Pleural Diffuse Malignant Mesothelioma cT4 TNM Finding v9

**Semantic type:** Finding

**Definition:** Pleural diffuse malignant mesothelioma with tumor invasion of any of the following (any Psum): chest wall bony invasion (rib); mediastinal organs (heart, spine, esophagus, trachea, great vessels); diffuse chest wall invasion; direct tumor extension through the diaphragm or pericardium; direct extension to the contralateral pleura; presence of malignant pericardial effusion. Note: Psum: pmax1+pmax2+pmax3 (sum of 3 measurements of maximal pleural thickness measured on axial images along the chest wall or mediastinum in each of the three divisions of the chest - upper, middle and lower divided by two lines; one at the top of the aortic arch and the second drawn at the top of the left atrium). Fmax: maximal thickness of pleural tumor along the fissures measured on sagittal images. (from AJCC 9th ed.)