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Hypopharyngeal SCC - N Staging

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Hello everyone, Dr. Sydney Levy here.

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3 00:00:05,369 --> 00:00:07,820 Today, I'd like to discuss the end staging

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of hypopharyngeal squamous cell malignancy.

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As with other parts of the pharynx, we have

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N1, N2A, N2B, N2C, N3A, and N3B classifications.

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The good news is that these are the

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same as for oropharyngeal tumours.

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So you can remember one, and you will remember both.

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N1 is a single ipsilateral lymph node less

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than 3 cm without extranodal extension.

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N2A is a single ipsilateral lymph node more than

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3 cm, less than 6 cm, without extranodal extension.

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N2B is multiple ipsilateral lymph nodes

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less than 6 cm without extranodal extension.

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N2C is bilateral or contralateral lymph nodes

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less than 6 cm without extranodal extension.

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N3A is any lymph node more than

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6 cm without extranodal extension.

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And N3B, which is the new classification

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introduced with the 8th edition of guidelines,

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is the presence of clinically overt extranodal extension.

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The word "clinically" is important there, because

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as radiologists, we can only infer that it is

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likely that extranodal extension is present.

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But it is really up to the clinician or the

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pathologist to confirm extranodal extension.

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Clinically, this may be ascertained if a node is

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fixed on clinical examination. Pathologically,

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it is seen at the histopathological level.

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So we shouldn't be saying there is definite extranodal

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extension, but we can say that the morphology of the

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lymph node is suggestive of extranodal extension.

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And that is a helpful thing to put in the report.

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N staging is, as for other parts of the head and neck, M1

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being presence of distant metastasis, M0 being nothing.

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The last point to remember is that, uh, the superior

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mediastinal lymph nodes, otherwise known as level seven,

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in the head and neck classification, are considered

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regional lymph nodes for the purposes of N staging.

Report

Description

Faculty

Sidney Levy, PhD, MBBS

Radiologist and Nuclear Medicine Specialist

I-MED

Tags

Neuroradiology

Neuro

Neoplastic

MRI

Head and Neck

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