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Liver and intrahepatic bile ducts - tumor


TNM staging of Intrahepatic bile duct tumors

Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.


● Includes combined hepatocellular and cholangiocarcinoma
● Excludes hepatocellular carcinoma, extrahepatic bile duct malignancies

Primary tumor (T)

TX: primary tumor cannot be assessed
T0: no evidence of primary tumor
Tis: carcinoma in situ (intraductal tumor)
T1: solitary tumor without vascular invasion
T2a: solitary tumor with vascular invasion
T2b: multiple tumors, with or without vascular invasion
T3: tumor perforating the visceral peritoneum or involving the local extrahepatic structures by direct invasion
T4: tumor with periductal invasion

● Vascular invasion includes gross or microscopic involvement
● For T3, a major branch means the right or left portal vein, or right-middle or left hepatic vein
● Multiple tumors includes satellitosis, multifocal tumors and intrahepatic metastases

Regional lymph nodes (N)

NX: regional lymph nodes cannot be assessed
N0: no regional lymph node metastasis
N1: regional lymph node metastasis

Distant metastasis (M)

M0: no distant metastasis
M1: distant metastasis

Stage grouping

0:  Tis N0 M0
I:   T1 N0 M0
II:  T2 N0 M0
III: T3 N0 M0
IVA: T4 N0 M0 or any T N1 M0
IVB: any T any N M1

End of Liver and intrahepatic bile ducts - tumor > Miscellaneous > TNM staging of Intrahepatic bile duct tumors

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