Pathologic N
This input is used for staging
Notes
**Note 1:** Histological examination of a selective neck dissection specimen will ordinarily include 6 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0. (1) **Note 2:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in M (distant metastasis). **Note 3:** This field includes all lymph nodes defined as Levels I-VI, retropharyngeal or superior mediastinal lymph nodes (Level VII). **Note 4:** Assignment of N value for thyroid does not depend on laterality. All codes for nodal involvement include ipsilateral, bilateral, contralateral, and midline lymph 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 regional nodes for TNM staging. **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 **Level V - Posterior triangle group** Posterior cervical Level VA - Spinal accessory Level VB - Transverse cervical, supraclavicular **Level VI - Anterior compartment group** Laterotracheal Paralaryngeal Paratracheal - above suprasternal notch Perithyroidal Precricoid (Delphian) Prelaryngeal Pretracheal - above suprasternal notch Recurrent laryngeal **Level VII - Superior mediastinal group (for other mediastinal nodes see M [distant metastasis])** Esophageal groove Paratracheal - below suprasternal notch Pretracheal - below suprasternal notch **Other groups** Cervical, NOS Deep cervical, NOS Facial Buccinator (buccal) Mandibular Nasolabial Internal jugular, NOS Parapharyngeal Parotid Infraauricular Intraparotid Periparotid Preauricular Retroauricular (mastoid) Retropharyngeal SuboccipitalNAACCR Item
NAACCR #890| Pathologic N | Pathologic N Display | Description | Registrar Notes |
|---|---|---|---|
| pX | pNX | Regional lymph node(s) cannot be assessed | 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 regional lymph node metastasis | |
| p1 | pN1 | Regional lymph node metastasis | Note: N1 has subcategories of N1a and N1b. Assign N1 only when there is no information available to assign one of the subcategories Regional lymph nodes, NOS Lymph nodes, NOS Stated as N1 [NOS] |
| p1A | pN1a | Metastasis in Level VI Pretracheal Paratracheal Prelaryngeal/Delphian lymph nodes |
Level VI nodes - Anterior compartment group: Stated as N1a |
| p1B | pN1b | Metastasis in other unilateral, bilateral or contralateral cervical Levels I, II, III, IV or V Retropharyngeal Superior mediastinal lymph nodes |
Other groups of lymph nodes Stated as N1b |
| 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 | Primary site/histology not TNM defined In situ case but no pTis is defined by TNM 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) |