MerkelCellVulva - 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 107 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 the CS Lymph Nodes field.
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 130.

^ When CS Lymph Nodes Eval is coded, forCS Lymph Nodes codes 010, 105-109, 114-130, and 600, ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Lymph Nodes Eval and CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, as shown in the Lymph Node and Nodal Status Eval AJCC 7 Table. When CS Lymph Nodes Eval is blank, forCS Lymph Nodes codes 010, 105-109, 114-130, and 600, ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, and Regional Nodes Positive, as shown in the Lymph Node and Nodal Status Eval Blank AJCC 7 Table.
* For CS Lymph Nodes codes 105, 108, 109, 114-130, 520, 540, 570, and 580, the N category for AJCC 6 staging is assigned based on the value of CS Site Specific Factor 11. Regional Lymph Node - Laterality, as shown in the Lymph Nodes and SSF 11 AJCC 6 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	OBSOLETE DATA RETAINED V0200 Unilateral regional lymph nodes: Inguinal, NOS: Deep inguinal, NOS: Node of Cloquet or Rosenmuller (highest deep inguinal) Superficial inguinal (femoral) Regional lymph nodes, NOS (unilateral) FIGO Stage III	ERROR	N1	RN	RN
105	Regional lymph nodes (unilateral or bilateral): Inguinal, NOS: Deep inguinal, NOS: Node of Cloquet or Rosenmuller (highest deep inguinal) Superficial inguinal (femoral) Regional lymph nodes, NOS	^	*	RN	RN
106	Unilateral or bilateral regional lymph nodes: External iliac	^	N0	RN	D
107	Unilateral or bilateral regional lymph nodes: Internal iliac (hypogastric) Obturator Pelvic nodes in contiguous or secondary nodal basin (see Note 3) Pelvic, NOS	^	N0	D	D
108	106 + 105 Regional nodes listed in code 106 plus nodes listed in code 105	^	*	RN	D
109	107 + 105 Regional nodes listed in code 107 plus nodes listed in code 105	^	*	D	D
110	OBSOLETE DATA CONVERTED V0204 See code 115 Stated as N1a with no other information on regional lymph nodes	ERROR	ERROR	ERROR	ERROR
114	Evaluated clinically: Clinically stated as N1 with no other information on regional lymph nodes	^	*	RN	RN
115	Evaluated pathologically: Pathologically stated as N1a with no other information on regional lymph nodes	^	*	RN	RN
120	Evaluated pathologically: Pathologically stated as N1b with no other information on regional lymph nodes	^	*	RN	RN
125	Evaluated pathologically: Pathologically stated as N1 [NOS] with no other information on regional lymph nodes	^	*	RN	RN
130	Stated as N1 [NOS] with no other information on pathologic or clinical evaluation	^	*	RN	RN
500	OBSOLETE DATA RETAINED V0200 Bilateral or contralateral regional lymph nodes: Inguinal, NOS: Deep inguinal, NOS: Node of Cloquet or Rosenmuller (highest deep inguinal) Superficial inguinal (femoral) Regional lymph nodes, NOS (bilateral/contralateral) FIGO Stage IVA	ERROR	N2	RN	RN
510	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
520	Satellite nodule(s) or in transit metastasis, distance from primary tumor greater than 2 cm 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	*	RE	RN
540	Satellite nodule(s) or in transit metastasis WITH regional lymph nodes listed in code 105 (See Note 4)	N2	*	RN	RN
550	Satellite nodule(s) or in transit metastasis WITH regional lymph nodes listed in code 106 (See Note 4)	N2	N1	RN	D
560	Satellite nodule(s) or in transit metastasis WITH regional lymph nodes listed in code 107 (See Note 4)	N2	N1	D	D
570	Satellite nodule(s) or In transit metastasis WITH regional lymph nodes listed in code 108 (See Note 4)	N2	*	RN	D
580	Satellite nodule(s) or In transit metastasis WITH regional lymph nodes listed in code 109 (See Note 4)	N2	*	D	D
600	Regional lymph nodes, NOS	^	N1	RN	RN
650	Satellite nodule(s) or in transit metastasis WITH regional lymph nodes, NOS	N2	N1	RN	RN
700	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