| 0 |
In situ, intraepithelial, noninvasive
High-grade biliary intraepithelial neoplasia (BilIn-3) |
| 1 |
Localized only (localized, NOS)
- Confined to
+ Cystic duct, NOS
+ Distal bile duct(s), NOS
+ Extrahepatic bile duct(s), NOS
+ Perihilar bile duct(s), NOS
- Lamina propria
- Mucosa, NOS
- Muscle layer of fibrous tissue (bile ducts perihilar only)
- Muscularis propria
- Subepithelial connective tissue (tunica mucosa) (bile ducts perihilar only)
- Submucosa (superficial invasion) |
| 2 |
Regional by direct extension only
- All sites
+ Adipose tissue
+ Adjacent (connective) tissue, NOS
+ Colon
+ Duodenum
+ Gallbladder
+ Hepatic artery (common, NOS)
+ Liver
+ Main portal vein or its branches bilaterally
+ Omentum (greater, lesser, NOS)
+ Pancreas
+ Periductal/fibromuscular connective tissue
+ Portal vein, NOS
+ Stomach
- Cystic duct
+ Ampulla of Vater
+ Beyond wall of cystic duct
+ Perimuscular connective tissue
+ Perimuscular tissue, NOS
+ Serosa (visceral peritoneum)
+ Small intestine
+ Unilateral branches of hepatic artery (right or left)
+ Unilateral branches of portal vein (right or left)
- Distal bile duct(s)
+ Adjacent hepatic parenchyma
+ Beyond wall of bile duct
+ Porta hepatis
+ Unilateral branches of hepatic artery (right or left)
+ Unilateral branches of portal vein (right or left)
- Perihilar bile duct(s)
+ Beyond wall of bile duct
+ Second-order biliary radicals bilaterally
* Unilateral second-order biliary radicals
* WITH contralateral portal vein or hepatic artery involvement
+ Unilateral branches of hepatic artery (right or left)
+ Unilateral branches of portal vein (right or left) |
| 3 |
Regional lymph node(s) involved only
- Choledochal (bile ducts perihilar only)
- Cystic duct (node of the neck of the gallbladder) (Calot's node)
- Hepatic/hepatic artery nodes (common, NOS)
- Hilar (porta hepatic) (portal) (in hilus of liver)
- Node of the foramen of Winslow (omental) (epiploic)
- Pancreaticoduodenal (anterior, posterior) (bile ducts distal only)
- Pancreaticoduodenal, NOS (cystic duct only)
- Pericholedochal (node along common bile duct)
- Periduodenal
- Peripancreatic (near head of pancreas only)
- Periportal
- Portal vein
- Regional lymph node(s), NOS
+ Lymph node(s), NOS |
| 4 |
Regional by BOTH direct extension AND regional lymph node(s) involved
- Codes (2) + (3) |
| 7 |
Distant site(s)/lymph node(s) involved
- Distant site(s) (including further contiguous extension)
+ Abdominal wall
+ Celiac axis (bile ducts distal only)
+ Superior mesenteric artery (bile ducts distal only)
- Distant lymph node(s), NOS
+ Celiac (axis) artery
+ Para-aortic
+ Periaortic (cystic duct only)
+ Pericaval
+ Peripancreatic (along body and tail of pancreas only)
+ Superior mesenteric artery
+ Superior mesenteric vein
- Distant metastasis, NOS
+ Carcinomatosis
+ Distant metastasis WITH or WITHOUT distant lymph node(s) |
| 9 |
Unknown if extension or metastasis |
