Collaborative Stage

Collaborative Stage for TNM 7 - Revised 01/08/2010 [ Schema ]

Lymphoma

CS Extension

Note 1: For lymphoma an E lesion is defined as disease that involves extralymphatic site(s). Extralymphatic means other than lymph nodes and other lymphatic structures. These lymphatic structures include spleen (see note 2), thymus gland (C37.9), Waldeyer's ring (tonsils) (C02.4, C09.0-C09.9, C11.1, C14.2), Peyer's patches (ileum) (C17.2) and lymphoid nodules in the appendix (C18.1). Any lymphatic structure (other than spleen) is to be coded the same as a lymph node region (codes 100, 200, 300).
Note 2: While Spleen is considered a lymphatic structure, it is coded separately (see codes 120, 220, 230, 320, 330). S equals Spleen involvement.
Note 3: If there is no mention of lymphatic or extralymphatic involvement but several diagnostic procedures were done, including laparotomy, interpret as no involvement.
Note 4: Involvement of adjacent soft tissue does not alter the classification.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
100	Involvement of a single lymph node region Stated as Stage I	^	*	L	L
110	Localized involvement of a single extralymphatic organ/ site in the absence of any lymph node involvement Multifocal involvement of one extralymphatic organ/site Stated as Stage IE	^	*	L	L
120	Involvement of spleen only Staged as Stage IS	^	*	L	L
200	Involvement of two or more lymph node regions on the SAME side of the diaphragm Staged as Stage II	^	*	RNOS	RNOS
210	Localized involvement of a single extralymphatic organ/site WITH involvement of its regional lymph node(s) WITH or WITHOUT involvement of other lymph node(s) on the SAME side of the diaphragm Direct extension to adjacent organs or tissues Staged as Stage IIE	^	*	RNOS	RNOS
220	Involvement of spleen PLUS lymph node(s) BELOW the diaphragm Stated as Stage IIS	^	*	RNOS	RNOS
230	Involvement of spleen PLUS involvement of a single extralymphatic organ/site BELOW the diaphragm WITH/WITHOUT involvement of lymph node(s) BELOW the diaphragm Staged as Stage IIES	^	*	RNOS	RNOS
300	Involvement of lymph node regions on BOTH sides of the diaphragm Staged as Stage III	^	*	D	D
310	Involvement of an extralymphatic organ/site PLUS involvement of lymph node(s) on the OPPOSITE side of the diaphragm Staged as Stage IIIE	^	*	D	D
320	Involvement of the spleen PLUS lymph node(s) ABOVE the diaphragm Involvement of spleen PLUS lymph nodes on both sides of the diaphragm. Staged as Stage IIIS	^	*	D	D
330	(31) + (32) OR Involvement of the spleen PLUS a single extralymphatic site ABOVE the diaphragm WITH/WITHOUT involvement of lymph node(s) Involvement of the spleen PLUS involvement of lymph node region(s)ABOVE the diaphragm PLUS involvement of a single extralymphatic organ/site on either side of the diaphragm Staged as Stage IIIES	^	*	D	D
800	Diffuse or disseminated (multifocal) involvement of ONE OR MORE extralymphatic organ(s)/site(s) WITH OR WITHOUT associated lymph node involvement Multifocal involvement of MORE THAN ONE extralymphatic organ/site Involvement of isolated extralymphatic organ in absence of involvement of adjacent lymph nodes, but in conjunction with disease in distant sites Metastasis/involvement: Bone marrow Liver Nodular involvement of lung(s) Staged as Stage IV	^	*	D	D
999	Unknown extension Primary tumor cannot be assessed Not documented in patient record	^	*	U	U

* AJCC stage group for this site is derived directly from the extension code and SSF#2, as shown in the AJCC TNM 6th edition Stage table. The AJCC Stages Groups I-IV are subdivided into A and B based on presence or absence of symptoms as shown in SSF#2.
^ AJCC stage group for this site is derived directly from the extension code and SSF#2, as shown in the AJCC TNM 7th edition Stage table. The AJCC Stages Groups I-IV are subdivided into A and B based on presence or absence of symptoms as shown in SSF#2.