MPH Rules/Behavior--Breast: Would a positive right axillary node following DCIS of the right breast indicate the presence of a new primary? See Discussion.
MP/H Rules/Histology--Rectum: When not specifically mentioned as part of the histology, is the adenoma a second histologic type, or just a further physical description of the tumor? See Discussion.
MP/H Rules/Multiple primaries--Lung: If a 1.7 cm LUL lung tumor is not treated surgically, would a 2.1 cm tumor in the same lobe three years later be a new primary? See Discussion.
CS Lymph Nodes--Breast: What code should be used for the the following? There is no mention of LNS clinically; the patient has neoadjuvant therapy; and the LNS are matted pathologically.
Primary site/Surgery of Primary Site--Lymphoma: What is the primary site for lymphoma involving lymph nodes and tonsil? Is a tonsillectomy coded as surgery for lymphoma? See Discussion.
MP/H Rules--Breast: Patient has 2 existing primaries, both of left breast and both were pure lobular carcinoma, one was diagnosed in 1994 and the other in 2005. Now a biopsy in 2008 of a supraclavicular lymph node (laterality unknown) and subcutaneous scalp tissue show metastatic DUCTAL carcinoma. Per path report, breast is the primary site. Slides from prior tumors were not reviewed. Should this be made a new primary or assumed to be metastasis from the prior breast tumors? See Discussion.
MP/H Rules--Breast: Is a ductal carcinoma diagnosed in August, 2008 following a lobular-ductal primary diagnosed in February 2007 a new primary? See Discussion.