甲状腺

2021年6月2日作成、2024年10月29日追記
pN1a-1 3 cm 以下、ENE なし
pN1a-2 それ以外
pN1a-3 XIb に及ぶ
pN1b-1 Va, Vb, VI, VII, VIII, IX に及ぶが3 cm 以下、ENE なし
pN1b-2  それ以外

UICC TNM (8th)

Primary Tumor (pT) [including papillary, follicular, poorly, Hurthle cell and anaplastic]
___ pT1a:  ≤ 1 cm, limited to thyroid
___ pT1b:  ≤ 2 cm, limited to thyroid
___ pT2:    ≤ 4 cm, limited to thyroid (Ex0 = 甲状腺被膜を越えない)
___ pT3a  > 4 cm limited to thyroid
___ pT3b   (Gross) extrathyroidal extension invading only strap muscles (sternohyoid, sternothyroid, or omohyoid muscle) or parathyroid
___ pT4a:    Grossly invading subcutaneous soft tissues (皮下軟部組織), larynx (喉頭), trachea (気管), esophagus (食道) or recurrent laryngeal nerve (反回神経)
___ pT4b:    Tumor invades prevertebral fascia (椎前筋膜) or encases carotid artery (頸動脈全周) or mediastinal vessels (縦隔血管).

Regional Lymph Nodes (pN)
    日本ではリンパ節にローマ数字を使用しているが,それはUICCで言及されているLevel (これもローマ数字)とは関係ないことに注意。
___ pNX:  Cannot be assessed
___ pN0: No regional lymph node metastasis
___ pN1a: Nodal metastases to Level VI (pretracheal, paratracheal and prelaryngeal=Delphian) lymph nodes
 日本の取扱い規約ではI(喉頭前 prelaryngeal), II(気管前 pretracheal), III(気管傍 paratracheal), IV(甲状腺周囲 perithyroidal), XI (上縦隔)がpN1a
___ pN1b: Metastases to unilateral, bilateral or contralateral cervical or superior mediastinal lymph nodes.
 日本の取扱い規約ではV(上内深頸 superior internal jugular), VI(下内深頸 inferior internal jugular), VII(外深頸), VIII, IX が pN1b

Papillary or Follicular including poorly differentiated


Medullary (変更なし)


Anaplastic Carcinoma of the Thyroid

IVA   T1-T3a N0
IVB T1-T3a N1
          T3b-T4b N0-1
IVC M1

主な組織型
___ Low-risk follicular cell-derived thyroid neoplasms
___ Thyroid follicular tumor of uncertain malignant potential
___ Thyroid well-differentiated tumor of uncertain malignant potential
___ Hyalinizing trabecular tumor
___ Non-invasive follicular thyroid neoplasm with papillary like nuclear features (NIFTP)
___ Other low-risk follicular cell-derived thyroid neoplasm (specify): _________________
___ Malignant follicular cell-derived thyroid neoplasms
___ Follicular thyroid carcinoma
___ Minimally invasive follicular carcinoma
___ Encapsulated angioinvasive follicular carcinoma
___ Widely invasive follicular carcinoma
___ Other follicular thyroid carcinoma (specify): _________________
___ Invasive encapsulated follicular variant papillary thyroid carcinoma
___ Minimally invasive follicular variant papillary carcinoma
___ Minimally invasive oncocytic follicular variant papillary carcinoma
___ Encapsulated angioinvasive follicular variant papillary carcinoma
___ Encapsulated angioinvasive oncocytic follicular variant papillary carcinoma
___ Widely invasive follicular variant papillary carcinoma
___ Widely invasive oncocytic follicular variant papillary carcinoma
___ Other invasive encapsulated follicular variant papillary thyroid carcinoma (specify): ________
___ Papillary thyroid carcinomas
All papillary microcarcinomas (less than or equal to 1 cm) should be subtyped based on the 5th edition of the WHO
classification of thyroid tumors.
___ Papillary carcinoma, classic subtype
___ Papillary carcinoma, encapsulated classic subtype
___ Papillary carcinoma, oncocytic classic subtype
___ Papillary carcinoma, infiltrative follicular subtype
___ Papillary carcinoma, tall cell subtype
___ Papillary carcinoma, hobnail subtype
___ Papillary carcinoma, columnar cell subtype
___ Papillary carcinoma, clear cell subtype
___ Papillary carcinoma, spindle cell subtype
___ Papillary carcinoma, solid subtype
___ Papillary carcinoma, diffuse sclerosing subtype
___ Papillary carcinoma with fibromatosis / fasciitis-like / desmoid type stroma
___ Papillary carcinoma, Warthin-like subtype
___ Papillary carcinoma, other subtype (specify): _________________
___ Oncocytic carcinoma of the thyroid
___ Minimally invasive oncocytic carcinoma
___ Encapsulated angioinvasive oncocytic carcinoma
___ Widely invasive oncocytic carcinoma
___ Oncocytic carcinoma, other (specify): _________________
___ High-grade follicular cell-derived differentiated thyroid carcinoma
___ High-grade follicular thyroid carcinoma (specify subtype): _________________
___ High-grade invasive encapsulated follicular variant papillary thyroid carcinoma (specify
subtype): _________________
___ High-grade papillary thyroid carcinoma (specify subtype): _________________
___ High-grade oncocytic carcinoma of the thyroid (specify subtype): _________________
___ High-grade differentiated thyroid carcinoma, NOS
___ Poorly differentiated thyroid carcinoma
___ Poorly differentiated thyroid carcinoma, NOS
___ Oncocytic poorly differentiated thyroid carcinoma
___ Poorly differentiated thyroid carcinoma, other (specify): _________________
___ Anaplastic follicular cell-derived thyroid carcinoma
Formerly known as squamous cell carcinoma of the thyroid is now considered a morphologic pattern of anaplastic thyroid
carcinoma.
___ Anaplastic thyroid carcinoma, NOS
___ Anaplastic thyroid carcinoma, focal or minor component without extrathyroidal extension
___ Anaplastic thyroid carcinoma, major component
___ Other anaplastic follicular cell-derived thyroid carcinoma (specify): _________________
___ Other malignant follicular cell-derived thyroid neoplasm (specify): _________________
___ C cell-derived thyroid carcinoma
___ Medullary thyroid carcinoma
___ Other medullary thyroid carcinoma (specify): _________________
___ Mixed medullary and follicular cell-derived thyroid carcinomas
___ Mixed medullary carcinoma and follicular thyroid carcinoma (specify): _________________
___ Mixed medullary carcinoma and follicular variant papillary carcinoma (specify): _____________
___ Mixed medullary carcinoma and papillary thyroid carcinoma (specify): _________________
___ Other mixed medullary and follicular cell-derived thyroid carcinoma (specify): ______________
___ Salivary gland-type carcinomas of the thyroid
___ Mucoepidermoid carcinoma of the thyroid gland
___ Secretory carcinoma of salivary gland type
___ Other salivary gland-type carcinoma of the thyroid (specify): _________________
___ Thymic neoplasms within the thyroid
___ Thymoma family (specify, if possible): _________________
___ Thymic carcinoma family (specify, if possible): _________________
___ Spindle epithelial tumor with thymus-like elements (SETTLE)
___ Other thymic neoplasm within the thyroid (specify): _________________
___ Thyroid neoplasms of uncertain cytogenesis
___ Cribriform-morular thyroid carcinoma
___ Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE)
___ Other thyroid neoplasm of uncertain cytogenesis (specify): _________________
___ Embryonal thyroid neoplasm, thyroblastoma
___ Other histologic type not listed (specify): _________________
___ Malignant thyroid neoplasm, type cannot be determined: _________________