Pathologic N

This input is used for staging

Notes

**Note 1:** Only peripheral lymph nodes are assessed which 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 classified in the nodal classification unless used to establish N3 histopathologically **Note 2:** 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 3:** National Cancer Institute - Lymph Nodes (NCI LN) grade system includes LN0 - No atypical lymphocytes LN1 - Occasional and isolated atypical lymphocytes not arranged in clusters LN2 - Many atypical lymphocytes or in 3-6 cell clusters LN3 - Aggregates of atypical lymphocytes; nodal architecture preserved LN4 - Partial/complete effacement of nodal architecture by atypical lymphocytes or frankly neoplastic cells **Note 4:** 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 5:** For this site, code all lymph node(s) (regional and distant) involvement in this field.

NAACCR Item

NAACCR #890

Pathologic N	Pathologic N Display	Description	Registrar Notes
pX	pNX	Clinically abnormal peripheral lymph nodes; no histologic confirmation	Pathologic classification criteria met, evaluation done: Physician unable to assess N Surgical resection primary tumor, no regional lymph nodes removed Involvement of regional lymph nodes not documented Physician assigns pNX, no other information available to determine N
p0	pN0	No clinically abnormal peripheral lymph nodes; biopsy not required	No regional lymph node involvement Clinically enlarged palpable lymph node(s) (adenopathy) WITH pathologically negative nodes
p1	pN1	Clinically abnormal peripheral lymph nodes; histolopathology Dutch grade1 or NCI LN0-2	Note: N1 has subcategories of N1a and N1b. Assign N1 only when there is no information available to assign one of the subcategories Clinically abnormal or normal peripheral lymph node(s) AND histopathologically Dutch grade 1 or unknown OR NCI LN0-2 or unknown Clone unknown Regional lymph nodes, NOS Lymph nodes, NOS Stated as N1 [NOS]
p1A	pN1a	Clone negative	Clinically abnormal or normal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN0-2: Clone negative Stated as N1a
p1B	pN1b	Clone positive	Clinically abnormal or normal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN0-2: Clone positive Stated as N1b
p2	pN2	Clinically abnormal peripheral lymph nodes; histopathology Dutch grade 2 or NCI LN3	Note: N2 has subcategories of N2a and N2b. Assign N2 only when there is no information available to assign one of the subcategories Clinically abnormal or normal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN3: Clone unknown Stated as N2 [NOS]
p2A	pN2a	Clone negative	Clinically abnormal or normal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN3: Clone negative Stated as N2a
p2B	pN2b	Clone positive	Clinically abnormal or normal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN3: Clone positive Stated as N2b
p3	pN3	Clinically abnormal peripheral lymph nodes; histolopathology Dutch grades 3-4 or NCI LN4; clone positive or negative	Clinically abnormal or normal peripheral lymph nodes AND histopathologically Dutch grades 3-4 or NCI LN4: Clone positive or negative or unknown Stated as N3
c0	cN0	Clinically: No regional lymph node metastasis	Use only for TNM defined pTis cases where there is a resection of the primary and the nodes are not evaluated pathologically
88	88	Not applicable	In situ case but no pTis is defined by EORTC Death certificate only (DCO) case
<BLANK>	BLANK	See Registrar Notes	Pathologic classification criteria not met No surgical resection of primary tumor and there isn’t a positive biopsy of a structure in the highest T category and highest N category Evidence of metastatic disease (pM1), no other workup Only Pathologic Stage Group documented (no T, N, or M information available)