By Frederick L. Greene M.D., Carolyn C. Compton M.D., PH.D., April G. Fritz C.T.R., R.H.I.T., Jatin P. Shah M.D., David P. Winchester M.D. (eds.)
The AJCC melanoma Staging Atlas comprises black-and-white illustrations, created completely for the publication, depicting the anatomic quantity of affliction for tumor (T), nearby lymph node (N), and far-off metastasis (M). the pictures supply thorough anatomic depictions to explain serious constructions and make allowance the reader to right away visualize the revolutionary volume of malignant affliction. quite a few labels establish very important anatomic structures.
NOTE: The AJCC melanoma Staging Atlas relies at the sixth variation staging schemas and lots of pictures would possibly not replicate the present seventh variation staging system.
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No imaging study (as yet) can identify microscopic foci of cancer in regional nodes or distinguish between small reactive nodes and small malignant nodes (unless central radiographic inhomogeneity is present). For pN, a selective neck dissection will ordinarily include six or more lymph nodes, and a radical or modiﬁed radical neck dissection will ordinarily include 10 or more lymph nodes. Negative pathologic examination of a lesser number of nodes still mandates a pN0 designation. Metastatic Sites.
T2 tumors of the oropharynx invade more than one subsite or an adjacent site and measure more than 2 cm but not more than 4 cm. 11. T3 tumors of the oropharynx are more than 4 cm in greatest dimension. 12. T4a tumor of the oropharynx is described as a tumor that invades the larynx, deep/extrinsic music of tongue, medial pterygoid, hard plate, or mandible. 13. T4b tumor of oropharynx showing submucosal extension to the pterygoid fossa. 14. A. T1 tumor of the hypopharynx with involvement of the pyriform sinus.
Pathologic examination is necessary for documentation of such disease extent. Imaging studies showing amorphous spiculated margins of involved nodes or involvement of internodal fat resulting in loss of normal oval-to-round nodal shape strongly suggest extracapsular (extranodal) tumor spread; however, pathologic examination is necessary for documentation of such disease extent. No imaging study (as yet) can identify microscopic foci of cancer in regional nodes or distinguish between small reactive nodes and small malignant nodes without central radiographic inhomogeneity.