Usually the letters before the T in the TNM staging are for how that staging determination was reached. For example, the p is for pathologically staged. In the past I have seen a npT stage, and the patient had had a fine-needle aspiration which was sent to pathology. I think it is just further clarification of the pathology determination. It was more likely a n not a m, but I don't know for sure because I didn't hear it or see the rest of the report to know what they had down. If it is an n, it would be written as npT1c N0
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