Clinical staging for T-cell lymphoma

Box 13.7 outlines how the disease develops in different parts of the body, T indicating the skin, N lymph nodes, M visceral involvement and B haematological involvement.
   
 
Box 13.7 Summary of clinical changes seen in T-cell lymphoma

T1: Patches or plaques <10% body surface area
T2: Patches of plaques >10% body surface area
T3: Tumours
T4: Erythroderma
N0: No palpable nodes
N1: 1 palpable node without histological involvement (dermatopathic)
N2: Non-palpable nodes with histological involvement
N3: Palpable nodes with histological involvement
M0: No visceral disease
M1: Visceral disease
B1: No haematological involvement
B2: Sezary count >5% of total peripheral blood lymphocytes
 
 Source: Whittaker et al. (2003). 
Once the clinical level of involvement has been established, this can be summarised using the grading system outlined in Box 13.8.

   
 
Box 13.8 Burn and Lambert grading system

Stage IA: T1 N0
Stage IB: T2 N0
Stage IIA: T1/2 N1
Stage IIB: T3 N0/1
Stage III: T4 N0/1
Stage IVA: T any N 2/3
Stage IVB: T any N any M1