(ICD‐O‐3 C23.9 and C24.0)


GALLBLADDER (ICD‐O‐3 C23.9 and C24.0)


Rules for Classification


The classification applies only to carcinomas of the gallbladder and cystic duct. There should be histological confirmation of the disease.


Regional Lymph Nodes (Fig. 216)


Regional lymph nodes are limited to the hepatic hilus (including nodes along the common bile duct, hepatic artery, portal vein and cystic duct).


Coeliac, periduodenal, peripancreatic and superior mesenteric artery node involvement is considered distant metastasis (M1).

Schematic illustration of coeliac, periduodenal, peripancreatic and superior mesenteric artery node involvement is considered distant metastasis.

Fig. 212


TNM Clinical Classification


T – Primary Tumour




































TX Primary tumour cannot be assessed
T0 No evidence of primary tumour
Tis Carcinoma in situ
T1 Tumour invades lamina propria or muscular layer (Fig. 213)

T1a Tumour invades lamina propria

T1b Tumour invades muscular layer
T2 Tumour invades perimuscular connective tissue; no extension beyond serosa or into liver (Fig. 214)

T2a Tumour invades perimuscular connective tissue on the peritoneal side with no extension to the serosa

T2b Tumour invades perimuscular connective tissue on the hepatic side with no extension into the liver
T3 Tumour perforates the serosa (visceral peritoneum) and/or directly invades the liver and/or one other adjacent organ or structure, such as stomach, duodenum, colon, pancreas, omentum, extrahepatic bile ducts (Figs. 215, 216)
T4 Tumour invades main portal vein or hepatic artery or invades two or more extrahepatic organs or structures (Figs. 217, 218)
Schematic illustration of tumour invades lamina propria or muscular layer.

Fig. 213

Schematic illustration of tumour invades perimuscular connective tissue; no extension beyond serosa or into liver.

Fig. 214

Schematic illustration of tumour perforates the serosa and directly invades the liver and one other adjacent organ or structure, such as stomach, duodenum, colon, pancreas, omentum, extrahepatic bile ducts.

Fig. 215

Schematic illustration of tumour perforates the serosa and directly invades the liver and one other adjacent organ or structure, such as stomach, duodenum, colon, pancreas, omentum, extrahepatic bile ducts.

Fig. 216

Schematic illustration of tumour invades main portal vein or hepatic artery or invades two or more extrahepatic organs or structures.

Fig. 217

Schematic illustration of tumour invades main portal vein or hepatic artery or invades two or more extrahepatic organs or structures.

Fig. 218


N – Regional Lymph Nodes (Figs. 219, 220)












NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1N2 Metastases to 1‐3 nodesMetastases to 4 or more nodes
Schematic illustration of Metastases to 1-3 nodes.

Fig. 219

Schematic illustration of Metastases to 4 or more nodes.

Fig. 220


M – Distant Metastasis









M0 No distant metastasis
M1 Distant metastasis

TNM Pathological Classification


The pT and pN categories correspond to the T and N categories.






pM1 Distant metastasis microscopically confirmed

Note


pM0 and pMX are not valid categories.






pN0 Histological examination of a regional lymphadenectomy specimen will ordinarily include 3 or more lymph nodes. If the regional lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0.

Summary

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Dec 15, 2022 | Posted by in ONCOLOGY | Comments Off on (ICD‐O‐3 C23.9 and C24.0)

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