CS Lymph Nodes

Notes

**Note 1**: For head and neck schemes, 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 schemes, 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 cricoid 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.
Code Description AJCC 7 N TNM 6 N Summary Stage 1977 N Summary Stage 2000 N
000 No regional lymph node involvement NA NA NONE NONE
100 Single positive ipsilateral regional node:
Level I:
Level IA node - Submental
Level IB - Submandibular (submaxillary), sublingual
Level II - Upper jugular:
Jugulodigastric (subdigastric)
Upper deep cervical
Level IIA - Anterior
Level IIB - Posterior
Retropharyngeal
Cervical , NOS
Deep cervical, NOS
Internal jugular, NOS
Regional lymph node, NOS
NA NA RN RN
120 Single positive ipsilateral regional node:
Level III - Middle jugular:
Middle deep cervical
Level IV - Lower jugular:
Jugulo-omohyoid (supraomohyoid)
Lower deep cervical
Level V - Posterior triangle group:
Level VA - Spinal accessory
Level VB - Transverse cervical, supraclavicular (see Note 4)
Level VI - Anterior compartment group:
Laterotracheal
Paralaryngeal
Paratracheal - above suprasternal notch
Perithyroidal
Precricoid (Delphian)
Prelaryngeal
Pretracheal - above suprasternal notch
Recurrent laryngeal
Level VII - Superior mediastinal group (for other mediastinal nodes see CS Mets at DX):
Esophageal groove
Paratracheal - below suprasternal notch
Other groups:
Facial :
Buccinator (buccal)
Mandibular
Nasolabial
Parotid :
Infraauricular
Intraparotid
Periparotid
Preparotid
Parapharyngeal
Retroauricular (mastoid)
Suboccipital
NA NA D D
800 Lymph nodes, NOS NA NA RN RN
999 Unknown; regional lymph nodes not stated
Regional lymph nodes cannot be assessed
Not documented in patient record
NA NA U U