MP/H Rules--Breast: For tubulolobular carcinoma, do we use 8522? See Discussion.
Path comment: This mixed variant of ductal and lobular carcinoma has been called in the past tubulolobular carcinoma, however, more recently is a mixed pattern of ductal and lobular carcinoma and not a variant of lobular carcinoma.
For cases diagnosed 2007 or later, use rule H18 and assign code 8524 [lobular mixed with other types of carcinoma]. According to the MP/H rules, tubular is not a specific type of duct or lobular. This is based on the latest WHO classification of breast tumors.
The combination histology of tubular and lobular will be reviewed during the upcoming revision of the MP/H rules.
MP/H Rules--Breast: What histology code is used for lobular carcinoma, pleomorphic type?
For cases diagnosed 2007 or later, use rule H14 and code the histology 8520 [lobular carcinoma]. 8520 is the only ICD-O-3 code for lobular carcinoma. There are no codes for specific lobular types.
MP/H Rules--Breast: What is the histology code for a breast tumor that is ductal ca with focal squamous differentiation? See Discussion.
SINQ 20021062 states for cases Dx'd prior to 2007, use 8570. Is 8570 also used when the squamous differentiation is focal?
For cases diagnosed 2007 or later, use rule H14 and code the histology 8500 [duct carcinoma]. Ignore histologies described as "focal," "focus," or "foci." This instruction will be added to the histology rules in the upcoming revision of the MP/H manual.
MP/H Rules--Colon: What histology would you assign to a single tumor with the histology 'well differentiated mucinous cystadenocarcinoma in a villous adenoma confined to the appendix'? Does rule H4 apply to this diagnosis or should we continue on in the rules to H14 and code the higher histology?
For cases diagnosed 2007 or later, use rule H4.
Stop at the first rule that applies to the case. Rule H4 is the first rule that applies.
The polyp rule, H4, comes before many of the other colon rules because it is important to know that the malignancy originated in a polyp.
MP/H Rules--Breast: What histology code is used for lobular with focal ductal features? Do we ignore the focal features and code as lobular or do we use the combination code for duct and lobular?
For cases diagnosed 2007 or later, use rule H14 and assign code 8520 [lobular]. Ignore histologies described as "focal," "foci," or "focus." This instruction will be added to the next version of the MP/H manual.
MP/H Rules--Breast: What histology code should be used with invasive papillary carcinoma with cribriform carcinoma component? There is also DCIS adjacent to the invasive tumor, predominant cribriform and focal papillary patterns. This is a single breast tumor. See Discussion.
Registry staff is divided between 8523 and 8255.
For cases diagnosed 2007 or later:
First apply rule H9, code the invasive. To determine the code for the invasive histology, start with rule H10 and stop at rule H15. Code the histology 8503 [papillary]. Papillary (8503) and cribriform (8201) are listed in Table 1 as specific duct types, but in this case they are invasive.
Table 1 and Table 2 will be clarified in the next version of the MP/H rules.
MP/H Rules/Histology--Breast: What is the histology code for the following?
4/21/03 Left breast: infiltrating ductal carcinoma, grade 3 micropapillary type. Tumor size: 3.5 cms; deep margin negative. Skin, nipple & areola positive for invasive ductal carcinoma. Dermal lymphatic invasion by carcinoma breast. Extensive intraductal component absent. 6+/6. See Discussion.
How should histology be coded for a 2003 diagnosis and also for the same diagnosis in 2007 or later?
For a case diagnosed in 2003, code 8507/3 [Duct micropapillary carcinoma]. See Coding Complex Morphologic Diagnoses, revised August 2002, 3rd example on page 5 and page 3, #4.
For cases diagnosed 2007 or later, code 8507/3 [Duct micropapillary carcinoma]. Use rule H12.
MP/H Rules/Histology--Thyroid: How would the histology "micropapillary carcinoma" of the thyroid be coded for cases dx'd 2007 and after?
For cases diagnosed 2007 or later, assign code 8260/3 [Papillary adenocarcinoma] according to rule H14.
For thyroid cancer only, the term micropapillary does not refer to a specific histologic type. It means that the papillary portion of the tumor is minimal or occult, usually less than 1 cm. in diameter.
MP/H Rules--Brain and CNS: Are stigmata of neurofibromatosis in the brain reportable neurofibromatosis lesions? See Discussion.
Reference: SINQ 20051108; SINQ 20061018 Three year old patient with history of neurofibromatosis 1. 3/05 MRI of the brain showed right optic nerve glioma. It also showed heterogeneous high t2 signal in the middle cerebellar peduncles and near the genu of the internal capsules bilaterally are stigmata of neurofibromatosis type I. 3/08 MRI showed new mass suspicious for glioma in the hypothalamus. Clinical diagnosis is benign glioma secondary to diagnosis of neurofibromatosis. How many primaries are to be accessioned for this patient? Should the matrix principle be invoked for the second glioma? Should the behavior code for the glioma be 0?
For cases diagnosed 2007 through 2017
Accession NF (9540/1) when there is CNS tumor -- a glioma or some other intracranial/intraspinal tumor. Stigmata of NF are reportable when the stigmata themselves are reportable tumors. For example, glioma, or another intracranial/intraspinal tumor. Do not report sitgmata that are only termed "stigmata seen on MRI," for example, without other reportable terminology.
Do NOT accession NF (9540/1) when there is only peripheral nerve/nervous system involvement.
Accession the neurofibromatosis itself only once per patient. Accession any initial neoplasm in the CNS separately. Abstract and code any subsequent CNS neoplasms according to the multiple primary brain rules.
Accession three primaries for the case described above.
Neurofibromatosis (C729 9540/1)
Optic nerve glioma (C723 9421/3)--> see below.
Hypothalamus glioma (C710 9380/0)
--> Optic nerve gliomas associated with NF are pilocytic astrocytomas. Code pilocytic astrocytoma as 9421/3 in North America.
For cases diagnosed 2018 or later
See the 2018 Solid Tumor Rules for Non-Malignant CNS tumors.
An official website of the United States government
Home