MALT lymphoma staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2], Ahmed Younes M.B.B.CH [3]

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Overview

The staging of MALT lymphoma is based on two staging systems: Ann Arbor staging system and the TNM staging system.

Staging

The staging of MALT lymphoma is based on two staging systems: Ann Arbor staging system and the TNM staging system.

Ann Arbor Staging System

The Ann Arbor staging system has been modified for gastric MALT lymphoma.

Stage	Description
Stage I	Tumor is confined to the stomach without spread to the lymph nodes
Stage II	Tumor extends into the abdomen and has spread to the lymph nodes II1: Cancer has spread to local lymph nodes (such as paragastric nodes) II2: Cancer has spread to distant lymph nodes (such as para-aortic, pelvic, or inguinal nodes)
Stage IIE	Tumor penetrates the serosa to spread to adjacent organs or tissues
Stage IV	Disseminated spread to extranodal sites or spread to the lymph nodes above the diaphragm (supradiaphragmatic nodal involvement)

TNM Staging System

The TNM staging system for stomach cancer has also been applied to gastric MALT lymphoma. TNM stands for tumor, nodes, and metastasis.

TNM Classification	Definition
Primary Tumor (T)
T1	The lymphoma is confined to the mucosa or submucosa T1m: Lymphoma confined to the mucosa T1sm: Lymphoma confined to the submucosa
T2	Lymphoma invades the muscularis propria
T3	Lymphoma penetrates the subserosa
T4	Lymphoma has grown through the serosa or invades organs near the stomach
T1a	Tumor invades subepithelial connective tissue, but has no lymphovascular invasion
T1b	Tumor invades subepithelial connective tissue and has spread to the lymphatic channels or blood vessels
T2	Tumor invades the erectile tissue (corpus spongiosum or cavernosum)
Regional Lymph Nodes (N)
N0	No cancer in regional lymph nodes
N1-3	There is cancer in the regional lymph nodes
Distant Metastasis (M)
M0	No distant metastasis
M1	Distant metastasis