Paris staging system for primary gastrointestinal lymphomas*¶[1] |
Primary tumor (T) |
TX | Lymphoma extent not specified |
T0 | No evidence of lymphoma |
T1 | Lymphoma confined to the mucosa/submucosa |
T1m | Lymphoma confined to the mucosa |
T1sm | Lymphoma confined to the submucosa |
T2 | Lymphoma infiltrates muscularis propria or subserosa |
T3 | Lymphoma penetrates serosa (visceral peritoneum) without invasion of adjacent structures |
T4 | Lymphoma invades adjacent structures or organs |
Regional lymph node involvement (N) |
NX | Involvement of lymph nodes not assessed |
N0 | No evidence of lymph node involvement |
N1Δ | Involvement of regional lymph nodes |
N2 | Involvement of intra-abdominal lymph nodes beyond the regional area |
N3 | Spread to extra-abdominal lymph nodes |
Distant metastasis (M) |
MX | Dissemination of lymphoma not assessed |
M0 | No evidence of extranodal dissemination |
M1 | Non-continuous involvement of separate site in gastrointestinal tract (eg, stomach and rectum) |
M2 | Non-continuous involvement of other tissues (eg, peritoneum, pleura) or organs (eg, tonsils, parotid gland, ocular adnexa, lung, liver, spleen, kidney, breast) |
Bone marrow involvement (B) |
BX | Involvement of bone marrow not assessed |
B0 | No evidence of bone marrow involvement |
B1 | Lymphomatous infiltration of bone marrow |
Application |
TNM | Clinical staging: status of tumor, node, metastasis, bone marrow |
pTNMB | Histopathological staging: status of tumor, node, metastasis, bone marrow |
pN | The histological examination will ordinarily include 6 or more lymph nodes |
Lugano staging system for gastrointestinal lymphomas[2] |
Stage I - The tumor is confined to the gastrointestinal tract. It can be a single primary lesion or multiple, noncontiguous lesions. (Corresponds to Paris stage T1-3 N0 M0.) |
Stage II - The tumor extends into the abdomen. This is further subdivided based upon the location of nodal involvement: |
- Stage II1: Involvement of local nodes (paragastric nodes for gastric lymphoma or para-intestinal nodes for intestinal lymphoma). (Corresponds to Paris stage T1-3 N1 M0.)
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- Stage II2: Involvement of distant nodes (para-aortic, para-caval, pelvic, or inguinal nodes for most tumors; mesenteric nodes in the case of intestinal lymphoma). (Corresponds to Paris stage T1-3 N2 M0.)
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- Stage IIE: The tumor penetrates the serosa to involve adjacent organs or tissues. (Corresponds to Paris stage T4 N0-2 M0.)
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Stage III - There is no stage III disease in this system. |
Stage IV - There is disseminated extranodal involvement or concomitant supra-diaphragmatic nodal involvement. (Corresponds to Paris stage T1-4 N3 M0 or T1-4 N0-3 M1-2.) |