CS Lymph Nodes

Notes

**Note 1**: Only peripheral lymph nodes are assessed; these include the cervical, supraclavicular, epitrochlear, axillary, and inguinal nodal groups. Clinically abnormal peripheral lymph node(s) is defined as any palpable peripheral node that on physical examination is firm, irregular, clustered, fixed, or 1.5 centimeter (cm) or larger in diameter. Central nodes, which are not generally amenable to pathologic assessment, are not currently considered in the nodal classification unless used to establish N3 histopathologically. **Note 2**: Clinically abnormal nodes must be histopathologically confirmed as positive to assign codes 110-405. **Note 3**: Dutch grade system includes: * Grade 1 - Dermatopathic lymphadenopathy (DL) * Grade 2 - Early involvement by mycosis fungoides (MF), (presence of cerebriform nuclei larger than 7.5 micrometers (um) * Grade 3 - Partial effacement of lymph node architecture; many atypical cerebriform mononuclear cells (CMCs) * Grade 4 - Complete effacement of lymph node architecture **Note 4**: National Cancer Institute - Lymph Nodes (NCI-LN) grade system includes: * LN 0 - No atypical lymphocytes * LN 1 - Occasional and isolated atypical lymphocytes not arranged in clusters * LN 2 - Many atypical lymphocytes or in 3-6 cell clusters * LN 3 - Aggregates of atypical lymphocytes; nodal architecture preserved * LN 4 - Partial/complete effacement of nodal architecture by atypical lymphocytes or frankly neoplastic cells **Note 5**: A T-cell clone (clone negative or clone positive) is defined by polymerase chain reaction (PCR) or Southern blot analysis of the T-cell receptor gene. **Note 6**: For this site, code all lymph node (regional and distant) involvement in this field.
Code Description AJCC 7 N TNM 6 N Summary Stage 1977 N Summary Stage 2000 N
000 No regional lymph node involvement
No clinically abnormal peripheral lymph nodes		 N0 N0 NONE NONE
100 Clinically enlarged palpable lymph node(s) (adenopathy),
WITH pathologically negative nodes		 N0 N1 RN RN
110 Clinically normal peripheral lymph node(s)
AND histopathologically Dutch grade 1 or NCI LN 0-2:
Clone negative		 N1a N2 RN RN
115 Clinically abnormal peripheral lymph node(s)
AND histopathologically Dutch grade 1 or NCI LN 0-2:
Clone negative

Stated as N1a with no other information on regional lymph nodes		 N1a N3 RN RN
120 Clinically normal peripheral lymph node(s)
AND histopathologically Dutch grade 1 or NCI LN 0-2:
Clone positive		 N1b N2 RN RN
125 Clinically abnormal peripheral lymph node(s)
AND histopathologically Dutch grade 1 or NCI LN 0-2:
Clone positive

Stated as N1b with no other information on regional lymph nodes		 N1b N3 RN RN
130 Clinically normal peripheral lymph node(s)
AND histopathologically Dutch grade 1 or NCI LN 0-2:
Clone unknown		 N1NOS N2 RN RN
135 Clinically abnormal peripheral lymph node(s)
AND histopathologically Dutch grade 1 or NCI LN 0-2:
Clone unknown		 N1NOS N3 RN RN
140 Stated as N1 [NOS] with no other information on regional lymph nodes N1NOS N1 RN RN
200 OBSOLETE DATA RETAINED V0200

No clinically enlarged palpable lymph node(s) (adenopathy); pathologically positive lymph node(s)		 ERROR: N2 RN RN
210 Clinically normal peripheral lymph node(s)
AND histopathologically Dutch grade 2 or NCI LN 3:
Clone negative		 N2a N2 RN RN
215 Clinically abnormal peripheral lymph node(s)
AND histopathologically Dutch grade 2 or NCI LN 3:
Clone negative

Stated as N2a with no other information on regional lymph nodes		 N2a N3 RN RN
220 Clinically normal peripheral lymph node(s)
AND histopathologically Dutch grade 2 or NCI LN 3:
Clone positive		 N2b N2 RN RN
225 Clinically abnormal peripheral lymph node(s)
AND histopathologically Dutch grade 2 or NCI LN 3:
Clone positive

Stated as N2b with no other information on regional lymph nodes		 N2b N3 RN RN
230 Clinically normal peripheral lymph node(s)
AND histopathologically Dutch grade 2 or NCI LN 3:
Clone unknown		 N2NOS N2 RN RN
235 Clinically abnormal peripheral lymph node(s)
AND histopathologically Dutch grade 2 or NCI LN 3:
Clone unknown		 N2NOS N3 RN RN
240 Stated as N2 [NOS] with no other information on regional lymph nodes N2NOS N2 RN RN
300 OBSOLETE DATA RETAINED V0200

Both clinically enlarged palpable lymph node(s) (adenopathy) and pathologically positive lymph nodes		 ERROR: N3 RN RN
310 Clinically normal peripheral lymph nodes
AND histopathologically Dutch grades 3-4 or NCI LN 4:
Clone positive or negative or unknown		 N3 N2 RN RN
315 Clinically abnormal peripheral lymph nodes
AND histopathologically Dutch grades 3-4 or NCI LN 4:
Clone positive or negative or unknown

Stated as N3 with no other information on regional lymph nodes		 N3 N3 RN RN
400 Clinically normal peripheral lymph node(s), histopathologically confirmed
BUT Dutch grade and NCI LN grade unknown:
Clone positive, negative or unknown		 N1NOS N2 RN RN
405 Clinically abnormal peripheral lymph node(s), histopathologically confirmed
BUT Dutch grade and NCI LN grade unknown:
Clone positive, negative or unknown		 N1NOS N3 RN RN
800 Lymph nodes, NOS N1NOS N1 RN RN
850 Clinically abnormal peripheral lymph nodes
AND no histopathologic confirmation		 NX N1 U U
999 Unknown; regional lymph nodes not stated
Regional lymph node(s) cannot be assessed
Not documented in patient record		 NX NX U U