Surgical Pathology Criteria

Thymoma Staging

TNM for thymomas has been proposed (based on Masaoka scheme):

pT  
pT1 Completely encapsulated
pT2 Invades through capsule into fat or normal thymus, but not through pleura or pericardium (may be adherent) or into adjacent organs
pT3 Invades through pleura or pericardium or into adjacent organs (great vessels, lung)
pT4 Pleural or pericardial implants
pN  
pN1 Metastasis only to anterior mediastinal nodes
pN2 Metastasis to other intrathoracic nodes
pN3 Metastasis to extrathoracic nodes
pM  
pM1 With distant metastases

Moran (2012) has proposed a system that reflects the indolent nature of completely resected pT1 and pT2 thymomas better than does the Masaoka based TNM system above

Stage Features
0 Completely encapsulated
1 Invasive into perithymic fat
2 Direct invasion into
A) Innominate vein, mediastinal pleura, lung
B) Pericardium
C) Great vessels, heart
3 Metastatic disease
A) Intrathoracic structures, diaphragm, lymph nodes
B) Extrathoracic invasion
No data was supplied to justify the substaging of stages 2 and 3
No provision was made for pleural or pericardial dissemination

 

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