Cervical lymph node (staging)

Cervical lymph node staging is important in a variety of tumors, 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 oral cavity, oropharynx, hypopharynx, and larynx.

  • Nx: nodes cannot be assessed
  • N0: no regional nodal metastases
  • N1: single ipsilateral node, ≤3 cm
  • N2
    • N2a: single ipsilateral node, 3-6 cm
    • N2b: multiple ipsilateral nodes, <6 cm
    • N2c
      • bilateral nodal metastases
      • contralateral nodal metastases <6 cm
  • N3: any nodal metastasis >6 cm
Size dependent criteria
  • most nodes should be <10 mm in short-axis except:
    • submental/submandibular and jugulodigastric: <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

See also

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Article information

rID: 6621
Section: Staging
Synonyms or Alternate Spellings:
  • Neck lymph node staging

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