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SEER Inquiry System - Report
Produced: 05/15/2026 10:54 AM
Question 20190022
Inquiry Details
References:
Solid Tumor Rules. Lung, updated January 2019
Question:
Solid Tumor Rules (2018)/Histology--Lung: Is histology code or the number of primaries assigned differently in SINQ 20180093 if the word "pattern' was omitted? See Discussion.
Discussion:
Regarding the answer to SINQ 20180093: This is a single primary; coded 8140/3 adenocarcinoma. In the biopsy and the two tumors found on lobectomy, the specific adenocarcinoma histologies are described as acinar predominant pattern, solid growth pattern and lepidic predominant pattern. You do not code a pattern, so rule M7 above applies and this is a single primary.
My question is based on Note 2 in Coding Multiple Histologies for lung cancers that says: Predominantly describes the greater amount of tumor. Predominant and majority are synonyms. Per the CAP protocol, the term predominant is acceptable for the following specific subtypes of adenocarcinoma. For these subtypes only, the word predominant is used to describe both the subtype and the grade of the tumor.
Answer:
If the word "pattern' was omitted, you would abstract multiple primaries per the Lung Solid Tumor Rule M6 and code histology to adenocarcinoma, acinar predominant (8551/3) and adenocarcinoma, lepidic predominant (8250/3) per Rule H4 as the word "pattern' is not included in each histology.
