1、Clinic Staging of Thymic Tumors,Thymic Tumors,Rare diseases Remain localized to the mediastinum in many cases Often indolent progression May be locally aggressive Dissemination within the chest Distant metastases unusual Lymphatic spread unusual,No official stage classification by UICC(Union for Int
2、ernational Cancer Control) and AJCC(American Joint Committee on Cancer)Various classification (Masaoka, modified Masaoka, NETT,TNM)ITMIG(International Thymic Malignancy Interesting Group) has chosen to use the Masaoka-Koga stage classification system, consistent with what has been adopted most broad
3、ly.(2011.02) .,Thymoma Staging System,Stage Definition I Grossly and microscopically completely encapsulated tumor II a Microscopic transcapsular invasion b Macroscopic invasion into thymic or surrounding fatty tissue, or grossly adherent to but not breaking through mediastinal pleura or pericardium
4、 III Macroscopic invasion into neighboring organ (i.e. pericardium, great vessel or lung) IV a Pleural or pericardial metastasesb Lymphogenous or hematogenous metastasis,Masaoka-Koga staging system,Grossly and microscopically completely encapsulated tumor This includes tumors with invasion into but
5、not through the capsuleIf capsule is partially absent - should not be interpreted as invasion,Stage I,Microscopic transcapsular invasion If there is limited microscopic extension into tissues surrounding the capsule the tumor should be classified as stage IIa, minimally invasive,Stage IIa,Gross visu
6、al tumor extension into normal thymus or perithymic fat surrounding the thymoma (microscopically confirmed),Stage IIb,Adherence to pleura or pericardium making removal of these structures necessary during resection, with microscopic confirmation of perithymic invasion but without microscopic extensi
7、on into or through the mediastinal pleura or into the fibrous layer of the pericardium,Stage IIb,This includes extension of the primary tumor to any of the following tissues: Microscopic involvement of mediastinal pleura (either partial or penetrating the elastin layer) Microscopic involvement of th
8、e pericardium (either partial in the fibrous layer or penetrating through to the serosal layer),Stage III,Microscopically confirmed direct penetration into the outer elastin layer of the visceral pleura or into the lung Invasion into the phrenic or vagus nerves (microscopically confirmed, adherence
9、alone is not sufficient) Invasion into or penetration through major vascular structures (microscopically confirmed),Stage III,Microscopically confirmed nodules, separate from the primary tumor, involving the visceral or parietal pleural surfaces, or the pericardial or epicardial surfaces,Stage IVa,A
10、ny nodal involvement (e.g. anterior mediastinal, intrathoracic, low/anterior cervical nodes, any other extrathoracic nodes)Distant metastases (i.e. extrathoracic and outside the cervical perithymic region) or pulmonary parenchymal nodules (not a pleural implant),Stage IVb,胸腺瘤的分期,I期 肿瘤局限在胸腺内，肉眼及镜下均无包膜浸润 II期 IIa期 肿瘤镜下超出胸膜包膜IIb期 侵犯邻近脂肪组织，但未侵犯至纵隔胸膜 III期 肿瘤侵犯邻近组织或器官，包括心包、肺及大 血管IIIa期 肿瘤未侵犯大血管IIIb期 肿瘤侵犯大血管 IV期 IVa期 肿瘤广泛侵犯胸膜和（或）心包IVb期 肿瘤扩散到远处器官,胸腺瘤的分期,胸腺瘤的分期,胸腺瘤的分期,胸腺瘤的分期,Thanks for attention!,
