Clinical and Pathological Staging Cases in Oncology
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KCR Spring Training
T,N,M Case Examples
Tonya Brandenburg
Colon Case – Clinical Staging
Clinical T
cTX – The biopsy tissue from the colonoscopy
wasn’t adequate to assess depth of invasion
Clinical N
cNX – There was no imaging to assess lymph
nodes
Clinical M
cM0 – No mets signs or symptoms on H&P
Clinical Stage - 99
Colon Case – Pathological Staging
Pathological T
pTX – Nothing to assess depth of invasion
Pathological N
pN2b – More than 7 regional lymph nodes
involved
Pathological M
pM1a – Para-aortic lymph nodes positive (not
regional for ascending colon, so distant lymph
nodes)
Pathological Stage - IVA
Lung Case – Clinical Staging
Clinical T
cT4 – Tumor in the main bronchus that involves
the trachea
Clinical N
cN3 – Positive scalene node biopsy
Clinical M
cM0 – No mets signs or symptoms on H&P
Clinical Stage - IIIB
Lung Case – Pathological Staging
Pathological T
pT
Pathological N
pN
Pathological M
pM
Pathological Stage – 99
This patient did not meet the criteria for
pathological staging
Bladder Case – Clinical Staging
Clinical T
cT1(m) – Stromal invasion = submucosa.
Multiple distinct tumors with the same
histology get the m modifier
Clinical N
cN0 – CT scan was negative
Clinical M
cM0 – No mets signs or symptoms on H&P
Clinical Stage - I
Bladder Case – Pathological Staging
Pathological T
ypT2a(m) – Superficial muscle invasion
(muscularis propria)
Pathological N
ypN0 – Negative nodes
Pathological M
cM0 – No mets signs or symptoms on H&P
Pathological Stage – y II
Kidney Case – Clinical Staging
Clinical T
cT2b – 12 cm tumor in the left lower pole
Clinical N
cN0 – CT scan was negative for nodes
Clinical M
cM0 – No mets signs or symptoms on H&P
Clinical Stage - II
Kidney Case – Pathological Staging
Pathological T
pT3a – 10 cm tumor extending into renal vein
Pathological N
pNX – No nodes examined
Pathological M
cM0 – No mets signs or symptoms on H&P
Pathological Stage – III – The nodal status doesn’t
play a role in T3 tumors
This collection highlights clinical and pathological staging cases in oncology, covering scenarios from colon, lung, bladder, and kidney cancer. Each case presents detailed information on tumor characteristics, lymph node involvement, metastasis status, and clinical stages. Images accompany the descriptions, aiding in better understanding and visualization of each case.
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Presentation Transcript
KCR Spring Training T,N,M Case Examples Tonya Brandenburg
Colon Case Clinical Staging Clinical T cTX The biopsy tissue from the colonoscopy wasn t adequate to assess depth of invasion Clinical N cNX There was no imaging to assess lymph nodes Clinical M cM0 No mets signs or symptoms on H&P Clinical Stage - 99
Colon Case Pathological Staging Pathological T pTX Nothing to assess depth of invasion Pathological N pN2b More than 7 regional lymph nodes involved Pathological M pM1a Para-aortic lymph nodes positive (not regional for ascending colon, so distant lymph nodes) Pathological Stage - IVA
Lung Case Clinical Staging Clinical T cT4 Tumor in the main bronchus that involves the trachea Clinical N cN3 Positive scalene node biopsy Clinical M cM0 No mets signs or symptoms on H&P Clinical Stage - IIIB
Lung Case Pathological Staging Pathological T pT Pathological N pN Pathological M pM Pathological Stage 99 This patient did not meet the criteria for pathological staging
Bladder Case Clinical Staging Clinical T cT1(m) Stromal invasion = submucosa. Multiple distinct tumors with the same histology get the m modifier Clinical N cN0 CT scan was negative Clinical M cM0 No mets signs or symptoms on H&P Clinical Stage - I
Bladder Case Pathological Staging Pathological T ypT2a(m) Superficial muscle invasion (muscularis propria) Pathological N ypN0 Negative nodes Pathological M cM0 No mets signs or symptoms on H&P Pathological Stage y II
Kidney Case Clinical Staging Clinical T cT2b 12 cm tumor in the left lower pole Clinical N cN0 CT scan was negative for nodes Clinical M cM0 No mets signs or symptoms on H&P Clinical Stage - II
Kidney Case Pathological Staging Pathological T pT3a 10 cm tumor extending into renal vein Pathological N pNX No nodes examined Pathological M cM0 No mets signs or symptoms on H&P Pathological Stage III The nodal status doesn t play a role in T3 tumors
