Site-Specific Factor 8
Extracapsular Extension Clinically, Lymph Nodes for Head and Neck
Notes
**Note 1:** Clinical assessment can be by physical examination or imaging. According to AJCC, "ECS [extracapsular spread] can be diagnosed clinically by a matted mass of nodes adherent to overlying skin, adjacent soft tissue, or clinical evidence of cranial nerve invasion. Radiologic signs of ECS include amorphous, spiculated margins of a metastatic node and stranding of the perinodal soft tissue in previously untreated patients." (1) **Note 2:** Code the status of extracapsular extension assessed clinically for any involved regional lymph node(s) coded in Clinical N. Do not code extracapsular extension for any distant lymph node(s). **Note 3:** If nodes are involved clinically, and documentation of physical examination or imaging is available without a statement of extracapsular extension, use code 010. **Note 4:** If the only documentation is a reference to clinically involved nodes with no reference to extracapsular extension, use code 030. **Note 5:** If there is no information about clinical assessment of nodes, use code 999.Default
988NAACCR Item
NAACCR #2862| Code | Description |
|---|---|
| 000 | No regional lymph nodes involved clinically |
| 010 | Regional lymph node(s) involved clinically, no extracapsular extension clinically |
| 020 | Regional lymph node(s) involved clinically, extracapsular extension clinically (nodes described as fixed or matted) |
| 030 | Regional lymph node(s) involved clinically, unknown if extracapsular extension |
| 988 | Not applicable: Information not collected for this case |
| 997 | Clinical examination of regional lymph nodes performed, unknown results |
| 998 | No clinical examination of regional lymph nodes |
| 999 | Unknown if regional lymph nodes involved clinically, not stated Regional lymph nodes cannot be assessed Not documented in patient record |