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CANCERUL BRONHOPULMONAR

clasificare anatomopatologic
Squamous cell carcinoma,
Small cell carcinoma
- pure small cell carcinoma,
- small- large cell carcinoma,
- combined small cell carcinoma (with areas of squamous or glandular
differentiation),
Adenocarcinoma
- variant: bronchioloalveolar carcinoma,
Large cell carcinoma,
Adenosquamous carcinoma,
Sarcoame.
TNM
Tumora primar (T) Tx citologie pozitiv fr eviden de leziune neoplazic
bronhoscopic sau radiologic
T0 fr eviden a unei tumori.
Tis Carcinom in situ
T1 Tumor <3 cm nconjurat de plmn sau pleur visceral , leziune n
bronhie lobar
T2 Tumor cu oricare din caracteristicile: >3cm; prinde bronhia primitiv >2
cm distal de carin ; invadeaz pleura visceral; asociat cu atelectazie sau
penumonit obstructiv ce se extinde spre regiunea hilar frr a prinde
ntregul plmn.
T3 tumor de orice mrime dar care invadeaz: perete toracic( inclusiv
apertura superioar) ,diafragm, pleur mediastinal, pericard; sau orice
tumor ce se dezvolt <2 cm distal de carin dar fr invayia carinei;
atelectazie sau pneumonit obstructiv a ntregului plmn
T4 Tumor de orice dimensiuni care prinde : mediastinul, cordul, vasele mari,
trahea, esofagul, corpii vertebrali, carina; sau tumor cu pleurezie sau
pericardit malign sau cu tumor satelit n acelai lob ipsilateral
Regional lymph nodes (N)
Nx Regional lymph nodes cannot be assessed

N0No regional lymph node metastases


N1 Metastases to ipsilateral
peribronchial and/or ipsilateral hilar lymph nodes
and intrapulmonary nodes involved by direct
extension of primary tumour
N2 Metastases to ipsilateral mediastinal and/or subcarinal lymph nodes
N3 Metastases to contralateral mediastinal,
contralateral hilar, ipsilateral or contralateral
saclene or supraclavicular lymph nodes
Distant metastases (M)
Mx Presence of distant metastases cannot be assessed
M0 No distant metastases
M1Distant metastases present
Stage grouping TNM subsets
0Carcinoma in situ
IA T1N0M0 IB T2N0M0
IIA T1N1M0 IIB T2N1M0 T3N0M0
IIIA T3N1M0 T1N2M0 T2N2M0 T3N2M0
IIIB T4N0M0 T4N1M0 T4N2M0 T1N3M0 T2N3M0 T3N3M0 T4N3M0
IV Any T Any N M1