Overview=
===Systems===
*[[TNM staging system]] - most common, and used for the most common (adult) cancers.
*World Health Organization (WHO) grading system - for [[CNS tumours]].
*St. Jude system - pediatric pathology.
*Durie-Salmon system - for [[multiple myeloma]].
*Ann Arbour system - for [[Hodgkin lymphoma]] and non-Hodgkin lymphoma (excluding [[mycosis fungoides]] and Sezary syndrome).
*Sheldon system - for [[urachal carcinoma]].<ref name=pmid22901574>{{Cite journal | last1 = Bruins | first1 = HM. | last2 = Visser | first2 = O. | last3 = Ploeg | first3 = M. | last4 = Hulsbergen-van de Kaa | first4 = CA. | last5 = Kiemeney | first5 = LA. | last6 = Witjes | first6 = JA. | title = The clinical epidemiology of urachal carcinoma: results of a large, population based study. | journal = J Urol | volume = 188 | issue = 4 | pages = 1102-7 | month = Oct | year = 2012 | doi = 10.1016/j.juro.2012.06.020 | PMID = 22901574 }}</ref>
*Modified Masaoka Stage - for [[thymoma]]

===Stage===
Most system are four tiered and use ''Roman numerals'' to denote the stage:
*Stage I: early cancer.
*Stage II: late early cancer (cancer between early and advanced stage).
*Stage III: advanced cancer - often defined by [[lymph node metastasis]].
*Stage IV: late advanced cancer - often defined by metastasis.

==TNM staging system==
*Name of the system comes from the elements: '''T'''umour, '''N'''odes (lymph nodes), '''M'''etastasis (distant).
*Most common staging system.
*Staging parameters dependent on the specific site.

===Modifiers===
Table of modifiers:<ref>URL: [http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/page3 http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/page3]. Accessed on: 28 March 2012.</ref>
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
! Modifier
! Meaning
! Example
! Notes
|-
| m
| multiple tumours
| pT(m)NM ''or'' pT2(2)N0Mx
| tumour stage = highest stage of all the individual tumours
|-
| c
| clinical stage
| cTNM
| if it is not specified ''clinical'' is assumed
|-
| p
| pathologic stage
| pTNM
| derived from a surgical specimen or biopsy
|-
| a
| stage at [[autopsy]]
| aTNM
| malignancy was '''not''' staged previously ''or'' treated - unless otherwise specified
|-
| y
| staging after therap'''y'''
| ypTNM
| do '''not''' try to estimate pretreatment stage
|-
| r
| recurrent tumour stage
| rTNM
| must have a clinically documented disease freedom
|-
|}
===Tumour stage===
Usually determined by one of the following:
#Size of the tumour (maximal dimension).
#Depth of invasion.

Other factors:
*[[Lymphovascular invasion]] usually does not affect the tumour stage.
**Exceptions:
***[[Seminoma]].
***Intrahepatic bile duct carcinoma.
***[[Hepatocellular carcinoma]].<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf]. Accessed on: 6 April 2012.</ref>
*[[Margin status]] usually does not affect the tumour stage.
**Exception:
***[[Prostate adenocarcinoma]] - bladder neck margin positivity.

===Nodal stage===
*[[Lymph node]] involvement.
*Positive lymph nodes (without mets) often upstage to ''stage III''.
**May upstage to ''stage II'' in some tumours.
*Sampling may be selective ([[sentinel lymph nodes]]).

===Metastasis stage===
*[[Metastases]].

=See also=
*[[Cancer]].

=References=
{{Reflist|1}}

=External links=
*[http://www.cancer.gov/cancertopics/factsheet/detection/staging Cancer staging (cancer.gov)] - an overview directed at individuals with cancer.

[[Category:Basics]]

Cancer staging systems

2014-11-20T20:02:29Z

Lik: /* Overview */

[[Image:Diagram showing the T stages of bladder cancer CRUK 372.svg|thumb|right|180px|Schematic showing the T stages in bladder cancer. (WC/CRUK)]]
'''Cancer staging systems''' are used to prognosticate cancer and determine treatment. They classify cancers based on the extent of tumour or the location of the tumour in relation to where it arose.

=Overview=
===Systems===
*[[TNM staging system]] - most common, and used for the most common (adult) cancers.
*World Health Organization (WHO) grading system - for [[CNS tumours]].
*St. Jude system - pediatric pathology.
*Durie-Salmon system - for [[multiple myeloma]].
*Ann Arbour system - for [[Hodgkin lymphoma]] and non-Hodgkin lymphoma (excluding [[mycosis fungoides]] and Sezary syndrome).
*Sheldon system - for [[urachal carcinoma]].<ref name=pmid22901574>{{Cite journal | last1 = Bruins | first1 = HM. | last2 = Visser | first2 = O. | last3 = Ploeg | first3 = M. | last4 = Hulsbergen-van de Kaa | first4 = CA. | last5 = Kiemeney | first5 = LA. | last6 = Witjes | first6 = JA. | title = The clinical epidemiology of urachal carcinoma: results of a large, population based study. | journal = J Urol | volume = 188 | issue = 4 | pages = 1102-7 | month = Oct | year = 2012 | doi = 10.1016/j.juro.2012.06.020 | PMID = 22901574 }}</ref>
*Modified Masaoka Stage - for [[thymomas]]

===Stage===
Most system are four tiered and use ''Roman numerals'' to denote the stage:
*Stage I: early cancer.
*Stage II: late early cancer (cancer between early and advanced stage).
*Stage III: advanced cancer - often defined by [[lymph node metastasis]].
*Stage IV: late advanced cancer - often defined by metastasis.

==TNM staging system==
*Name of the system comes from the elements: '''T'''umour, '''N'''odes (lymph nodes), '''M'''etastasis (distant).
*Most common staging system.
*Staging parameters dependent on the specific site.

===Modifiers===
Table of modifiers:<ref>URL: [http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/page3 http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/page3]. Accessed on: 28 March 2012.</ref>
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
! Modifier
! Meaning
! Example
! Notes
|-
| m
| multiple tumours
| pT(m)NM ''or'' pT2(2)N0Mx
| tumour stage = highest stage of all the individual tumours
|-
| c
| clinical stage
| cTNM
| if it is not specified ''clinical'' is assumed
|-
| p
| pathologic stage
| pTNM
| derived from a surgical specimen or biopsy
|-
| a
| stage at [[autopsy]]
| aTNM
| malignancy was '''not''' staged previously ''or'' treated - unless otherwise specified
|-
| y
| staging after therap'''y'''
| ypTNM
| do '''not''' try to estimate pretreatment stage
|-
| r
| recurrent tumour stage
| rTNM
| must have a clinically documented disease freedom
|-
|}
===Tumour stage===
Usually determined by one of the following:
#Size of the tumour (maximal dimension).
#Depth of invasion.

Other factors:
*[[Lymphovascular invasion]] usually does not affect the tumour stage.
**Exceptions:
***[[Seminoma]].
***Intrahepatic bile duct carcinoma.
***[[Hepatocellular carcinoma]].<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf]. Accessed on: 6 April 2012.</ref>
*[[Margin status]] usually does not affect the tumour stage.
**Exception:
***[[Prostate adenocarcinoma]] - bladder neck margin positivity.

===Nodal stage===
*[[Lymph node]] involvement.
*Positive lymph nodes (without mets) often upstage to ''stage III''.
**May upstage to ''stage II'' in some tumours.
*Sampling may be selective ([[sentinel lymph nodes]]).

===Metastasis stage===
*[[Metastases]].

=See also=
*[[Cancer]].

=References=
{{Reflist|1}}

=External links=
*[http://www.cancer.gov/cancertopics/factsheet/detection/staging Cancer staging (cancer.gov)] - an overview directed at individuals with cancer.

[[Category:Basics]]

Mediastinum

2014-09-18T23:44:35Z

Lik: /* Differenital diagnosis */

The '''mediastinum''' is a place where tumours occasionally grow. It is also a place one can find various cysts.

=Differential diagnosis=
==General==
===Benign===
Common:<ref name=emed_med_cysts>URL: [http://emedicine.medscape.com/article/426659-overview#a0102 http://emedicine.medscape.com/article/426659-overview#a0102]. Accessed on: 15 November 2011.</ref>
*[[Bronchogenic cyst]].
*[[Enterogenous cyst]].
*[[Mesothelial cyst]].
*[[Neurenteric cyst]]. 

Rare:<ref name=emed_med_cysts>URL: [http://emedicine.medscape.com/article/426659-overview#a0102 http://emedicine.medscape.com/article/426659-overview#a0102]. Accessed on: 15 November 2011.</ref>
*[[Thymic cyst]].
*[[Thoracic duct cyst]].

===Malignant===
*[[Teratoma]] and other [[germ cell tumours]] (GCTs).
**[[Seminoma]]/[[dysgerminoma]] is the most common.
*Terrible [[lymphoma]].
*[[Thymoma]].
**Mix of epithelial cells and small lymphoid cells.
*[[Thyroid gland]].
*[[Metastasis]].

===Rare===
*[[NUT midline carcinoma]].

==Divided into subsites==
===Anterior===
*[[Thymoma]].
*[[Teratoma]] and other germ cell tumours.
*[[Thyroid gland]].
*Terrible [[lymphomas]].

===Middle===
*[[Lymphoma]].
*Pericardial cyst.
*[[Bronchogenic cyst]].

===Posterior===
*Neurogenic tumours.
*Gastroenteric cyst.
*[[GIST]].

=Specific diagnoses=
==Fibrosing mediastinitis==
===General===
Clinical:<ref>{{Ref WMSP|143}}</ref>
*Fever.
*Cough.

Etiology:
*Various - infectious, idiopathic.<ref name=pmid15988098>{{Cite journal | last1 = Patil | first1 = PL. | last2 = Salkar | first2 = HR. | title = Idiopathic mediastinal fibrosis presenting as mediastinal compression syndrome. | journal = Indian J Med Sci | volume = 59 | issue = 6 | pages = 268-71 | month = Jun | year = 2005 | doi = | PMID = 15988098 }}</ref>

===Microscopic===
Features:
*Fibrous tissue.
*+/-Microorganisms.

=See also=
*[[Lung]].
*[[Thymus]].
*[[Cytopathology]].

=References=
{{Reflist|1}}

[[Category:Stuff]]