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 the 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. **Note 6**: Facial nodes including mandibular nodes have been moved from code 100 in CS Version 1 to code 110.

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 I: Level IA - Submental Level IB - Submandibular (submaxillary), sublingual Level II - Upper jugular : Jugulodigastric (subdigastric) Upper deep cervical Level IIA - Anterior Level IIB - Posterior Level III - Middle jugular : Middle deep cervical Level IV - Lower jugular: Jugulo-omohyoid (supraomohyoid) Lower deep cervical Virchow node 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: Facial: Buccinator (buccal) Mandibular Nasolabial	Lymph Nodes Size	Lymph Nodes Size	D	RN
120	Single positive ipsilateral regional node: Level V - Posterior triangle group: Posterior cervical 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 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: Parotid: Infraauricular Intraparotid Periparotid Preauricular Parapharyngeal Retroauricular (mastoid) Retropharyngeal 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	D
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 nodes	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 codes 100-120, 200-220, 300-320, 400-420, 500-520, and 800 ONLY, the N category for AJCC 7th Edition staging is assigned based on the value of Site-Specific Factor 1, Size of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this site. - For codes 100-120, 200-220, 300-320, 400-420, 500-520, and 800 ONLY, the N category for AJCC 6th Edition staging is assigned based on the value of Site-Specific Factor 1, Size of Lymph Nodes, using the extra table, Lymph Nodes Size Table for this site.