SHOTTY POSTERIOR CERVICAL LYMPH NODE CODE

Wide excision performed within four months of excisional biopsy should be included when determining the code for site-specific surgery. If lymph nodes are described as matted and cannot be counted individually, the procedure that removed them should be coded as a lymph node dissection. A radical or modified radical neck dissection will ordinarily include 10 or more lymph nodes. The terms enlarged, palpable, lymphadenopathy, and shotty are not considered to be involvement.Ī selective neck dissection will ordinarily include six or more lymph nodes. In descriptions of cervical lymph nodes, the terms fixed and matted are to be considered as involvement of the nodes. If cervical nodes are reported as involved and laterality is not specified, assume nodes are ipsilateral. The equivalent structure to the submucosa for gum and hard palate is the mucoperiosteum. The gum and hard palate have neither a submucosa nor a muscularis propria, because they lie directly on bone. The muscularis propria forms the 'wall' of the organ. None of the head and neck sites has a serosal surface. Oral cavity and pharynx cancers described as confined to mucosa should be reviewed with a pathologist to determine whether the tumor has penetrated the basement membrane, or whether it remains in situ. The maxillary sinuses develop squamous carcinoma, while the ethmoid sinuses tend to develop adenocarcinoma. Tumors are malignant in 20-25% of parotid gland masses, 35-40% of submandibular gland, 50% of palate, and 95-100% of sublingual gland.Ībout 80% of paranasal sinus and nasal cavity tumors are squamous cell carcinoma the remainder are adenocarcinomas.

The most common site for minor salivary gland tumors is the palate. Tumors of minor salivary glands are assigned topography codes of the site in which they arise for example, a tumor of a minor salivary gland of the floor of the mouth is coded to floor of mouth.

Overall, 20-30% of head and neck patients develop a second primary at some point in their history. Subclinical second primaries are most frequently diagnosed in the esophagus. Approximately 10-15% of head and neck cancers have a second primary diagnosed at the time of workup of the symptomatic primary site.

Shotty posterior cervical lymph node