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pulmonary carcinoid tumor

Friday 5 July 2013

pulmonary carcinoid tumors; bronchial carcinoid tumor

eMedicine

Types

- pulmonary typical carcinoid tumor
- pulmonary atypical carcinoid tumor

Staging

The staging system for lung carcinoid tumors is the same one used to stage other types of lung cancer – the American Joint Committee on Cancer (AJCC) TNM staging system.

T categories

TX: The main (primary) tumor can’t be assessed, or cancer cells were seen on sputum cytology or bronchial washings but no tumor can be found.

T0: There is no evidence of a primary tumor.

Tis: The cancer is found only in the top layers of cells lining the air passages. It has not invaded into deeper lung tissues. This stage is also known as carcinoma in situ.

T1: The tumor is no larger than 3 cm (slightly less than 1¼ inches) across. It has not reached the membranes that surround the lungs (visceral pleura), and it does not affect the main branches of the bronchi.

T1a: The tumor is 2 cm (about 4/5 of an inch) or less across.
T1b: The tumor is larger than 2 cm but not larger than 3 cm across.

T2: The tumor has 1 or more of the following features:

It is larger than 3 cm but not larger than 7 cm across. If the tumor is 5 cm or less across (but still larger than 3 cm), it is called T2a. If the tumor is larger than 5 cm across (but not larger than 7 cm), it is called T2b.
It involves a main bronchus, but is not closer than 2 cm (about ¾ inch) to the carina (the point where the windpipe splits into the left and right main bronchi).
It has grown into the membranes that surround the lungs (visceral pleura).
The tumor partially clogs the airways, but this has not caused the entire lung to collapse or develop pneumonia.

T3: The tumor has 1 or more of the following features:

It is larger than 7 cm across.
It has grown into the chest wall, the breathing muscle that separates the chest from the abdomen (diaphragm), the membranes surrounding the space between the lungs (mediastinal pleura), or membranes of the sac surrounding the heart (parietal pericardium).
It invades a main bronchus and is closer than 2 cm (about ¾ inch) to the carina, but it does not involve the carina itself.
It has grown into the airways enough to cause an entire lung to collapse or to cause pneumonia in the entire lung.
Two or more separate tumor nodules are present in the same lobe of a lung

T4: The cancer has 1 or more of the following features:

A tumor of any size has grown into the space between the lungs (mediastinum), the heart, the large blood vessels near the heart (such as the aorta), the windpipe, the esophagus (tube connecting the throat to the stomach), the backbone, or the carina.
Two or more separate tumor nodules are present in different lobes of the same lung.

N categories

NX: Nearby lymph nodes cannot be assessed.

N0: There is no spread to nearby lymph nodes.

N1: The cancer has spread to lymph nodes within the lung and/or around the area where the bronchus enters the lung (hilar lymph nodes). Affected lymph nodes are on the same side as the primary tumor(s).

N2: The cancer has spread to lymph nodes around the carina (the point where the windpipe splits into the left and right bronchi), or it has spread to lymph nodes in the space between the lungs (mediastinum) on the same side as the primary tumor.

N3: The cancer has spread to lymph nodes near the collarbone on either side, and/or spread to hilar or mediastinal lymph nodes on the side opposite the primary tumor.
M categories

M0: No spread to distant organs or areas. This includes other lobes of the lungs, lymph nodes further away than those mentioned in the N stages above, and other organs or tissues such as the liver, bones, or brain.

M1: The cancer has spread to 1 or more distant sites. This can be to another lobe of the lung, to distant lymph nodes, or to other organs.

M1a: Any of the following:

The cancer has spread to the other lung.
Cancer cells are found in the fluid around the lung (called a malignant pleural effusion).
Cancer cells are found in the fluid around the heart (called a malignant pericardial effusion).

M1b: The cancer has spread to distant organs or lymph nodes.

References

- http://www.cancer.org/cancer/lungcarcinoidtumor/detailedguide/lung-carcinoid-tumor-staging