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TNM STAGING OF LUNG CANCER - The Lung Center

TNM STAGING OF LUNG CANCER - The Lung Center

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<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>Primary Tumor (T)CriteriaT1(a&b&c)a. Size 3 cm AnyMain bronchus (>(2 cm distal to thecarina)d.Other - AtelectasisMain bronchus (


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>METASTASES (M)METASTASES (M)MO MO :AbscentM1 : PresentSeparate metastatic tumor nodule (s) in the ipsilateralNonprimary – tumor lobe (s) of the lung also are classified M1Separate metastatic tumor nodule (s) in the ipsilateralNonprimary – tumor lobe (s) of the lung also are classified M1Tis : Caricinoma in situStaging is not relevant for Occult Carcinoma( Tx, NO, MO)


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>• STAGE 0 T IS• STAGE 1A T 1N O• STAGE 1B T 2 N 0• STAGE II A T 1 N 1• STAGE II B T 2N IT 3 N 0


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>• STAGE III A T N 1-3 2T N 3 1• STAGE IIIB Any T N 3T 4 Any N• STAGE IV Any T Any N M 1


Small cell lung cancer:Station 1 (green) :This node is lying betweenthe left common carotidartery and the leftsubclavian arteryStation 3A (pink) :This is anterior to and leftof major arterial vessels


Small cell lung cancer and superior venacava syndrome:Station 2 (purple) :Note reflux into anteriorchest wall collaterals(curved arrows) and bothinternal mammary veins(straight arrows).


Small cell lung carcinoma and superiorvena cava syndrome:Station 4 (orange) :<strong>The</strong> inferior nodes arebelow a horizontal linedrawn at the superioraspect of the azygos vein.


Small cell lung carcinoma and superiorvena cava syndrome:Station 7 (blue) : SubcarinaladenopathyStation 8 (tan) : <strong>The</strong>paraesophageal nodes lieposterolateral to theesophagus (white arrow)between azygos vein (blackarrow) and aortaStation 10 (yellow) : Hilar nodes


Small cell lung carcinoma:Station 13 :<strong>The</strong> segmental nodes are seen anterior tothe lateral basal bronchus.


Small cell lung carcinoma:Station 14 :<strong>The</strong> subsegmental node is seenadjacent to the subsegmentalbronchus (curved arrow). <strong>The</strong>ground glass opacity (blackarrow) represents the top of theprimary tumour.


<strong>Lung</strong> Anatomy (Showing ICD-O-2/3Codes)ICD-0-2/3 TermC34.0 Main BronchusC34.1 Upper lobe, lungC34.2 Middle lobe, rt.lungC34.3 Lower Lobe, lungC34.8 OverlappingLesion of lungC34.9 <strong>Lung</strong> NOSC33.9 Trachea, NOSRELATED ADJECTIVES: <strong>Lung</strong> = pneumo-, pulmono-, broncho-,bronchiolo-, alveolar, hilar, Breathing = -pnea


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>


<strong>TNM</strong> <strong>STAGING</strong> <strong>OF</strong> <strong>LUNG</strong> <strong>CANCER</strong>

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