Cervical lymph node (staging)
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Cervical lymph node staging is important in a variety of tumours, especially squamous cell carcinoma of the head and neck.
TNM nodal staging
Nodal staging is the same for squamous cell carcinomas of most regions of the upper aerodigestive tract of the head and neck, including those of the of the oral cavity, oropharynx, hypopharynx, and larynx.
- Nx: nodes cannot be assessed
- N0: no regional nodal metastases
- N1: single ipsilateral node, ≤3 cm
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N2
- N2a: single ipsilateral node, 3-6 cm
- N2b: multiple ipsilateral nodes, <6 cm
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N2c
- bilateral nodal metastasesor
- contralateral nodal metastases <6 cm
- N3: any nodal metastasis >6 cm
Size dependant criteria
- most nodes should be <10 mm in short-axis except:
- submental/submandibular and jugulodiagastric: <15 mm
- retropharyngeal: <8 mm
- if using size criteria alone then there is a 10-20% error rate
The long-to-short axis ratio has also been proposed 2 to help evaluate enlarged nodes in the setting of head and neck SCC. When nodes have a ratio of >2 (i.e. long and flat) 95% are benign. When the ratio <2 (i.e. rounder) then a similar proportion were malignant.
Size independent criteria
- loss of fatty hilum
- focal necrosis
- cystic necrotic nodes
See also
-<p><strong>Cervical lymph node staging</strong> is important in a variety of tumours, especially <a href="/articles/squamous-carcinoma-of-the-head-and-neck">squamous cell carcinoma of the head and neck</a>.</p><h5>TNM nodal staging</h5><p>Nodal staging is the same for squamous cell carcinomas of most regions of the upper aerodigestive tract of the head and neck, including those of the of the <a title="Oral cavity" href="/articles/oral-cavity-1">oral cavity</a>, <a title="Oropharynx" href="/articles/oropharynx">oropharynx</a>, <a title="Hypopharynx" href="/articles/hypopharynx">hypopharynx</a>, and <a title="Larynx" href="/articles/larynx">larynx</a>.</p><ul>- +<p><strong>Cervical lymph node staging</strong> is important in a variety of tumours, especially <a href="/articles/squamous-carcinoma-of-the-head-and-neck">squamous cell carcinoma of the head and neck</a>.</p><h5>TNM nodal staging</h5><p>Nodal staging is the same for squamous cell carcinomas of most regions of the upper aerodigestive tract of the head and neck, including those of the of the <a href="/articles/oral-cavity-1">oral cavity</a>, <a href="/articles/oropharynx">oropharynx</a>, <a href="/articles/hypopharynx">hypopharynx</a>, and <a href="/articles/larynx">larynx</a>.</p><ul>
-</ul><p>The long-to-short axis ratio has also been proposed <sup>2</sup> to help evaluate enlarged nodes in the setting of <a title="Head and neck SCC" href="/articles/squamous-cell-carcinoma-head-and-neck">head and neck </a><a href="/articles/scc">SCC</a>. When nodes have a ratio of >2 (i.e. long and flat) 95% are benign. When the ratio <2 (i.e. rounder) then a similar proportion were malignant.</p><h5>Size independent criteria</h5><ul>- +</ul><p>The long-to-short axis ratio has also been proposed <sup>2</sup> to help evaluate enlarged nodes in the setting of <a href="/articles/squamous-cell-carcinoma-head-and-neck">head and neck </a><a href="/articles/scc">SCC</a>. When nodes have a ratio of >2 (i.e. long and flat) 95% are benign. When the ratio <2 (i.e. rounder) then a similar proportion were malignant.</p><h5>Size independent criteria</h5><ul>
References changed:
- 1. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual. (2018) <a href="https://books.google.co.uk/books?vid=ISBN9783319406176">ISBN: 9783319406176</a><span class="ref_v4"></span>
- 2. American College of Surgeons. AJCC Cancer Staging Form Supplement. AJCC Cancer Staging Manual, Eighth Edition. 5 Jun 2018. Available at https://cancerstaging.org/references-tools/deskreferences/Documents/AJCC%20Cancer%20Staging%20Form%20Supplement.pdf
- 1. Steinkamp HJ, Cornehl M, Hosten N et-al. Cervical lymphadenopathy: ratio of long- to short-axis diameter as a predictor of malignancy. Br J Radiol. 1995;68 (807): 266-70. <a href="http://dx.doi.org/10.1259/0007-1285-68-807-266">doi:10.1259/0007-1285-68-807-266</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/7735765">Pubmed citation</a><div class="ref_v2"></div>
- 2. AJCC Cancer Staging Manual. Springer. ISBN:0387884408. <a href="http://books.google.com/books?vid=ISBN0387884408">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0387884408">Find it at Amazon</a><span class="auto"></span>
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