Pathologic Staging (pTNM)

CAP Approved Hematologic • Ocular Adnexa 3.0.0.0

TNM Descriptors (required only if applicable) (select all that apply)

___ b (bilateral)

___ m (multiple primary tumors)

___ r (recurrent)

___ y (posttreatment)

Primary Tumor (pT)

___ pTX:        Lymphoma extent not specified

___ pT0:        No evidence of primary tumor

pT1:        Lymphoma involving the conjunctiva alone without orbital involvement

___ pT1a:        Bulbar conjunctiva involvement only

___ pT1b:        Palpebral conjunctiva involvement (with or without fornix or caruncle

involvement)

___ pT1c:        Extensive conjunctival involvement (ie, both bulbar and nonbulbar

conjunctiva involvement)

pT2:        Lymphoma with orbital involvement with or without conjunctival involvement

___ pT2a:        Anterior orbital involvement,# but no lacrimal gland involvement (with

or without conjunctival involvement)

___ pT2b:        Anterior orbital involvement with lacrimal gland involvement (with or

               without conjunctival involvement)

___ pT2c:        Posterior orbital involvement (with or without anterior orbital

involvement; with or without conjunctival involvement; with or without extraocular muscle involvement)

___ pT2d:        Nasolacrimal drainage system involvement (with or without

conjunctival involvement, but not involving nasopharynx)

___ pT3:        Lymphoma with pre-septal eyelid involvement## (with or without

orbital or conjunctival involvement)

pT4:        Lymphoma extends beyond orbit to involve adjacent structures (eg, bone,

brain)

___ pT4a:        Involvement of nasopharynx

___ pT4b:        Osseous involvement (including periosteum)

___ pT4c:        Involvement of maxillofacial, ethmoidal, and/or frontal sinuses

___ pT4d:        Intracranial spread

# The anterior orbit is defined as the area between the orbital septum and the

equator of the globe. The posterior orbit is defined as the area posterior to the

equator of the globe, extending to the orbital apex.

## Eyelid involvement is said to exist when the ocular adnexal lymphoma infiltrates

preseptal tissues (ie, tissues anterior to the orbital septum).

Regional Lymph Nodes (pN)

___ pNX:        Involvement of lymph nodes not assessed

___ pN0:        No evidence of lymph node involvement

___ pN1:        Involvement of ipsilateral regional lymph nodes (preauricular/parotid,

submandibular, or cervical)

___ pN2:        Involvement of contralateral or bilateral regional lymph nodes

(preauricular/parotid, submandibular, or cervical)

___ pN3:        Involvement of peripheral lymph nodes not draining ocular adnexal

region

___ pN4:        Involvement of central lymph nodes

Distant Metastasis (pM)

___ Not applicable

___ pM1a:        Non-contiguous involvement of tissues or organs external to the ocular

adnexa (eg, salivary glands, lung, liver)

___ pM1b:        Bone marrow involvement

___ pM1c:        Both pM1a and pM1b involvement

Hematologic

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