N (REGIONAL LYMPH NODES)
| NX |
Minimum requirements to assess lymph nodes
cannot be met |
| N0 |
No evidence of regional node involvement |
| N1, N2, N3, N4 |
Increasing abnormality of lymph nodes (size,
characteristics, location) |
N CATEGORIES
I. NO INVOLVEMENT / INVOLVEMENT
Absence or presence of regional lymph node metastases. Assigns
N element simply by the presence of lymph node metastases,
regardless of size, number, or location.
- Esophagus
- Small intestine
- Liver
- Ampulla of Vater
- Bone
- Soft tissues
- Skin
- Cervix
- Corpus uteri
- Ovary
- Fallopian tube
- Vagina
- Prostate
- Eyelid (carcinoma)
- Conjunctiva, uvea (melanoma)
- Retinoblastoma
- Orbit (sarcoma)
- Lacrimal gland
- Wilms' tumor
- Neuroblastoma
- Pediatric soft tissue sarcoma
II. SIZE, NUMBER, AND/OR LOCATION OF INVOLVED NODES
A. Number and size of nodes
involved. Pathologist must count the number of lymph
nodes positive or measure the size of the involved node(s),
or both.
- Colon and rectum (number only)
- Pancreas
- Testis
- Bladder
- Kidney
- Renal pelvis, ureter
- Urethra
B. Laterality and size of
nodes involved. Attending physician must identify whether
the involved nodes are on the same side of the body as the
primary tumor (ipsilateral) or on the opposite side (contralateral).
Pathologist must measure the size of the involved node(s).
Both criteria apply for some sites.
- Lip and oral cavity
- Pharynx
- Larynx
- Paranasal sinuses
- Salivary glands
- Melanoma (size and location)
- Breast (pN)
- Penis
Laterality Only
8. Thyroid
9. Vagina
10. Vulva
C. Specific lymph node chains.
N element criteria include names of specific lymph node chains
as part of staging.
- Anal canal
- Gallbladder, bile ducts
- Lung
- Pleural mesothelioma
III. NOT APPLICABLE
The N element is not used for staging
of the following sites:
- Brain (no scheme available in TNM)
- Hodgkin's disease and Non-Hodgkin's lymphoma
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