MycosisFungoides - CS Lymph Nodes

Note 1: Only peripheral lymph nodes are assessed; these 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 considered in the nodal classification unless used to establish N3 histopathologically.
Note 2: Clinically abnormal nodes must be histopathologically confirmed as positive to assign codes 110-405.
Note 3: 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 4: National Cancer Institute - Lymph Nodes (NCI-LN) grade system includes:
    LN 0 - No atypical lymphocytes
    LN 1 - Occasional and isolated atypical lymphocytes not arranged in clusters
    LN 2 - Many atypical lymphocytes or in 3-6 cell clusters
    LN 3 - Aggregates of atypical lymphocytes; nodal architecture preserved
    LN 4 - Partial/complete effacement of nodal architecture by atypical lymphocytes or frankly neoplastic cells
Note 5: 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 6: For this site, code all lymph node (regional and distant) involvement in this field.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	No regional lymph node involvement No clinically abnormal peripheral lymph nodes	N0	N0	NONE	NONE
100	Clinically enlarged palpable lymph node(s) (adenopathy), WITH pathologically negative nodes	N0	N1	RN	RN
110	Clinically normal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN 0-2: Clone negative	N1a	N2	RN	RN
115	Clinically abnormal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN 0-2: Clone negative Stated as N1a with no other information on regional lymph nodes	N1a	N3	RN	RN
120	Clinically normal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN 0-2: Clone positive	N1b	N2	RN	RN
125	Clinically abnormal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN 0-2: Clone positive Stated as N1b with no other information on regional lymph nodes	N1b	N3	RN	RN
130	Clinically normal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN 0-2: Clone unknown	N1NOS	N2	RN	RN
135	Clinically abnormal peripheral lymph node(s) AND histopathologically Dutch grade 1 or NCI LN 0-2: Clone unknown	N1NOS	N3	RN	RN
140	Stated as N1 [NOS] with no other information on regional lymph nodes	N1NOS	N1	RN	RN
200	OBSOLETE DATA RETAINED V0200 No clinically enlarged palpable lymph node(s) (adenopathy); pathologically positive lymph node(s)	ERROR	N2	RN	RN
210	Clinically normal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN 3: Clone negative	N2a	N2	RN	RN
215	Clinically abnormal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN 3: Clone negative Stated as N2a with no other information on regional lymph nodes	N2a	N3	RN	RN
220	Clinically normal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN 3: Clone positive	N2b	N2	RN	RN
225	Clinically abnormal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN 3: Clone positive Stated as N2b with no other information on regional lymph nodes	N2b	N3	RN	RN
230	Clinically normal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN 3: Clone unknown	N2NOS	N2	RN	RN
235	Clinically abnormal peripheral lymph node(s) AND histopathologically Dutch grade 2 or NCI LN 3: Clone unknown	N2NOS	N3	RN	RN
240	Stated as N2 [NOS] with no other information on regional lymph nodes	N2NOS	N2	RN	RN
300	OBSOLETE DATA RETAINED V0200 Both clinically enlarged palpable lymph node(s) (adenopathy) and pathologically positive lymph nodes	ERROR	N3	RN	RN
310	Clinically normal peripheral lymph nodes AND histopathologically Dutch grades 3-4 or NCI LN 4: Clone positive or negative or unknown	N3	N2	RN	RN
315	Clinically abnormal peripheral lymph nodes AND histopathologically Dutch grades 3-4 or NCI LN 4: Clone positive or negative or unknown Stated as N3 with no other information on regional lymph nodes	N3	N3	RN	RN
400	Clinically normal peripheral lymph node(s), histopathologically confirmed BUT Dutch grade and NCI LN grade unknown: Clone positive, negative or unknown	N1NOS	N2	RN	RN
405	Clinically abnormal peripheral lymph node(s), histopathologically confirmed BUT Dutch grade and NCI LN grade unknown: Clone positive, negative or unknown	N1NOS	N3	RN	RN
800	Lymph nodes, NOS	N1NOS	N1	RN	RN
850	Clinically abnormal peripheral lymph nodes AND no histopathologic confirmation	NX	N1	U	U
999	Unknown; regional lymph nodes not stated Regional lymph node(s) cannot be assessed Not documented in patient record	NX	NX	U	U