Collaborative Stage

Note 1: AJCC's TNM, 7th ed., includes a newly standardized and precise definition of visceral pleural invasion (abbreviated as 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 invasion of the parietal pleura

Categories PL1 and PL2 are considered pleural invasion for staging and are classified as T2. PL3 is classified as T3. PL0 is not considered pleural invasion for TNM staging and the T category is assigned based on other criteria.

When pathologists have difficulty assessing the relationship of the tumor to the elastic layer on routine H&E stains, they may perform a special elastic stain to make the determination.
Note 2: Code results as stated on pathology report. Code 998 if no pathologic examination of pleura.
Note 3: Metastasis to the pleura, that is pleural tumor foci or nodules separate from direct invasion, are not coded here. See code 24 in Mets at Dx.

Code	Description
000	No evidence of visceral pleural invasion Tumor does not completely traverse the elastic layer (PL 0)
010	Invasion beyond the visceral elastic pleura, but limited to the pulmonary pleura Tumor extends through the elastic layer (PL 1)
020	Invasion to the surface of the pulmonary pleura Tumor extends to the surface of the visceral pleura (PL 2)
030	Tumor extends to the parietal pleura (PL 3)
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
999	Unknown if visceral pleural invasion is present Not documented in patient record Cannot be assessed

CS Site-Specific Factor 2
Visceral Pleural Invasion (VPI)/Elastic Layer