ASCP Staging

0.5-4 hours

myocardial infarction time: no gross change

4-12 hours

myocardial infarction time: occasional dark mottling

12-24 hours

myocardial infarction time: dark mottling

1-3 days

myocardial infarction time: mottling with yellow-tan infarct center

3-7 days

myocardial infarction time: hyperemic border; central yellow-tan softening

7-10 days

myocardial infarction time: maximally yellow-tan and soft with depressed red-tan margins

10-14 days

myocardial infarction time: red-gray depressed infarct borders

2-8 weeks

myocardial infarction time: gray-white scar, progressive from border toward core of infarct

> 2 months

myocardial infarction time: scarring complete

3, 5, 7 cm in GD

what are the important T stage boundaries for lung cancers (size)?

pT2

T stage: lung cancer involving the visceral pleura or main bronchus

pT3

T stage: lung cancer involving the phrenic nerve, parietal pleura, or parietal pericardium

pT1

T stage: thymic tumor involving the mediastinal fat or mediastinal pleura

pT2

T stage: thymic tumor involving the pericardium

pT3

T stage: thymic tumor involving the lung

pT3

T stage: laryngeal tumor involving the paraglottic space or inner cortex of thyroid cartilage

pT4

T stage: laryngeal tumor involving the outer cortex of the thyroid cartilage

2 and 4 cm in GD, 5 and 10 mm DOI

what are the important T stage boundaries for cancers of the oral cavity?

2 and 4 cm in GD; extraparenchymal extension (without = pT1/2, with = pT3/4)

what are the important T stage boundaries for cancers of the major salivary glands?

1. at least 22 lymph nodes from levels I-V

2. SCM

3. IJV

4. spinal accessory nerve

5. submandibular gland

6. sometimes tail of parotid

components of a standard radical neck dissection

standard radical (22 LN, SCM, IJV, CN XI, submandibular gland, tail of parotid) with retropharyngeal, paratracheal, parotid, suboccipital, and/or mediastinal nodes

components of an extended radical neck dissection

at least 15 lymph nodes from levels I-V and sparing SCM, CN XI, and/or IJV

components of a modified radical neck dissection

2 levels or less (nodes from the first metastatic site)

components of a regional/super selective lymph node dissection

IB

what level includes the submandibular gland?

pT1

T stage for organs with a DOI (GI tract/ureter/renal pelvis/bladder): lamina propria/submucosa

pT2

T stage for organs with a DOI (GI tract/ureter/renal pelvis/bladder): muscularis propria

pT3

T stage for organs with a DOI (GI tract/ureter/renal pelvis/bladder): subserosal CT (adventitia/periureteric fat/peripelvic fat/perivesical ST)

pT4

T stage for organs with a DOI (GI tract/ureter/renal pelvis/bladder): through serosa

15 (???)

minimum lymph node requirement: esophagus

30

minimum lymph node requirement: stomach

12

minimum lymph node requirement: hemicolectomy

20

minimum lymph node requirement: total colectomy

submucosa and muscularis mucosa

what histological components are not present within the gallbladder wall?

pT1 (no submucosa/muscularis mucosa)

gallbladder T stage: muscularis propria

pT2

gallbladder T stage: subserosal/perimuscular CT

pT3

gallbladder T stage: liver

pT4

gallbladder T stage: involves at least 2 extrahepatic structures

pT1

HCC T stage: solitary tumor > 2 cm without vascular invasion

pT2

HCC T stage: multiple tumors all < 5 cm

pT3

HCC T stage: multiple tumors, at least one > 5 cm

pT4

HCC T stage: major portal or hepatic vein involvement

2 and 4 cm in GD

what are the important T stage boundaries for pancreatic tumors

7 cm in GD

what size tumor distinguishes pT1 and pT2 for kidney cancers?

pT3

kidney T stage: renal vein or renal sinus fat

pT4

kidney T stage: through Gerota’s fascia and/or ipsilateral adrenal gland

pT3

renal pelvic T stage: renal parenchyma

pT4

ureter/renal pelvis T stage: perinephric fat

pT2a

urinary bladder T stage: muscularis propria inner 1/2

pT2b

urinary bladder T stage: muscularis propria outer 1/2

pT3a

urinary bladder T stage: microscopic invasion of the perivesical ST

pT3b

urinary bladder T stage: macroscopic invasion of the perivesical ST

pT2

penile T stage: corpus spongiosum

pT3

penile T stage: corpus cavernosum

pT2

testis T stage: epididymis or rete testis

pT3

testis T stage: spermatic cord

pT4

testis T stage: scrotum

pT3b

prostate T stage: seminal vesicles

IA

endometrial FIGO stage: < ½ of the myometrium

IB

endometrial FIGO stage: > ½ of the myometrium

III

endometrial FIGO stage: through serosa, adnexa, vagina, parametrium

IV

endometrial FIGO stage: bladder or bowel mucosa

II

vulva FIGO stage: lower 1/3 vagina, lower 1/3 urethra

III

vulva FIGO stage: upper 2/3 vagina or upper 2/3 urethra

III

vulva FIGO stage: bladder or rectum

IV

vulva FIGO stage: pubic bone

II

vulva FIGO stage: anus

2 and 5 cm in GD

what are the important T stage boundaries for breast cancer?

5 cm in GD

what size tumor distinguishes pT1 and pT2 for adrenal gland cancers?

pT4

adrenal gland T stage: kidney involvement

2 and 4 cm in GD

what are the important T stage boundaries for thyroid cancer?

pT3b

thyroid T stage: strap muscles

1, 2, and 4 mm in thickness, ulceration (a = without, b = with)

what are the important T stage boundaries for melanoma?

8 cm in GD

what size tumor distinguishes pT1 and pT2 for general bone cancers?

pT3

bone T stage: discontinuous tumor in the primary site