CS Lymph Nodes

Notes

**Note 1**: For head and neck schemas, this field includes all lymph nodes defined as Levels I-VII and Other by AJCC. The complete definitions are provided in the General Rules, Section 2. **Note 2**: For head and neck schemas, additional information about lymph nodes (size of involved nodes, extracapsular extension, levels involved, and location of involved nodes above or below the lower border of the cricoids cartilage) is coded in CS Site-Specific Factors 1, 3-9. **Note 3**: If laterality of lymph nodes is not specified, assume nodes are ipsilateral. Midline nodes are considered ipsilateral. **Note 4**: For head and neck cancers, if lymph nodes are described only as "supraclavicular", try to determine if they are in Level IV (deep to the sternocleidomastoid muscle, in the lower jugular chain) or Level V (in the posterior triangle, inferior to the transverse cervical artery) and code appropriately. If the specific level cannot be determined, consider them as Level V nodes. **Note 5**: The description of lymph nodes has been standardized across the head and neck schemas. All lymph node levels and groups listed here are considered regional nodes for AJCC staging. Summary Stage 1977 and Summary Stage 2000 divide these nodes into regional and distant groups. **Note 6**: Level II nodes have been moved from code 100 in CS Version 1 to code 120, Level III nodes moved from code 100 to code 110 Level IV nodes added to code 100. Mandibular nodes are included with Facial nodes.
Code Description AJCC 7 N TNM 6 N Summary Stage 1977 N Summary Stage 2000 N
000 No regional lymph node involvement N0 N0 NONE NONE
100 Single positive ipsilateral regional node:
Level IV - Lower jugular:
Jugulo-omohyoid (supraomohyoid)
Lower deep cervical
Virchow node
Level VI - Anterior compartment group:
Laterotracheal
Paralaryngeal
Paratracheal - above suprasternal notch
Perithyroidal
Precricoid (Delphian)
Pretracheal - above suprasternal notch
Recurrent laryngeal
Cervical, NOS
Deep cervical, NOS
Internal jugular, NOS
Regional lymph node, NOS		 Lymph Nodes Size Lymph Nodes Size RN RN
110 Single positive ipsilateral regional node:
Level I:
Level IA - Submental
Level IB - Submandibular (submaxillary), sublingual
Level III - Middle jugular:
Middle deep cervical
Retropharyngeal		 Lymph Nodes Size Lymph Nodes Size D RN
120 Single positive ipsilateral regional node:
Level II Upper jugular:
Jugulodigastric (subdigastric)
Upper deep cervical
Level IIA - Anterior
Level IIB - Posterior
Level V - Posterior triangle group:
Level VA - Spinal accessory
Level VB - Transverse cervical, supraclavicular (see Note 4)
Level VII node - Superior mediastinal group (for other mediastinal nodes see CS Mets at DX):
Esophageal groove
Paratracheal - below suprasternal notch
Pretracheal - below suprasternal notch
Other groups:
Facial:
Buccinator
Mandibular
Nasolabial
Parotid:
Infraauricular
Intraparotid
Periparotid
Preauricular
Parapharyngeal
Periparotid
Retroauricular (mastoid)
Suboccipital		 Lymph Nodes Size Lymph Nodes Size D D
180 Stated as N1 with no other information on regional lymph nodes Lymph Nodes Size Lymph Nodes Size RN RN
190 Stated as N2a with no other information on regional lymph nodes Lymph Nodes Size Lymph Nodes Size RN RN
200 Multiple positive ipsilateral nodes listed in code 100 Lymph Nodes Size Lymph Nodes Size RN RN
210 Multiple positive ipsilateral nodes, any listed in code 110
WITH or WITHOUT nodes listed in code 100		 Lymph Nodes Size Lymph Nodes Size D RN
220 Multiple positive ipsilateral nodes, any listed in code 120
WITH or WITHOUT nodes listed in code 100 or 110		 Lymph Nodes Size Lymph Nodes Size D D
290 Stated as N2b with no other information on regional lymph nodes Lymph Nodes Size Lymph Nodes Size RN RN
300 Positive ipsilateral nodes listed in code 100, not stated if single or multiple Lymph Nodes Size Lymph Nodes Size RN RN
310 Positive ipsilateral nodes listed in code 110, not stated if single or multiple Lymph Nodes Size Lymph Nodes Size D RN
320 Positive ipsilateral nodes listed in code 120, not stated if single or multiple Lymph Nodes Size Lymph Nodes Size D D
400 Positive bilateral or contralateral nodes listed in code 100 Lymph Nodes Size Lymph Nodes Size RN RN
410 Positive bilateral or contralateral nodes, any listed in code 110
WITH or WITHOUT nodes listed in code 100		 Lymph Nodes Size Lymph Nodes Size D RN
420 Positive bilateral or contralateral nodes, any listed in code 120
WITH or WITHOUT nodes listed in code 100 or 110		 Lymph Nodes Size Lymph Nodes Size D D
490 Stated as N2c with no other information on regional lymph node Lymph Nodes Size Lymph Nodes Size RN RN
500 Positive nodes listed in code 100, not stated if ipsilateral, or bilateral, or contralateral
AND not stated if single or multiple		 Lymph Nodes Size Lymph Nodes Size RN RN
510 Positive nodes listed in code 110, not stated if ipsilateral, or bilateral, or contralateral
AND not stated if single or multiple		 Lymph Nodes Size Lymph Nodes Size D RN
520 Positive nodes listed in code 120, not stated if ipsilateral, or bilateral, or contralateral
AND not stated if single or multiple		 Lymph Nodes Size Lymph Nodes Size D D
600 Stated as N2 [NOS] with no other information on regional lymph nodes Lymph Nodes Size Lymph Nodes Size RN RN
700 Stated as N3 with no other information on regional lymph nodes Lymph Nodes Size Lymph Nodes Size RN RN
800 Lymph nodes, NOS N1 N1 RN RN
999 Unknown; regional lymph nodes not stated
Regional lymph nodes cannot be assessed
Not documented in patient record		 NX NX U U
- For CS Lymph Nodes codes 100-700 ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 1, Size of Lymph Nodes, as shown in the Lymph Nodes Size Table for this schema. - For CS Lymph Nodes codes 100-700 ONLY, the N category for AJCC 6 staging is assigned based on the value of CS Factor 1, Size of Lymph Nodes, as shown in the Lymph Nodes Size Table for this schema.