CS Lymph Nodes

Notes

**Note 1**: Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in CS Mets at DX. **Note 2**: Bilateral or contralateral nodes are considered regional nodes for head, neck, and truncal tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Truncal tumors may also drain to both cephalad and caudal primary nodal basins as shown on lymphoscintigraphy. Clinical assessment of bilateral/contralateral or cephalad/caudal regional nodal involvement is required for tumors where lymphoscintigraphy is not performed. **Note 3**: Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are considered regional for AJCC staging but may be distant for Summary Stage. Use code 250 for involvement of nodes in secondary nodal basins not specified in codes 100 and 200. **Note 4**: In transit metastasis is defined as a tumor distinct from the primary lesion and located either between the primary lesion and the draining regional lymph nodes or distal to the primary lesion. In transit metastasis is coded in CS Lymph Nodes. **Note 5**: Isolated tumor cells (ITCs) should be considered positive nodes. If only ITCs are present, defined as any tumor deposits in lymph nodess less than or equal to 0.2mm, use code 010. **Note 6**: If the only information about lymph nodes is a statement of N1 involvement without a clinical or pathologic designation, use code 360.
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
010 Isolated tumor cells (ITCs) only Determine Correct Table for AJCC 7 N N0 NONE NONE
100 Regional lymph nodes by primary site (includes bilateral or contralateral nodes for head, neck, and trunk)
Head and Neck:
All subsites:
Cervical
Lip:
Mandibular, NOS:
Submandibular (submaxillary)
External ear/auditory canal:
Mastoid (post-/retro-auricular) (occipital)
Preauricular
Face, Other (cheek, chin, forehead, jaw, nose and temple):
Facial, NOS:
Buccinator (buccal)
Nasolabial
Mandibular, NOS:
Submandibular (submaxillary)
Parotid, NOS:
Infra-auricular
Preauricular
Scalp:
Mastoid (post-/retro-auricular) (occipital)
Parotid, NOS:
Infra-auricular
Preauricular
Spinal accessory (posterior cervical)
Neck:
Axillary
Mandibular, NOS
Mastoid (post-/retro-auricular) (occipital)
Parotid, NOS:
Infra-auricular
Preauricular
Spinal accessory (posterior cervical)
Supraclavicular (transverse cervical)
Upper Trunk:
Axillary
Cervical
Internal mammary (parasternal)
Supraclavicular (transverse cervical)
Lower Trunk:
Femoral (superficial inguinal)
Arm/Shoulder:
Axillary
Epitrochlear for hand/forearm
Spinal accessory for shoulder
Leg/Hip:
Femoral (superficial inguinal)
Popliteal for heel and calf
All sites:
Regional lymph node(s), NOS
(See Note 2)
 Determine Correct Table for AJCC 7 N N1 RN RN
200 Head and Neck (includes bilateral or contralateral nodes for head and neck):
Lip:
Facial, NOS:
Buccinator (buccal)
Nasolabial
Submental
Parotid, NOS:
Infra-auricular
Preauricular
Face, Other (cheek, chin, forehead, jaw, nose, and temple):
Submental
Neck:
Submental
(See Note 2)		 Determine Correct Table for AJCC 7 N N1 D RN
250 Bidirectional nodal involvement (includes bilateral or contralateral nodes)
(See Note 2):
Upper Trunk:
Femoral (or cephalad/caudal drainage from primary tumor)
Lower Trunk:
Axillary (or cephalad/caudal drainage from primary tumor)

Secondary nodal basin involvement (includes bilateral or contralateral nodes for head and trunk)
(See Note 3):
Head:
All subsites:
Supraclavicular
Arm/Shoulder:
Supraclavicular
Leg/Hip:
Iliac
All sites:
Regional lymph node(s) in secondary nodal basins , NOS 		Determine Correct Table for AJCC 7 N N1 D D
300 200 + 100

Regional lymph nodes coded in 200 plus regional lymph nodes coded in 100		 Determine Correct Table for AJCC 7 N N1 D RN
305 250 + (100 and/or 200)

Regional lymph nodes coded in 250 plus regional lymph nodes coded in 100 and/or 200		 Determine Correct Table for AJCC 7 N N1 D D
310 Evaluated clinically:

Clinically stated as N1 with no other information on regional lymph nodes		 Determine Correct Table for AJCC 7 N N1 RN RN
320 Evaluated pathologically:

Pathologically stated as N1a with no other information on regional lymph nodes		 Determine Correct Table for AJCC 7 N N1 RN RN
340 Evaluated pathologically:

Pathologically stated as N1b with no other information on regional lymph nodes		 Determine Correct Table for AJCC 7 N N1 RN RN
350 Evaluated pathologically:

Pathologically stated as N1 [NOS] with no other information on regional lymph nodes		 Determine Correct Table for AJCC 7 N N1 RN RN
360 Stated as N1[NOS] with no information on pathologic or clinical evaluation Determine Correct Table for AJCC 7 N N1 RN RN
390 Satellite nodule(s) or in transit metastasis, distance from primary tumor less than or equal to 2 cm or distance not stated
WITHOUT regional lymph node involvement. Includes cases with ITCs only and cases with regional lymph node involvement not stated

OR

Described as tumor with satellite nodule(s), NOS
WITHOUT regional lymph node involvement or regional lymph node involvement not stated
(See Note 4)		 N2 N0 RE RE
400 Satellite nodule(s) or in transit metastasis, distance from primary tumor greater than 2 cm or distance not stated
WITHOUT regional lymph node involvement. Includes cases with ITCs only and cases with regional lymph node involvement not stated

OR

Described as tumor with in transit metastasis, NOS
WITHOUT regional lymph node involvement or regional lymph node involvement not stated
(See Note 4)		 N2 N1 RE RN
420 400 + 100

Satellite nodule(s) or in transit metastasis
WITH regional lymph nodes listed in code 100
(See Note 4)		 N2 N1 RN RN
440 400 + 200

Satellite nodule(s) or in transit metastasis
WITH regional lymph nodes listed in code 200
(See Note 4)		 N2 N1 D RN
460 400 + 300

Satellite nodule(s) or in transit metastasis
WITH regional lymph nodes listed in code 300
(See Note 4)		 N2 N1 D RN
470 400 + (250 or 305)

Satellite nodule(s) or in transit metastasis
WITH regional lymph nodes listed in code 250 or code 305
(See Note 4)		 N2 N1 D D
475 Satellite nodule(s) or in transit metastasis
WITH regional lymph node(s), NOS		 N2 N1 RN RN
480 Stated as N2 [NOS] with no other information on regional lymph nodes N2 N1 RE RE
800 Lymph nodes, NOS N1NOS 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
- When CS Lymph Nodes Eval is coded, for CS Lymph Nodes codes 010-370 ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Lymph Nodes Eval and CS Site-Specific Factor 3, Status of Lymph Node Mets, as shown in the Lymph Nodes and Nodal Status Eval AJCC 7 Table. When CS Lymph Nodes Eval is blank, for CS Lymph Nodes codes 010-370 ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 3, Status of Lymph Node Mets, and Regional Nodes Positive, as shown in the Lymph Nodes and Nodal Status Eval Blank AJCC 7 Table.