Stage IIIB

Fig. 46: Diagram, stage IIIB. Stage IIIB classifies extensive extrapulmonary tumor invasion of structures such as the trachea, esophagus, heart, and major vessels, and metastasis to the contralateral mediastinal and hilar lymph nodes, and the ipsilateral and contralateral supraclavicular/scalene lymph nodes--T4 Any N M0 and Any T N3 M0, stage IIIB disease.

Fig. 47: Posterior-anterior chest radiograph shows a large mass in the right paratracheal region. The trachea is deviated to the left by the mass (black arrow) in keeping with T4, stage IIIB disease. Elevated right hemidiaphragm suggests phrenic nerve involvement.