Paris staging system for primary gastrointestinal lymphomas*†
| *Valid for lymphomas originating from the gastro-oesophageal junction to the anus (as defined by identical histomorphological structure). | |
| †In case of more than one visible lesion synchronously originating in the gastrointestinal tract, give the characteristics of the more advanced lesion. | |
| ‡Anatomical designation of lymph nodes as “regional” according to site: (a) stomach: perigastric nodes and those located along the ramifications of the coeliac artery (that is, left gastric artery, common hepatic artery, splenic artery) in accordance with compartments I and II of the Japanese Research Society for Gastric Cancer (1995); (b) duodenum: pancreaticoduodenal, pyloric, hepatic, and superior mesenteric nodes; (c) jejunum/ileum: mesenteric nodes and, for the terminal ileum only, the ileocolic as well as the posterior caecal nodes; (d) colorectum: pericolic and perirectal nodes and those located along the ileocolic, right, middle, and left colic, inferior mesenteric, superior rectal, and internal iliac arteries. | |
| TX | Lymphoma extent not specified |
| TO | No evidence of lymphoma |
| T1 | Lymphoma confined to the mucosa/submucosa |
| T1m | Lymphoma confined to mucosa |
| T1sm | Lymphoma confined to submucosa |
| T2 | Lymphoma infiltrates muscularis propria or subserosa |
| T3 | Lymphoma penetrates serosa (visceral peritoneum) without invasion of adjacent structures |
| T4 | Lymphoma invades adjacent structures or organs |
| NX | Involvement of lymph nodes not assessed |
| NO | No evidence of lymph node involvement |
| N1‡ | Involvement of regional lymph nodes |
| N2 | Involvement of intra-abdominal lymph nodes beyond the regional area |
| N3 | Spread to extra-abdominal lymph nodes |
| MX | Dissemination of lymphoma not assessed |
| MO | No evidence of extranodal dissemination |
| M1 | Non-continuous involvement of separate site in gastrointestinal tract (eg, stomach and rectum) |
| M2 | Non-continuous involvement of other tissues (eg, peritoneum, pleura) or organs (eg, tonsils, parotid gland, ocular adnexa, lung, liver, spleen, kidney, breast etc.) |
| BX | Involvement of bone marrow not assessed |
| B0 | No evidence of bone marrow involvement |
| B1 | Lymphomatous infiltration of bone marrow |
| TNM | Clinical staging: status of tumour, node, metastasis, bone marrow |
| pTNMB | Histopathological staging: status of tumor, node, metastasis, bone marrow |
| pN | The histological examination will ordinarily include 6 or more lymph nodes |