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Clasificare TNM

Organe cavitare Organe Parenchimatoase


T1 Mucoasa, Submucoasa In interiorul parenchimului
T2 Musculara Capsula, muschi
T3 Seroasa, structuri inconjuratoare Oase, cartilaj
T4 Viscere Viscere

Marime (cm) T1 la diverse tumori:


 San
o T2 = 3 – 5 cm
o T3 = >5 cm
o T4 = extensie la perete
 Plaman
o T2 = 3 - 7 cm
o T3 = >7cm
CBP CM CCR CG

T1 <3 cm </= 2 cm Mucoasa + Submucoasa Mucoasa +


T1a: </= 2 cm T1a: 1-5mm Submucoasa
T1b: 2-3 cm T1b: 5-10mm
T1c: 10-20mm
Inconjurata de plaman sau pleura viscerala.
Fara invazie bronhie > decat primitiva.
(Ex: NU invadeaza lobara)
T2 3 – 7 cm >/= 2 – </= 5cm Musculara proprie Musculara
T2a: 3-5
T2b: 5-7 cm
Invazie pleura viscerala
+ Atelectazie
+ Pneumonie obstructiva
Invazie bronhie primitiva dar la distanta
> 2cm de bronhie traheala / lobara
T3 >7 cm >5cm Seroasa / tesut perirectal Seroasa
SAU subperitoneal
Orice dimensiune cu extensie directa la
perete toraic, diafragm pleura, pericard
Pe brohnie principala > 2cm de carena
Atelectazie asociata
Pneumonie obstructiva acelasi plaman
Nodul distinct in acelasi lob
T4 Orice dimensiune, invazie: Orice dimensiune, Direct alte organe / peritoneu Organe din jur
 Mediastin extensie directa la perete toracic sau visceral
 Inima tegument
 Mari vase T4a – perete toracic T4a – peritoneu visceral
 Trahee T4b – edem/ ulceratie cutanata / noduli de T4b – alte organe si structuri
 Esofag permeatie la tegumentul mamar ipsilateral
 Corpuri vertebrale
T4c – T4a + T4b
 Carena
T4d – Carcinom inflamator
 NODUL IN ALT LOB AL ACELUISASI
PLAMAN
CBP CM CCR (minim 12) CG

N1 Peribronsici ipsilaterali Axilari, mobili 1-3 regionali Vecinatate


Hilari (incl. Extensie directa)
N1a – 1 regional
N1b – 2 -3 regionali
N1c – noduli tumorali sateliti in:
 subseroasa
 tesuturi neperitonizate
pericolice / perirectale
Fara diseminare limf regionala!
N2 Mediastinali ipsilaterali N2a: axilari, fixati >4 ggl regionali Distanta
Subcarinari N2b: mamari interni, singurii!
N2a: 4-6 regionali
N2b: >7 regionali
N3 Mediastinali / hilari contralaterali N3a: subclaviculari - ?
Scaleni / supraclaviculari (homo/contra) N3b: mamari interni sI axilari
N3c: supraclaviculari

CBP CM CCR (minim 12) CG

M1 La distanta, dovedite La distanta La distanta Cu metastaze

M1a – M1a – singur organ, ggl limfatici


 Revarsat pleural malign altii decat regionali
 Revarsat pericardic malign (ficat, plaman, ovar)
 Noduli in plaman contralat
M1b – peritoneale / mai multor
M1b – la distanta in alte organe organe