LN Size
Description
Lymph Nodes Size records diameter of the involved regional lymph node(s) with the largest diameter of any involved regional lymph node(s). Pathological measurement takes precedence over a clinical measurement for the same node.
Rationale
Lymph Nodes Size is a Registry Data Collection Variable in AJCC for several chapters. It was previously collected in the Head and Neck chapters as Size of Lymph Nodes, SSF #1.
Additional Info
* **Source documents:** pathology report, imaging reports, physical exam
* **For further information**, refer to the **Head and Neck** cancer protocols published by the College of American Pathologist for the AJCC Staging Systems for *Head and Neck*
Notes
**Note 1:** **Physician Statement**
* Physician statement of Lymph Nodes Size can be used to code this data item when no other information is available.
**Note 2:** **Clinical vs Pathological size**
* If the largest involved node is not examined pathologically, use the clinical node size.
* If the same largest involved node (or same level) is examined both clinically and pathologically, record the size of the node from the pathology report, even if it is smaller.
* *Example*: Clinical evaluation shows 1.5 cm (15 mm) Level II lymph node, pathological examination shows Level II 1.3 cm (13 mm).
* Code 13.0.
**Note 3:** **Regional vs. distant nodes**
* Do not code the size of any distant nodes.
Coding Guidelines
Code the largest diameter of any involved regional lymph nodes for head and neck (cervical lymph nodes). The measurement can be pathological, if available, or clinical.
**1)** **Code 0.0** when no regional lymph nodes are involved
**2)** **Code XX.1** for 100 millimeters (10 cm) or greater
**3)** **Code XX.2** for microscopic focus or foci only and no size of focus given
**4)** **Code XX.3** for lymph node met less than 1 cm (10 mm)
* **a.** Lymph node described as “subcentimeter")
**5)** **Code XX.9** when
* **a.** Positive lymph nodes but size not stated
* **b.** No information about regional lymph nodes
* **c.** Lymph nodes not assessed or unknown if assessed
In order to align with the CAP guidelines, additional codes have been added for “at least” categories which are used in the CAP protocols. Only use these codes when the pathologist has used this terminology to indicate the lymph node size.
**6)** **XX.4**: Describes a lymph node size at least 2 cm (20 mm)
**7)** **XX.5**: Described a lymph node size at least 3 cm (30 mm)
**8)** **XX.6**: Describes a lymph node size at least 4 cm (40 mm)
**9)** **XX.7**: Describes a lymph node size 5 cm (50 mm) or greater
Default
XX.8
Metadata
SSDI
| Code |
Description |
| 0.0 |
No regional lymph node involvement
Non-invasive neoplasm (behavior /2) |
| 0.1-99.9 |
0.1 - 99.9 millimeters (mm)
(Exact size of lymph node to nearest tenth of a mm) |
| XX.1 |
100 millimeters (mm) or greater |
| XX.2 |
Microscopic focus or foci only and no size of focus given |
| XX.3 |
Described as "less than 1 centimeter (cm)" or "subcentimeter" |
| XX.4 |
Described as "at least" 2 cm |
| XX.5 |
Described as "at least" 3 cm |
| XX.6 |
Described as "at least" 4 cm |
| XX.7 |
Described as greater than 5 cm |
| XX.8 |
Not applicable: Information not collected for this case
(If this item is required by your standard setter, use of code XX.8 will result in an edit error) |
| XX.9 |
Not documented in medical record
Regional lymph node(s) involved, size not stated
Lymph Nodes Size not assessed, or unknown if assessed |
