Criteria
Modified Blackledge staging system (Lugano staging) of gastrointestinal non-Hodgkin's lymphoma[42][43]
Stage I: confined to GI tract (single primary, or multiple, non-contiguous lesions)
Stage I1: infiltration limited to mucosa, with or without submucosal involvement
Stage I2: infiltration into muscularis propria, subserosa, or serosa, or both.
Stage II: extending into abdomen from primary GI site
Stage II1: local nodal involvement (paragastric in gastric lymphoma)
Stage II2: distant nodal involvement.
Stage IIE: penetration of serosa to involve adjacent organ or tissues.
Stage IV: disseminated extranodal involvement or concomitant supra-diaphragmatic nodal involvement.
Paris TNM staging for primary gastrointestinal lymphomas[44]
Depth of tumour infiltration (T):
TX: lymphoma extent not specified
T0: no evidence of lymphoma
T1: lymphoma confined to the mucosa/submucosa
T1m: lymphoma confined to mucosa
T1sm: lymphoma confined to submucosa
T2: lymphoma infiltrates muscularis propria or subserosa
T3: lymphoma penetrates serosa (visceral peritoneum) without invasion of adjacent structures
T4: lymphoma invades adjacent structures or organs
Nodal involvement (N):
NX: involvement of lymph nodes not assessed
N0: no evidence of lymph node involvement
N1: involvement of regional lymph nodes
N2: involvement of intra-abdominal lymph nodes beyond the regional area
N3: spread to extra-abdominal lymph nodes
Metastasis (M):
MX: dissemination of lymphoma not assessed
M0: no evidence of extranodal dissemination
M1: non-continuous involvement of separate site in gastrointestinal tract (e.g., stomach and rectum)
M2: non-continuous involvement of other tissues (e.g., peritoneum, pleura) or organs (e.g., tonsils, parotid gland, ocular adnexa, lung, liver, spleen, kidney, breast)
Bone marrow involvement (B):
BX: involvement of bone marrow not assessed
B0: no evidence of bone marrow involvement
B1: lymphomatous infiltration of bone marrow
Lugano staging classification[45]
Stage I: involvement of one lymph node or a group of adjacent nodes; or involvement of single extranodal lesions without nodal involvement (stage IE).
Stage II: involvement of 2 or more nodal groups on the same side of the diaphragm; or stage I or II nodal extent with limited contiguous extranodal involvement (stage IIE).
Stage II (bulky): as above for stage II, but with bulky disease (i.e., a single nodal mass ≥10 cm in greatest diameter or greater than one third of the transthoracic diameter at any level of thoracic vertebrae).
Stage III: involvement of lymph node on both sides of the diaphragm (includes involvement of lymph node above the diaphragm and the spleen).
Stage IV: involvement of additional non-contiguous extranodal site(s) (i.e., beyond extranodal site[s], contiguous or proximal to known nodal site).
Note: Tonsils, Waldeyer's ring, and spleen are considered nodal tissue.
Histological grading system for gastric MALT lymphomas[22]
Category A: classic low-grade MALT lymphoma, with <5% blasts in clusters of up to 10 cells.
Category B: tumours with >10% to 20% blasts or blast clusters of up to 20 cells.
Category C: consistent with typical high-grade transformation, in which sheets of blasts and only small-foci of low-grade tumour can be seen.
Category D: corresponds to large B-cell lymphoma, without a low-grade component.
Use of this content is subject to our disclaimer