2018 Solid Tumor Rules/Multiple primaries--Lung: What is the histology and number of primaries for a lung case diagnosed in 2018 with adenocarcinoma with acinar predominant pattern on biopsy, and subsequent lobectomy showing adenocarcinoma with solid growth pattern and separate adenocarcinoma with lepidic predominant pattern? Should this be coded as one primary with an adenocarcinoma, NOS (8140/3) histology since we cannot use pattern or predominant, based on the histologic type listed in the synoptic report, and the fact it states synchronous primary tumors in the same lobe. See Discussion.
Reportability--Prostate: According to the 2018 SEER Program Manual, a prostatic intraepithelial neoplasia (PIN) III is not reportable, but is an atypical small acinar proliferation (ASAP) PIN 4 reportable?
Solid Tumor Rules (2018)/Histology--Lung: How is histology coded when the term "predominant" is used to describe solid adenocarcinoma, acinar adenocarcinoma, etc.? Pathology reports often say "See Synoptic" (also known as the College of American Pathologists (CAP) protocol) included in the Final Diagnosis rather than including all the detail. Based upon the new Solid Tumor Rules for lung, predominant/predominantly is no longer a subtype/variant and should not be coded unless there is a specific code/subtype-variant for the NOS in Table 3, e.g., adenocarcinoma, lepidic predominant. See Discussion.
Reportability/Histology--Liver: Are primary hepatic neuroendocrine neoplasm and primary hepatic neuroendocrine tumor (PHNET) reportable? What are the specific histology codes?
Reportability/Primary Site--Skin: Is vulvar intraepithelial neoplasia III (VIN III) or associated invasive squamous cell carcinoma reportable when stated to be of the or or ? See Discussion.
Histology--Kidney: What is the histology code for renal cell clear cell of the kidney with subsequent epithelioid angiomyolipoma PEComa of the liver stated to be metastatic? Case originaly diagnosed in 2016. See discussion.
Histology/Grade--Small intestine: For a 2017 diagnosis, is the grade/differentiation field coded 1 or 9 when the diagnosis is well-differentiated neuroendocrine tumor (NET) (carcinoid)? It seems as though the term well-differentiated defines type of neuroendocrine tumor so they can diagnosis the carcinoid. See Discussion.