Patients with biopsy-confirmed CTCL are staged according to the extent of their skin disease and treatment is determined by their stage. The staging system used is as follows:
| T0 | No skin involvement |
T1 | Patches or plaques, covering<10% of the body surface |
T2 | Same as above but covering >10% of the body surface |
T3 | Tumours with or without patches or plaques |
T4 | Generalized erythema |
NP0 | No abnormal peripheral lymph nodes |
NP1- | Abnormal peripheral lymph nodes, biopsy negative |
| (i.e., dermatopathic lymphadenopathy) |
NP1+ | Abnormal peripheral lymph nodes, biopsy positive |
NV0 | No abnormal visceral lymph nodes |
NV1 | Abnormal visceral lymph nodes (no information regarding biopsy) |
NV1- | Abnormal visceral lymph nodes, biopsy negative |
NV1+ | Abnormal visceral lymph nodes, biopsy positive |
M0 | No visceral organ involvement |
M1 | Visceral organ involvement (on basis of histology) |
B0 | <5% circulating Sézary cells and <250 Sézary cells per cc |
B1 | >5% circulating Sézary cells, or>250 Sézary cells per cc |
Prior to staging, each patient has a careful clinical examination. If any superficial lymph nodes are enlarged, and the disease is otherwise clinically confined to the skin, the largest node is biopsied. A CT scan of the abdomen and pelvis is done to assess the intra-abdominal and pelvic lymph nodes. If an abnormal node is demonstrated, (usually in the pelvis) and the disease is clinically confined to the skin, biopsy is considered. A quantitative Sézary cell count is performed to assess the presence and number of circulating lymphoma cells as well as a CBC and LDH.
