Report | Question ID | Question | Discussion | Answer | Year |
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20240031 | Reportability/Histology: Is a diagnosis of non-lung neuroendocrine tumorlet reportable? See Discussion. |
Patient was diagnosed March 2023 with a neuroendocrine tumorlet of the rectum measuring 0.8 mm via excisional biopsy during colonoscopy. Prior SINQ 20160011 (stomach specific) indicates microcarcinoid and carcinoid tumors are reportable. Microcarcinoid is a designation for neuroendocrine tumors of the stomach when they are less than 0.5 cm. in size. Is the current rectal tumor a reportable gastrointestinal neuroendocrine tumor if it is less than 5 mm (i.e., is a neuroendocrine tumorlet equivalent to a microcarcinoid)? |
Do not report neuroendocrine tumorlet of lung and non-lung sites. Microcarcinoid and carcinoid tumors are reportable. Tumorlet is a tumor of neuroendocrine differentiation, defined by size < 5 mm in diameter, mitotic count < 2 mitoses/2 mm², and absence of necrosis. Microcarcinoid is a designation for neuroendocrine tumors when they are less than 0.5 cm. in size. The term "tumorlet" is used in a number of other settings, referring to small tumors (usually < 0.5 cm), and does not necessarily mean carcinoid tumor. The term microcarcinoid tumor is not equivalent to neuroendocrine tumorlet. |
2024 |
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20180014 | Reportability/Histology--Brain and CNS: Is multinodular and vacuolating neuronal tumor of the cerebrum reportable, and if so, is the histology coded as 9492/0? See Discussion. |
Patient diagnosed with multinodular and vacuolating neuronal tumor of the cerebrum. My research shows: Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion that is included in the 2016 updated World Health Organization classification of brain neoplasms as a unique cytoarchitectural pattern of gangliocytoma. There is no code in ICD-O-3 for it, so do I report it and use 9492/0 or not ? |
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. |
2018 |
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20240034 | SEER Manual/Reportability--Skin: Is keratoacanthoma (8071/3) of the skin reportable? This code is also for squamous cell carcinoma (SCC), keratinizing. In the 2024 SEER manual, 8071/3 falls under the not reportable section of skin (outside of specific sites). |
Do not report keratoacanthoma of the skin (8071/3). The preferred term for keratoacanthoma is squamous cell carcinoma (SCC), keratinizing, NOS. According to the 2024 SEER Manual, Reportability section, SCC of skin (8050-8084) is not reportable. |
2024 | |
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20100013 | Reportability--Lymphoma: Should a December 2008 diagnosis of in situ follicular lymphoma be accessioned? See Discussion. |
Patient with mesenteric lymphadenopathy had a biopsy. Consult supports original pathology findings: The histologic and immunophenotypic findings represent what has been referred to in the literature as "in situ follicular lymphoma." The oncology assessment states, "At this point the patient has no other obvious evidence of other disease. ...no hepatosplenomegaly...no peripheral adenopathy...no significant abnormalities on PET scan to suggest active lymphoma." No treatment is planned at this time. The patient will only be monitored. |
Do not report in situ lymphoma at this time. Currently, lymphoma cannot be reported with a behavior code of in situ (/2) and it would be incorrect to abstract in situ lymphoma as a /3.
It is true that this is a recently identified pathologic entity. Our experts say that there is still some controversy to be ironed out regarding the criteria for identifying an in situ lymphoma. Their recommendation was to wait until clear guidelines had been established for the pathologists before we start collection of in situ lymphomas. We anticipate collecting these entities in the future. |
2010 |
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20180040 | Reportability--Kidney: Is congenital cellular mesoblastic nephroma reportable for a newborn baby? See discussion. |
2015 Rt kidney nephrectomy pathology states: congenital cellular mesoblastic nephroma, tumor sz 5.9cm, tumor limited to kidney, extension into pelvicalyceal system, margin not applicable, LVI negative. Per PubMed.gov: (In newborns) among the low-grade malignant tumors, congenital mesoblastic nephromas can be successfully treated with simple nephrectomy. Per ScienceDirect: ...currently thought that cellular mesoblastic nephroma is actually a renal variant of infantile fibrosarcoma. |
Do not report congenital mesoblastic nephroma (8960/1). Congenital mesoblastic mephromas are low-grade fibroblastic neoplasms of the infantile renal sinus according to WHO Classification of Tumors of the Urinary System and Male Genital Organs. The WHO classification is the standard used to determine behavior and histology for entities not listed in ICD-O-3. |
2018 |
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20230052 | Reportability/Primary Site--Brain and CNS: What is the primary site of a meningioma arising from the jugular bulb/petrous aspect of the temporal bone? See Discussion. |
Example July 2022, Brain CT describes a mass appearing to be centered on the petrous aspect of the temporal bone with intracranial and extracranial extension. July 2022, Brain MRI describes an extra-axial mass centered in the right jugular bulb with intracranial and intraosseous extension as well as extension within the internal jugular vein. September 2022, Resection operative report surgical findings are of a calcified mass filling middle ear, abutting stapes and appearing to enter the stapes obturator foramen, debulked. Final diagnosis is right middle ear meningioma, WHO grade I of III. Is this a reportable intraosseous meningioma of the temporal bone/skull base, or a non-reportable meningioma arising in a meningocele within the middle ear? |
Do not report cases of meningioma originating in the jugular bulb or petrous aspect of temporal bone or middle ear. These are not intracranial locations. This is a non-reportable meningioma arising in a meningocele within the middle ear. The jugular bulb is the confluence of the lateral venous sinuses situated in the jugular fossa. The precise location of this structure within the temporal bone is variable.The jugular bulb, petrous aspect of temporal bone, and middle ear are not intracranial locations, and therefore meningiomas arising in these areas are not reportable. |
2023 |
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20240024 | Reportability/Histology: Is angiomyxoma (this includes borderline or behavior code /1 cases) of the soft tissue reportable? Can you provide us with coding guidelines for angiomyxoma for when its reportable or not reportable? |
Do not report angiomyxoma. ICD-O-3.2 assigns 8841/0 to this benign tumor. This includes superficial and deep (aggressive) angiomyxoma. |
2024 | |
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20230045 | Reportability/Histology--Thyroid: Is a diagnosis of “angioinvasive oncocytic thyroid neoplasm with features worrisome for a poorly differentiated oncocytic carcinoma” reportable if the diagnosis comment states, additional immunostains were performed which demonstrate the carcinoma cells are positive for thyroglobulin and negative for calcitonin? See Discussion. |
Patient had a right thyroid lobectomy on 12/2022, with initial diagnosis of “thyroid carcinoma pending expert consultation for definitive classification.” The slide review documented in the addendum shows a final diagnosis of “Angioinvasive oncocytic thyroid neoplasm, see comment.” The subsequent comment states, “I would classify this lesion as an angioinvasive oncocytic thyroid neoplasm with features worrisome for a poorly differentiated oncocytic carcinoma.” The comment goes on to state, “Additional immunostains were performed which demonstrate the carcinoma cells are positive for thyroglobulin and negative for calcitonin. The diagnosis remains unchanged.” |
Do not report angioinvasive oncocytic thyroid neoplasm with features worrisome for a poorly differentiated oncocytic carcinoma based on the final, unchanged diagnosis. Worrisome is not a reportable ambiguous terminology. |
2023 |
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20150002 | Reportability--Bladder: Please explain the reportability of UroVysion for bladder cancer in the following circumstances.
1. Patient has positive UroVysion test and follow up biopsy is negative. Is this case reportable with a diagnosis date the date of the UroVysion?
2. Patient has positive UroVysion test and follow up biopsy is positive for cancer. Is the diagnosis date of the date of the positive UroVysion or the date of the positive biopsy? Thank you. |
Do not report a case based on UroVysion test results alone. Report a case when there is positive histology, a physician statement of malignancy, and/or the patient was treated for cancer.
1. Do not report the case.
2. Report the case based on the positive biopsy. |
2015 | |
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20160048 | Reportability--Kidney: Is renal cell neoplasm of oncocytosis reportable based on the pathology from a nephrectomy? See Discussion. |
The pathology diagnosis reads: Diagnosis Right Kidney, Laparoscopic Nephrectomy:
-Renal Cell Neoplasm of Oncocytosis (pT1a, pNX See Comment and Template).
-Surgical margins free of tumor.
Kidney, right, nephrectomy:
Tumor histologic type: Renal cell neoplasms of oncocytosis (see Note)
Sarcomatoid features (%) Not identified
Tumor size: 4 cm (greatest dimension largest tumor)
Other dimensions: 2.7 x 2.5 cm
Macroscopic extent of tumor: Limited to kidney
Focality: Multifocal
Number of tumors: 11 grossly visible, range 0.2 4 cm
Fuhrman grade: 2 of 4
Microscopic extent of tumor:
Perinephric fat invasion: Not identified
Renal sinus invasion: Not identified
Other: N/A
Renal vein involvement: Not identified
Adrenal gland present: No
Involved by tumor: N/A
Direct invasion or metastasis: N/A
Cancer at resection margin: Not identified
Location(s): N/A
Pathologic findings in nonneoplastic kidney: Multiple collections of oncocytic cells
Hilar lymph nodes present: No
Number of involved/number present: N/A
"Thank you for sending this fascinating case. In reviewing the H&E-stained slides, we recognize that multiple lesions of varying sizes are present within the specimen, some with features of oncocytoma, some with those of chromophobe RCC, and yet others with features of both. The immunohistochemical studies for CK7 performed at your institution serve to highlight this point with "mass #1" showing focal single cell staining typical of oncocytoma and "mass #2" showing a patchy and confluent staining pattern typical of chromophobe RCC. This second mass was also positive with special stain for Hales colloidal iron. As mentioned, the morphology varies somewhat in each tumor, however, every single mass is comprised of cells with eosinophilic (pink to bright red) cytopolasm. Some tumors show more tightly nested or sheet like growth, others are more tubular or microcystic. Another important feature, present on slides of renal cortex are microscopic tumorlets seemingly emanating from eosinophilic tubules. This finding, along with the presence of numerous oncocytic neoplasms is supportive of the above diagnosis. The absence of clinical features to suggest Birt-Hogg-Dube syndrome is noted. Although these tumors are not recognized in the current classification of renal tumors, we regard these neoplasms as being a distinct entity, unrelated to both oncocytoma and chromophobe renal cell carcinoma, and have applied the designation "renal tumor of oncocytosis" to such lesions (Gobbo S, et al. Renal cell neoplasms of oncocytosis have distinct morphologic, immunohistochemical, and cytogenetic profiles. Am J Surg Patholl 34:620-626, 2010). We concur that the expected behavior in these cases is one of indolence." |
Do not report Renal cell neoplasms of oncocytosis. According to our expert pathologist consultant, these neoplasms do not behave "in a malignant fashion." They are not currently classified as malignant and are not reportable to cancer registries. |
2016 |