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Ovarian serous borderline tumor with node implants is not reportable; it is a borderline neoplasm. However, if the oncologist believes he or she is dealing with a low grade serous carcinoma rather than a borderline tumor, this case is reportable. We recommend that you determine whether the diagnosis of low grade serous carcinoma, chemotherapy not recommended, is based on the pathological findings or on something else before reporting this case.

The lung H rules and tables have been updated to include histologies that CAP identifies using the term "predominant" in the diagnosis. Example: Code adenocarcinoma, lepidic predominant, to 8250/3 rather than 8140/3. When the final pathology diagnosis includes more than one "predominant" adenocarcinoma subtype such as acinar, solid, or lepidic, then code the type with the greatest percentage according to Lung Solid Tumor Rule H7.

Code OPTUNE in the Other Treatment field. See NovaTTF in SEER*Rx (http://seer.cancer.gov/seertools/seerrx/). NovaTTF is the pre-FDA approval name for OPTUNE.

If OPTUNE was administered for recurrence, be sure NOT to record it in the first course of treatment fields. Check with CoC if you have questions about coding treatment for recurrence.

Code the histology to SCC 8070/3.

Based on registrar feedback on the NSCLC rule, we added a rule that specifically addresses when ambiguous terminology can be used to code histology other than NSCLC. The lung rules were update 10/12/2018 so please make sure you are using the currently posted rules. The new rule is: Rule H3-Code the specific histology when the diagnosis is non-small cell lung carcinoma (NSCLC) consistent with (or any other ambiguous term) a specific carcinoma (such as adenocarcinoma, squamous cell carcinoma, etc.) when:

* Clinically confirmed by a physician (attending, pathologist, oncologist, pulmonologist, etc.)

* Patient is treated for the histology described by an ambiguous term

* The case is accessioned (added to your database) based on ambiguous terminology and no other histology information is available/documented

Example 1: The pathology diagnosis is NSCLC consistent with adenocarcinoma. The oncology consult says the patient has adenocarcinoma of the right lung. This is clinical confirmation of the diagnosis, code adenocarcinoma.

Your case meets the criteria in bullet 1.

Assign code 9110/3, mesonephric adenocarcinoma. These tumors commonly arise in the cervical wall and more commonly involve the lower uterine segment than do other cervical adenocarcinomas.

There is no way for us to know what behavior to assign WHO grade II tumors when the pathologist does not provide that information. Defaulting to either benign or malignant is incorrect. Please follow back with the pathologist to determine behavior.

The behavior must be non-malignant, meaning /0 or /1, or the tumor is a WHO Grade 1, to be reportable as non-malignant CNS tumor. Refer to Table Instructions under Table 1, WHO Grades of Select CNS Neoplasms that says to use non-malignant CNS rules for all WHO Grade 1 tumors and to use the appropriate rules for WHO Grade 2 tumors

Use ICD-O and all updates if not listed in Table 6 according to non-malignant CNS Histology Rule H3 (for single tumor) and Rule H8 (for multiple tumors) when only one histology is present.

2022 and later

HAMN is reportable. Assign 8480/2.

In the CAP protocol, the term Histologic Type is a label where the histology that corresponds to the largest carcinoma is collected. According to the CAP protocol for invasive breast cancer, the histologic type corresponds to the largest carcinoma. If there are smaller carcinomas of a different type, this information should be included under "Additional Pathologic Findings." The findings noted in the Final Diagnosis, Histologic Type, and Additional Path Findings of the protocol should be used to determine the histology.

When there are multiple histologies and

1) the subtype or variant is listed as 90% when there is a Not Otherwise Specified/No Specific Type (NOS/NST) and a subtype, or

2) the subtype/variant histology reflects the majority of the tumor when there are two or more different histologies (two or more distinct subtypes)

Code the subtype/variant; otherwise, use the Specific and Not Otherwise Specified/No Specific Type (NOS/NST) Terms and Code listed in Table 2 (columns 1 and 2) of the 2018 Solid Tumor Rules for Breast Cancer.

Code NSCLC to 8046/3.

Do not change a histology code simply to assign TNM to the case. AJCC does not determine histology coding. While pathologists are no longer encouraged to use NSCLC, it does not mean the term and code are obsolete. NSCLC could be any number of histologies such as adenocarcinoma or squamous carcinoma. A diagnosis of NSCLC indicates that the initial exam of the tissue did not identify a more specific type of NSCLC. Additional immunohistochemical testing is needed to determine the histology. Update the case if better information becomes available from subsequent tests/review.

When analyzing the data, researchers and physicians will be able to identify the cases where the pathologist was unable to or did not perform further testing to determine a specific histology which drives treatment and survival.

Do not report multinodular and vacuolating neuronal tumor of the cerebrum. At this time, WHO is undecided about whether this is a neoplastic or a hamartomatous/malformative process. If WHO makes a determination that this is a neoplastic process, we will update reportability instructions and ICD-O-3 guidelines for registrars.