MerkelCellPenis - CS Lymph Nodes

Note 1: Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in CS Mets at DX.
Note 2: Bilateral nodes are considered regional nodes for tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Clinical assessment of bilateral 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 400 for involvement of nodes in secondary nodal basins not otherwise specified.
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 nodes less than or equal to 0.2 mm, 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 160.

^ When CS Lymph Nodes Eval is coded, for CS Lymph Nodes codes 010-400 and 500 ONLY, the N category for AJCC 7staging 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 010-400 and 500 ONLY, the N category for AJCC 7staging 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.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	No regional lymph node involvement	N0	N0	NONE	NONE
010	Isolated tumor cells (ITCs) only	^	N0	NONE	NONE
100	SINGLE superficial inguinal (femoral) regional lymph node SINGLE inguinal node, NOS (unknown if superficial or deep)	^	N1	RN	RN
110	Evaluated clinically: Clinically stated as N1 with no other information on regional lymph nodes	^	N1	RN	RN
120	Evaluated pathologically: Pathologically stated as N1a with no other information on regional lymph nodes	^	N1	RN	RN
140	Evaluated pathologically: Pathologically stated as N1b with no other information on regional lymph nodes	^	N1	RN	RN
150	Evaluated pathologically: Pathologically stated as N1 [NOS] with no other information on regional lymph nodes	^	N1	RN	RN
160	Stated as N1 [NOS] with no information on pathologic or clinical evaluation	^	N1	RN	RN
200	MULTIPLE or BILATERAL superficial inguinal (femoral) regional lymph nodes MULTIPLE or BILATERAL inguinal nodes, NOS (unknown if superficial or deep)	^	N2	RN	RN
300	Regional lymph node: Deep inguinal, NOS: Node of Cloquet or Rosenmuller (highest deep inguinal)	^	N3	RN	RN
400	Pelvic lymph nodes (unilateral or bilateral): External iliac Internal iliac (hypogastric): Obturator Pelvic nodes in contiguous or secondary nodal basin (see Note 3) Pelvic nodes, NOS	^	N3	RN	RN
410	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
420	Satellite nodule(s) or in transit metastasis, distance from primary tumor greater than 2cm 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	RE
440	420 + 100 Satellite nodule(s) or in transit metastasis WITH regional lymph nodes listed in code 100 (See Note 4)	N2	N1	RE+RN	RE+RN
460	420 + 200 Satellite nodule(s) or in transit metastasis WITH regional lymph nodes listed in code 200 (See Note 4)	N2	N2	RE+RN	RE+RN
480	420 + (300 or 400) Satellite nodule(s) or in-transit metastasis WITH regional lymph nodes listed in codes 300 or 400 (See Note 4)	N2	N3	RE+RN	RE+RN
500	Regional lymph node(s), NOS	^	N1	RN	RN
520	Satellite nodule(s) or in transit metastasis WITH regional lymph node(s), NOS	N2	N1	RE+RN	RE+RN
550	Stated as N2 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