Nasopharynx - CS Lymph Nodes

Note 1: For head and neck schemas, this field includes all lymph nodes defined as Levels I-VII and Other by AJCC. The complete definitions are provided in the General Rules, Section 2.
Note 2: For nasopharynx, unilateral and bilateral retropharyngeal nodes are mapped to N1, and nodes in the supraclavicular fossa are mapped to N3b. The supraclavicular fossa is defined by 3 points: the superior margin of the sterna end of the clavicle, the superior margin of the lateral end of the clavical, and the point where the neck meets the shoulder.
Note 3: For head and neck schemas, additional information about lymph nodes (size of involved nodes, extracapsular extension, levels involved, and location of involved nodes above or below the lower border of the cricoid cartilage) is coded in CS Site-Specific Factors 1,3-9.
Note 4: If laterality of lymph nodes is not specified, assume nodes are unilateral. Midline nodes are considered unilateral.
Note 5: For head and neck cancers, if lymph nodes are described only as "supraclavicular", try to determine if they are in Level IV (deep to the sternocleidomastoid muscle, in the lower jugular chain) or Level V (in the posterior triangle, inferior to the transverse cervical artery) and code appropriately. If the specific level cannot be determined, consider them as Level V nodes.
Note 6: The description of lymph nodes has been standardized across the head and neck schemas. All lymph node levels and groups listed here are considered regional nodes for AJCC staging. Summary Stage 1977 and Summary Stage 2000 divide these nodes into regional and distant groups.
Note 7: Most codes from CS Version 1 have been made obsolete and new codes added, to support AJCC assignment of N values for nasopharynx, which differs from the pattern for other head and neck sites. Retropharyngeal nodes have been moved from code 120 in CS Version 1 to code 050. Spinal accessory nodes have been moved from code 750 to code 110. Lower deep cervical and transverse cervical nodes have been moved from code 750 to code 120. Mandibular nodes are included with Facial nodes.

^ For CS Lymph Nodes codes 050-070, 105, 115, 130, 180, 405, 415, 430, 505, 515, and 530-620 ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 1, Size of Lymph Nodes, as shown in the Lymph Nodes Size CSv2 Table for this schema.
* For CS Lymph Nodes codes 050-070, 105, 115, 130, 180, 405, 415, 430, 505, 515, and 530-620 ONLY, the N category for AJCC 6 staging is assigned based on the value of CS Site-Specific Factor 1, Size of Lymph Nodes, as shown in the Lymph Nodes Size CSv2 Table for this schema.
**For OBSOLETE CS Lymph Nodes codes 100, 110, 120, 200, 210, 220, 300, 310, 320, 400, 410, 420, 500, 510, and 520 ONLY, the N category for AJCC 6 staging for cases collected in CSv1 is assigned based on the value of CS Site-Specific Factor 1, Size of Lymph Nodes, as shown in the Lymph Nodes Size AJCC 6 CSv1 Tablefor this schema.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	No regional lymph node involvement	N0	N0	NONE	NONE
050	Unilateral positive regional node(s): Retropharyngeal	^	*	RN	RN
060	Bilateral positive nodes: Retropharyngeal	^	*	RN	RN
070	Positive nodes, not stated if unilateral or bilateral: Retropharyngeal	^	*	RN	RN
100	OBSOLETE DATA RETAINED V0200 Single positive ipsilateral regional node: Level II node Jugulodigastric (subdigastric) Upper deep cervical Upper jugular Level III node Middle deep cervical Mid jugular Level IV node Lower deep cervical Lower jugular Retropharyngeal Cervical, NOS Deep cervical, NOS Internal jugular, NOS Mandibular Regional lymph node, NOS	ERROR	**	RN	RN
105	Unilateral positive regional node(s): Level II - Upper jugular: Jugulodigastric (subdigastric) Upper deep cervical Level IIA - Anterior Level IIB - Posterior Cervical, NOS Deep cervical, NOS Internal jugular, NOS Regional lymph node, NOS	^	*	RN	RN
110	OBSOLETE DATA RETAINED V0200 Single positive ipsilateral regional node: Level I node Submandibular (submaxillary) Submental	ERROR	**	D	RN
115	Unilateral positive regional node(s): Level I: Level IA - Submental Level IB - Submandibular (submaxillary), sublingual Level V: Level VA - Spinal accessory	^	*	D	RN
120	OBSOLETE DATA RETAINED V0200 Single positive ipsilateral regional node: Level V node Posterior cervical Posterior triangle (spinal accessory and transverse cervical) (upper, middle, and lower corresponding to the levels that define upper, middle, and lower jugular nodes) Level VI node Anterior deep cervical Laterotracheal Paralaryngeal Paratracheal Prelaryngeal Pretracheal Recurrent laryngeal Level VII node Upper mediastinum (for other mediastinal nodes see CS Mets at DX) Other groups Intraparotid Parapharyngeal Periparotid Retropharyngeal Sub-occipital Supraclavicular fossa	ERROR	**	D	D
130	Unilateral positive regional node(s): Level III - Middle jugular: Middle deep cervical Level VI - Anterior compartment group: Laterotracheal Paralaryngeal Paratracheal - above suprasternal notch Perithyroidal Precricoid (Delphian) Prelaryngeal Pretracheal - above suprasternal notch Recurrent laryngeal Other groups: Facial: Buccinator (buccal) Mandibular Nasolabial Parotid: Infraauricular Intraparotid Periparotid Preauricular Parapharyngeal Retroauricular (mastoid) Suboccipital	^	*	D	D
180	Stated as N1 with no other information on regional lymph nodes	^	*	RN	RN
200	OBSOLETE DATA RETAINED V0200 Multiple positive ipsilateral nodes listed in code 100	ERROR	**	RN	RN
210	OBSOLETE DATA RETAINED V0200 Multiple positive ipsilateral nodes listed in code 110	ERROR	**	D	RN
220	OBSOLETE DATA RETAINED V0200 Multiple positive ipsilateral nodes listed in code 120	ERROR	**	D	D
300	OBSOLETE DATA RETAINED V0200 Regional lymph nodes as listed in code 100: Positive ipsilateral node(s), not stated if single or multiple	ERROR	**	RN	RN
310	OBSOLETE DATA RETAINED V0200 Regional lymph nodes listed in code 110: Positive ipsilateral node(s), not stated if single or multiple	ERROR	**	D	RN
320	OBSOLETE DATA RETAINED V0200 Regional lymph nodes listed in code 120: Positive ipsilateral node(s), not stated if single or multiple	ERROR	**	D	D
400	OBSOLETE DATA RETAINED V0200 Regional lymph nodes as listed in code 100: Positive bilateral or contralateral nodes	ERROR	**	RN	RN
405	Positive bilateral nodes listed in code 105	^	*	RN	RN
410	OBSOLETE DATA RETAINED V0200 Regional lymph nodes as listed in code 110: Positive bilateral or contralateral nodes	ERROR	**	D	RN
415	Positive bilateral nodes, any listed in code 115 WITH or WITHOUT nodes listed in code 105	^	*	D	RN
420	OBSOLETE DATA RETAINED V0200 Regional lymph nodes as listed in code 120: Positive bilateral or contralateral nodes	ERROR	**	D	D
430	Positive bilateral nodes, any listed in code 130 WITH or WITHOUT nodes listed in code 105 or 115	^	*	D	D
500	OBSOLETE DATA RETAINED V0200 Regional lymph nodes as listed in code 100: Positive node(s), not stated if ipsilateral, or bilateral, or contralateral, AND not stated if single or multiple	ERROR	**	RN	RN
505	Positive nodes listed in code 105, not stated if unilateral, or bilateral	^	*	RN	RN
510	OBSOLETE DATA RETAINED V0200 Regional lymph nodes as listed in code 11: Positive node(s), not stated if ipsilateral, or bilateral, or contralateral, AND not stated if single or multiple	ERROR	**	D	RN
515	Positive nodes listed in code 115, not stated if unilateral, or bilatera	^	*	D	RN
520	OBSOLETE DATA RETAINED V0200 Regional lymph nodes as listed in code 12: Positive node(s), not stated if ipsilateral or bilateral, or contralateral, AND not stated if single or multiple	ERROR	**	D	D
530	Positive nodes listed in code 130, not stated if unilateral or bilateral	^	*	D	D
600	Stated as N2 with no other information on regional lymph nodes	^	*	RN	RN
620	Stated as N3a with no other information on regional lymph nodes	^	*	RN	RN
650	Unilateral or bilateral positive regional node(s): Level IV - Lower jugular: Jugulo-omohyoid (supraomohyoid) Lower deep cervical Virchow node Level VB - Transverse cervical, supraclavicular (see Note 4) Level VII - Superior mediastinal group (for other mediastinal nodes see CS Mets at DX): Esophageal groove Paratracheal - below suprasternal notch Pretracheal - below suprasternal notch Stated as N3b with no other information on regional lymph nodes	N3b	N3b	D	D
700	Stated as N3 [NOS] with no other information on regional lymph nodes	N3NOS	N3NOS	RN	RN
750	OBSOLETE DATA RETAINED V0200 Regional lymph nodes in the supraclavicular fossa: Inferior deep cervical (scalene) Spinal accessory (posterior cervical) Supraclavicular (transverse cervical) (See Note 4)	ERROR	N3b	D	D
800	Lymph nodes, NOS, no other information	N1	N1	RN	RN
999	Unknown; regional lymph nodes not stated Regional lymph node(s) cannot be assessed Not documented in patient record	NX	NX	U	U