System Guide
Back to Search Results

Search Results

Display Options
Display Options
Select Fields
Export Results to CSV Create Report 0
+ Add all results to report

Report Produced: 10/07/2026 04:43 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20220018

Solid Tumor Rules/Histology--Thyroid:  What is the correct histology code for the following thyroid primary with multiple tumors abstracted as one primary diagnosed prior to 2021?  See Discussion.

2016 Total thyroidectomy, Multifocal

-Dominant Tumor:  Right Lobe, Papillary thyroid carcinoma (8260/3)

-Tumors two through five:  Three tumors Papillary thyroid carcinoma (8260/3), and one tumor Papillary thyroid carcinoma, follicular variant (8340/3)

-An additional tumor: Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (8343/2)

Code this multifocal thyroid carcinoma, single primary, as papillary thyroid carcinoma, follicular variant (8340/3) using Solid Tumor Rules, Other Sites, Rule H13 that says to code the most specific histologic term. We consulted with our endocrine specialty pathologist and when there is a mix of papillary and follicular variants, assign 8340.

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features is coded as 8349/1 beginning in 2021.  According to the WHO Classification of Endocrine Organs, 4th edition, it was formerly classified as non-invasive encapsulated follicular variant of PTC (FVPTC) (8343/2) but was reclassified based on extremely low malignant potential.

 Thyroid Histology 2022
20130165 MP/H Rules/Multiple primaries--Thyroid: How many primaries are reported and what is histology for the papillary carcinomas if a Classical cytomorphology with a follicular architecture is on the right and a Columnar cell cytomorphology with a follicular and papillary architecture is on the left? See Discussion.

  • Dominant Tumor: Tumor

  • Laterality: Right lobe

  • Tumor Size: Greatest dimension: 9 cm

  • Histologic Type: Papillary carcinoma

  • Variant, specify: Classical

  • Architecture: Follicular

  • Cytomorphology: Classical

  • Tumor Size: Greatest dimension: 6 cm

  • Histologic Type: Papillary carcinoma

  • Variant, specify: Columnar cell

  • Architecture: Solid, follicular, and papillary

  • Cytomorphology: Columnar cell

    • The answer seems to hinge on whether or not the two tumors differ at the third digit of histology. Can we code the histology based on the terms listed for variant or architecture?

    		This is a single thyroid primary. The tumors are both papillary carcinoma with follicular architecture for the most part. Apply Rule M6 and abstract a single primary. Thyroid N/A 2013
    		20051129 Reportability/Behavior--Thyroid: Does the term "invasion" indicate the presence of a malignant tumor? See Discussion. Left thyroid lobectomy showed microfollicular neoplasm with evidence of minimal invasion. Micro portion of path report stated, "The capsular contour is focally distorted by a finger of the microfollicular nodule which appears to penetrate into the adjacent capsular and thyroid tissue."

    We recommend that you contact the pathologist for further information. If no further information is available, do not accession this case based on the information provided. There is no definitive statement of malignancy.

    If the case was sent to a consultant, there may be another opinion available. If there is information in the record, or the treating physician can be contacted, find out whether the tumor was benign or malignant and whether there was any further treatment.

    According to our pathologist consultant, based only on the information above and nothing else, do not report since there is no diagnosis of malignancy.

    		 Thyroid Behavior 2005
    		20220038

    Solid Tumor Rules/Histology--Thyroid:  What is the histology code for sclerosing mucoepidermoid carcinoma with eosinophilla in the left thyroid and papillary thyroid carcinoma in the right thyroid?  See Discussion.

    The left thyroid lobectomy/isthmusectomy returned a diagnosis of sclerosing mucoepidermoid carcinoma with eosinophina, 6.5 cm, replacing nearly the entire left lobe of the thyroid.

    The patient has a completion thyroidectomy of the right lobe and returned the diagnosis of papillary thyroid carcinoma, 0.5 mm, in maximum dimension.

    The endocrinologist describes it as "co-exsisting" and states the tumor is iodine non-avid.

    Abstract two primaries and assign code 8260/3 (papillary adenocarcinoma, NOS) to the right thyroid using Solid Tumor Rules, Other Sites, Rule H14, and 8430/3 (mucoepidermoid carcinoma) to the left thyroid as these are separate tumors with different histology types according to WHO Classification of Tumors of Endocrine Organs, 4th edition.

    		 Thyroid Histology 2022
    		20230068

    Solid Tumor Rules/Histology--Thyroid: What is the histology code for a diagnosis of poorly differentiated thyroid carcinoma arising in a background of solid papillary thyroid carcinoma? See Discussion.

    Patient had a hemithyroidectomy with the final diagnosis above. There does not appear to be an Other Sites H rule or table that addresses this combination of histologies for thyroid primaries.

    Code to poorly differentiated thyroid carcinoma, 8337/3.

    In this case the tumor is comrpised of two difffernat thyroid histologies: poorly differentiated carcinoma 8337/3 and papillary thyroid carcinoma 8260/3. WHO does not have a code for this combination. Per our endocrine pathology expert, the poorly differentiated carcinoma is the more agressive histology and will determine treatment and progrnosis.

    		 Thyroid Histology 2023
    		20170061

    MP/H Rules/Histology--Thyroid: What is the correct histology when final diagnosis of a thyroidectomy includes the descriptor "papillary and follicular architecture?" See Discussion.

    Total thyroidectomy Final Diagnosis: Papillary carcinoma, classical type, with papillary and follicular architecture.

    The 2007 MP/H rules state that the term architecture is reserved for coding subtype of in situ primaries only. However, SINQ 20130165 appears to indicate this should be coded for invasive thyroid subtypes as well. Can you confirm the addition of the term architecture for determining an invasive histologic subtype for thyroid?

    Assign code 8260/3, papillary carcinoma per Multiple Primaries/Histology Rule H14.

    Architecture is reserved for coding subtype of in situ primaries only. SINQ 20130165 is not intended to indicate this should be coded for invasive thyroid subtypes.

    		 Thyroid Histology 2017
    		20091030 MP/H Rules/Multiple Primaries--Thyroid: How many primaries should be coded if there is a clinical diagnosis of recurrent thyroid carcinoma in 3/08 in a patient with a history of thyroid carcinoma diagnosed in 1995 with a 2002 clinical recurrence? See Discussion. Thyroid carcinoma diagnosed in 11/95 and treated with total thyroidectomy (although path report only mentions the left lobe) and ablation. Elevated thyroglobulin level in 11/02, stated to have recurrent carcinoma and again treated with ablation. History on this case states patient had a near total thyroidectomy at diagnosis. Patient is seen again at a third hospital 3/08. Diagnosis again is recurrent carcinoma apparently because of a thyroid mass that is palpable. No treatment was performed and patient expired 4/08. Is this a new primary because of MP/H rule M10?

    For cases diagnosed 2007 or later:

    The pathology report takes precedence over the other information when there is a discrepancy. Based on the information available, only the left thyroid lobe was removed 11/95.

    Use the 2007 MP/H rules to evaluate new tumors. If the 3/08 diagnosis represents a new tumor, use the MP/H rules. If the diagnosis in 3/08 is not new tumor, the MP/H rules do not apply.

    For this case, a new tumor in 3/08 would be a new primary using rule M10 for Other Sites.

    		 Thyroid N/A 2009
    		20081041 MP/H Rules/Histology--Thyroid: How many primaries are to be reported and what histology is to be coded for an anaplastic/undifferentiated thyroid carcinoma with sarcomatoid transformation likely arising in association with a papillary thyroid carcinoma? Thyroid contains one tumor: 12.5 cm in greatest dimension...almost completely replaces entire thryroid gland.

    For cases diagnosed 2007 or later:

    This is a single primary using rule M2; a single tumor is always a single primary.

    The histology code for this case is 8260/3 [Papillary carcinoma of thyroid]. Begin with Histology Coding rule H8. Stop at rule H17 and code the histology with the numerically higher ICD-O-3 code.

    		 Thyroid Histology 2008
    		20091125

    Ambiguous terminology/Reportability--Thyroid: Should a thyroid case be accessioned based only on a cytology that is consistent with papillary carcinoma? See Discussion.

    Instructions in the 2007 SPCSM state that we are not to accession a case based only on a suspicious cytology. Does this rule apply only to the term "suspicious" or does it apply to all ambiguous terms? Example: FNA of thyroid nodule is consistent with papillary carcinoma.

    		 Do not accession the case if the cytology is the only information in the medical record. The phrase "Do not accession a case based only on suspicious cytology" means that the cytology is the only information in the record. If there is other information that supports the suspicion of cancer (radiology reports, physician statements, surgery), then accession the case. The phrase "suspicious cytology" includes all of the ambiguous terms. Thyroid N/A 2009
    		20031211

    EOD-Extension--Thyroid: Is this field coded as involvement of the thyroid capsule if the thyroidectomy path specimen reveals papillary thyroid ca "tumor present within capsular blood vessels?"

    For cases diagnosed 1998-2003: Tumor present within the blood vessels of the thyroid capsule is localized (extension code 30). The tumor has not penetrated the capsule itself if it is contained within the blood vessels.

    Keep in mind that tumor size determines the extent of disease for thyroid extension codes 10, 20, 30 and 40.

    		 Thyroid N/A 2003