(ICD‐O C32.0, 1, 2, C10.1)

LARYNX (ICD‐O C32.0, 1, 2, C10.1)

Rules for Classification

The classification applies only to carcinomas. There should be histological confirmation of the disease.

Anatomical Sites and Subsites

(Figs. 41, 42, 78, 79)

Supraglottis (C32.1)

Suprahyoid epiglottis [including tip, lingual (anterior)
(C10.1), and laryngeal surfaces]
Aryepiglottic fold, laryngeal aspect
Arytenoid
Infrahyoid epiglottis
Ventricular bands (false cords)

Epilarynx
(including
marginal zone)

Supraglottis
excluding
epilarynx

Glottis (C32.0)
1. Vocal cords
2. Anterior commissure
3. Posterior commissure
Subglottis (C32.2)

Regional Lymph Nodes

See Head and Neck Tumours.

Schematic illustration of head and neck tumours. — Fig. 78

Schematic illustration of head and neck tumours. — Fig. 79

TNM Clinical Classification

T – Primary Tumour

TX	Primary tumour cannot be assessed
T0	No evidence of primary tumour
Tis	Carcinoma in situ

Supraglottis

T1	Tumour limited to one subsite of supraglottis with normal vocal cord mobility (Figs. 80, 81)
T2	Tumour invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula or medial wall of piriform sinus) without fixation of the larynx (Figs. 82, 83)
T3	Tumour limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, pre‐epiglottic space, paraglottic space and/or inner cortex of thyroid cartilage (Figs. 84, 85)
T4a	Tumour invades through the thyroid cartilage and/or invades tissues beyond the larynx, e.g., trachea, soft tissues of neck including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus and styloglossus), strap muscles, thyroid, oesophagus (Fig. 86)
T4b	Tumour invades prevertebral space, mediastinal structures, or encases carotid artery (Fig. 68)

Schematic illustration of tumour limited to one subsite of supraglottis with normal vocal cord mobility. — Fig. 80

Schematic illustration of tumour limited to one subsite of supraglottis with normal vocal cord mobility. — Fig. 81

Schematic illustration of tumour invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis without fixation of the larynx. — Fig. 82

Schematic illustration of tumour invades mucosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis without fixation of the larynx. — Fig. 83

Schematic illustration of tumour limited to larynx with vocal cord fixation and invades any of the following: postcricoid area, pre‐epiglottic space, paraglottic space and inner cortex of thyroid cartilage. — Fig. 84

Schematic illustration of tumour limited to larynx with vocal cord fixation and invades any of the following: postcricoid area, pre‐epiglottic space, paraglottic space and inner cortex of thyroid cartilage. — Fig. 85

Schematic illustration of tumour invades through the thyroid cartilage and invades tissues beyond the larynx. — Fig. 86

Glottis

T1	Tumour limited to vocal cord(s) (may involve anterior or posterior commissure) with normal mobility (Fig. 87a)
T1a	Tumour limited to one vocal cord (Fig. 87b)
T1b	Tumour involves both vocal cords (Fig. 87c)
T2	Tumour extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility (Fig. 88)
T3	Tumour limited to larynx with vocal cord fixation and/or invades paraglottic space, and/or inner cortex of the thyroid cartilage (Fig. 89)
T4a	Tumour invades through the outer cortex of the thyroid cartilage, and/or invades tissues beyond the larynx, e.g., trachea, soft tissues of neck including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus and styloglossus), strap muscles, thyroid, oesophagus (Fig. 90)
T4b	Tumour invades prevertebral space, encases carotid artery, or mediastinal structures (Fig. 91)

Schematic illustration of tumour limited to vocal cord with normal mobility. — Fig. 87

Schematic illustration of tumour extends to supraglottis and subglottis, and with impaired vocal cord mobility. — Fig. 88

Schematic illustration of tumour limited to larynx with vocal cord fixation and invades paraglottic space, and inner cortex of the thyroid cartilage. — Fig. 89

Schematic illustration of tumour invades through the outer cortex of the thyroid cartilage, and invades tissues beyond the larynx. — Fig. 90

Schematic illustration of tumour invades prevertebral space, encases carotid artery, or mediastinal structures. — Fig. 91

Subglottis

T1	Tumour limited to subglottis (Fig. 92)
T2	Tumour extends to vocal cord(s) with normal or impaired mobility (Fig. 93)
T3	Tumour limited to larynx with vocal cord fixation (Fig. 94)
T4a	Tumour invades cricoid or thyroid cartilage and/or invades tissues beyond the larynx, e.g., trachea, soft tissues of neck including deep/extrinsic muscle of tongue (genioglossus, hyoglossus, palatoglossus and styloglossus), strap muscles, thyroid, oesophagus (Fig. 95)
T4b	Tumour invades prevertebral space, mediastinal structures, or encases carotid artery (Fig. 96)

Schematic illustration of tumour limited to subglottis. — Fig. 92

Schematic illustration of tumour extends to vocal cord(s) with normal or impaired mobility. — Fig. 93

Schematic illustration of tumour limited to larynx with vocal cord fixation. — Fig. 94

Schematic illustration of tumour invades cricoid or thyroid cartilage and invades tissues beyond the larynx, e.g., trachea, soft tissues of neck including deep/extrinsic muscle of tongue, strap muscles, thyroid, oesophagus. — Fig. 95

Schematic illustration of tumour invades prevertebral space, mediastinal structures, or encases carotid artery. — Fig. 96

N – Regional Lymph Nodes

See Head and Neck Tumours.

pTN Pathological Classification

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

Summary

Tags: TNM Atlas

Dec 15, 2022 | Posted by admin in ONCOLOGY | Comments Off

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