Table 2 Clinical staging of ocular adnexal lymphoma (OAL)
From: Classification, diagnosis, and management of conjunctival lymphoma
National Cancer Institute Working Formulation [48] | Low-grade | Small lymphocytic |
Follicular small cleaved cell | ||
Follicular mixed, small cleaved and large cell | ||
Intermediate-grade | Follicular large cell | |
Diffuse small cleaved cell | ||
Diffuse mixed, small and large cell | ||
Diffuse large cell | ||
High-grade | Large cell, immunoblastic | |
Lymphoblastic | ||
Small non-cleaved cell | ||
Ann Arbor Staging [49] | Stage I | Involvement of a single lymph node region or extralymphatic site (IE) |
Stage II | Involvement of 2 or more lymph nodes, lymphatic structures, or extralymphatic regions alone on the same side of the diaphragm (IIE) | |
Stage III | Involvement of lymph nodes on both sides of the diaphragm with localized extralymphatic (IIIE) or splenic (IIIS) involvement, or both (IIIES) | |
Stage IV | Involvement of one or more organs or tissues outside the lymphatic system | |
|  | A: Without B symptoms B: Fever, night sweats, weight loss of > 10% body weight over the last 6 months | |
TNM Staging System [50] | T0 | No evidence of lymphoma |
T1 | Lymphoma involving the conjunctiva alone without orbital involvement | |
T2 | Lymphoma with orbital involvement ± any conjunctival involvement | |
T3 | Lymphoma with preseptal eyelid involvement ± orbital involvement ± any conjunctival involvement | |
T4 | Orbital adnexal lymphoma extending beyond orbit to adjacent structures, such as bone and brain | |
N0 | No evidence of lymph node involvement | |
N1 | Involvement of ipsilateral regional lymph nodes | |
N2 | Involvement of contralateral or bilateral regional lymph nodes | |
N3 | Involvement of peripheral lymph nodes not draining ocular adnexal region | |
N4 | Involvement of central lymph nodes | |
M0 | No evidence of involvement of other extranodal sites | |
M1 | Lymphomatous involvement in other organs recorded either at first diagnosis or subsequently |