A 68 year old female ex-smoker has a chest x-ray as part of a septic screen. This show an ill-defined area of increased density within the left lower zone and CT is advised. CT of the thorax and abdomen demonstrates a 4cm mass within the left lower lobe suspicious for bronchogenic carcinoma. There is evidence of visceral pleura invasion and enlarged ipsilateral hilar, ipsilateral mediastinal and subcarinal lymph nodes. No other abnormality is identified.
What is the correct TNM classification for this tumour?
T1b N1 M0 | |
T2a N2 M0 | |
T2b N3 M0 | |
T3 N2 M0 | |
T3 N2 M1a |
The size of the tumour and visceral pleural invasion make this lesion T2a. Chest wall invasion would make this tumour T3 however this is not reported as present. Enlarged ipsilateral hilar, mediastinal and subcarinal nodes are N2. There is no evidence of a M1a/M1b lesion.