4. TNMB classifications.
| Modified ISCL/EORTC classification of MF and Sézary Syndrome according toOlsen 2011 | CTCL 1979 | ||
| T: Skin1 | |||
| T0 | N.E. | Clinically and/or histopathologically suspicious lesions | |
| T1 | Limited patches, papules, and/or plaques covering < 10% of the skin surface; may further stratify into T1a (patch only) vs. T1b (plaque ± patch) | Limited plaques, papules, or eczematous patches covering < 10% of the skin surface | |
| T2 | Patches, papules, or plaques covering ≥ 10% of the skin surface; may further stratify into T2a (patch only) vs. T2b (plaque patch) | Generalised plaques, papules, or erythematous patches covering ≥ 10% of the skin surface | |
| T3 | One or more tumours (≥ 1 cm diameter) | Tumours, 1 or more | |
| T4 | Confluence of erythema covering ≥ 80% body surface area | Generalised erythroderma | |
| N: Node2 | |||
| N0 | No clinically abnormal peripheral lymph nodes; biopsy not required | No clinically abnormal peripheral lymph nodes palpable, histopathology negative for CTCL | |
| N1 | Clinically abnormal lymph nodes; histopathology Dutch grade 1 or NCI LN0-2 | Palpable Clinically abnormal peripheral lymph nodes, histopathology negative for CTCL | |
| N1a | Clone negative | ‐ | |
| N1b | Clone positive | ‐ | |
| N2 | Clinically abnormal peripheral lymph nodes, histopathology Dutch grade 2 or NCI LN3 | No clinically abnormal peripheral lymph nodes, histopathology positive for CTCL | |
| N2a | Clone negative | ‐ | |
| N2b | Clone positive | ‐ | |
| N3 | Clinically abnormal lymph nodes; histopathology Dutch grade 3‐4 or NCI LN4; clone positive or negative |
Palpable clinically abnormal peripheral lymph nodes, pathology positive for CTCL | |
| Nx | Clinically abnormal lymph nodes without histologic confirmation or inability to fully characterize the histologic subcategories | ‐ | |
| M: Visceral | |||
| M0 | No visceral organ involvement | No visceral organ involvement | |
| M1 | Visceral involvement (must have pathology confirmation and organ involved should be specified) | Visceral involvement (must have pathology confirmation and organ involved should be specified) | |
| B: Blood | |||
| B0 | Absence of significant blood involvement: ≤ 5% of peripheral blood lymphocytes are atypical (Sézary) cells | Atypical circulating cells not present (less than 5%) | |
| B0a | Clone negative | ‐ | |
| B0b | Clone positive | ‐ | |
| B1 | Low blood tumour burden: > 5% of peripheral blood lymphocytes are atypical (Sézary) cells but does not meet the criteria of B2 | Atypical circulating cells present (more than 5%), record total white blood count and total lymphocyte counts, and number of atypical cells/100 lymphocytes | |
| B1a | Clone negative | ‐ | |
| B1b | Clone positive | ‐ | |
| B2 | High blood tumour burden: ≥ 1,000/L Sézary cells with positive clone3; one of the following can be substituted for Sézary cells: CD4/CD8 ≥ 10, CD4CD7‐ cells ≥ 40% or CD4CD26‐ cells ≥ 30% | ‐ | |
1 Patch any size lesion without induration or significant elevation above the surrounding uninvolved skin: poikiloderma may be present. Plaque any size lesion that is elevated or indurated: crusting or poikiloderma may be present. Tumour any solid or nodular lesion ≥ 1 cm in diameter with evidence of deep infiltration in the skin and/or vertical growth.
2 Lymph node classification has been modified from 2007 ISCL/EORTC consensus revisions1 to include central nodes. Lymph nodes are qualified as abnormal if ≥ 1.5 cm in diameter.
3 The clone in the blood should match that of the skin. The relevance of an isolated clone in the blood or a clone in the blood that does not match the clone in the skin remains to be determined.