Collaborative Stage

Note 1: AJCC Staging Manual 7th Edition includes a standardized and precise definition of pleural/elastic layer invasion (PL). There are four categories:
PL0 - Tumor that is surrounded by lung parenchyma or invades superficially into the pleural connective tissue beneath the elastic layer but falls short of completely traversing the elastic layer of the pleura
PL1 - Tumor that invades beyond the elastic layer
PL2 - Tumor that extends to the surface of the visceral pleura
PL3 - Tumor that invades the parietal pleura
Categories PL1 and PL2 are considered pleural invasion for staging and are classified as at least a T2. PL3 is classified as at least a T3. PL0 is not considered pleural invasion for TNM staging, and the T category is assigned based on other criteria. Other criteria can also raise the T category for PL1-3 tumors.
When pathologists have difficulty assessing the relationship of the tumor to the elastic layer on routine hematoxylin and eosin (H and E) stains, they may perform a special elastic stain to make the determination.
Note 2: Code results as stated on the pathology report. Code 998 if no histologic examination of pleura to assess pleural layer invasion.
Note 3: If pleural/elastic layer invasion (PL) is not mentioned on the pathology report, code 999.
Note 4: An FNA is not a histologic specimen and is not adequate to assess pleural layer invasion. If only an FNA is available, use code 998.
Note 5: Metastasis to the pleura, that is pleural tumor foci or nodules separate from direct invasion, are coded in CS Mets at Dx (code 24).

Code	Description
000	PL 0 No evidence of visceral pleural invasion (PL) Tumor does not completely traverse the elastic layer
010	PL 1 Invasion beyond the visceral elastic pleura, but limited to the pulmonary pleura Tumor extends through the elastic layer
020	PL 2 Invasion to the surface of the pulmonary pleura Tumor extends to the surface of the visceral pleura
030	PL 3 Tumor extends to the parietal pleura
040	Invasion of pleura, NOS
888	OBSOLETE DATA CONVERTED V0200 See code 988 Not applicable for this site
988	Not applicable: Information not collected for this case (May include cases converted from code 888 used in CSv1 for "Not applicable" or when the item was not collected. If this item is required to derive T, N, M, or any stage, use of code 988 may result in an error.)
998	No histologic examination of pleura to assess pleural layer invasion
999	Unknown if PL present PL/elastic layer cannot be assessed Not documented in patient record

Lung

CS Site-Specific Factor 2
Pleural/Elastic Layer Invasion (PL) by H and E or Elastic Stain

Lung

CS Site-Specific Factor 2Pleural/Elastic Layer Invasion (PL) by H and E or Elastic Stain

CS Site-Specific Factor 2
Pleural/Elastic Layer Invasion (PL) by H and E or Elastic Stain