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This terminology is not specifically included in either alternate names list for myelodysplastic syndrome, NOS (9989/3) or refractory anemia with excess blasts (9983/3).

Example: Bone Marrow Biopsy, Final Diagnosis: Consistent with involvement by myelodysplastic syndrome with excess blasts-2 (MDS EB-2).

Per SINQ 20160068, sphenoid wing meningiomas are reportable (unless stated to be intraosseous) because they arise from the meninges overlying or along the sphenoid wing/sphenoid bone. These are intracranial and not intraosseous meningiomas.

Therefore, wouldn't this logic also apply to cavernous sinus meningiomas? These are tumors that arise from the meninges of an intracranial space, not from bone or soft tissue. The cavernous sinus is a "true dural venous sinus" within the skull. While not specifically about meningiomas, SINQ 20071095 states a benign tumor in the cavernous sinus is coded to C490. This SINQ would still seem valid for a benign tumor like a blood vessel tumor, but not for a meningioma that doesn't arise from soft tissue or blood vessels.

Our pathologists have starting to use a new prostate cancer grading system that was adopted by WHO in 2016. The new grading scheme correlates with the prior Gleason grading scheme as follows:

Grade Group 1 = Gleason score 6 or less

Grade Group 2 = Gleason score 3+4=7

Grade Group 3 = Gleason score 4+3 = 7

Grade Group 4 = Gleason score 8

Grade Group 5 = Gleason score 9-10

Our pathologists are no longer dictating the Gleason Primary and Secondary Pattern values nor the Gleason's Score. Reverse correlation from the new grade groups to the required patterns and score are difficult with Grade Groups 2 and 3 needing to be distinguished from one another and Grade Group 5 including two unique scores.

The prostate-related fields include:

Collaborative Site Specific Factor 7: Gleason's Primary Pattern and Secondary Pattern Values on Needle Core Biopsy/TURP

Collaborative Site Specific Factor 8: Gleason's Score On Needle Core Biopsy/TURP

Collaborative Site Specific Factor 9: Gleason's Primary Pattern and Secondary Pattern Values on Prostatectomy/Autopsy

Collaborative Site Specific Factor 10: Gleason's Score on Prostatectomy/Autopsy

Pathology--Final description: Uterus, cervix, bilateral fallopian tubes and ovaries, total hysterectomy and bilateral salpingo-oophorectomy: Endometrial adenocarcinoma, endometrioid type, well differentiated, FIGO 1/3. Myometrial invasion: focal myometrial invasion (30% of myometrium) Tumor size: 2 x2 cm Tumor site: Fundus, exophytic/polypoid lesion Gross description: The 3.0 cm in length by 2.5 cm in diameter triangular endometrium is tan-red and smooth with a 2.0 x 2.0 cm tan-pink, exophytic fundic mass which extends on to both anterior and posterior aspects, 4.1 cm from the os.

Patient is an 11 month old with brain biopsy showing final diagnosis of pineal anlage tumor. How are behavior and histology coded for this rare tumor?

Patient has an April 2009 biopsy proven diagnosis of cholangiocarcinoma with a single liver mass in segment 4 that was treated with TACE and systemic chemotherapy. The treated lesion was stated to be stable in subsequent scans performed between 2010 and late 2015.

December 2015 imaging identified a new mass in the left hepatic lobe consistent with cholangiocarcinoma. Is the 2015 tumor a new primary?

In auditing files for expected (but not received) abstracts due from facilities, we've observed these types of cases not being consistently reported as multiple primaries.

The pathologist noted this was a challenging brain neoplasm that did not easily fit into a specific WHO diagnostic classification. Multiple differential diagnoses were given including pilomyxoid astrocytoma, ganglioglioma and dysembryoplastic neuroepithelial tumor (DNET), but there were no definitive features characteristic of any of these tumors. In the Comment section following the Final Diagnosis, it further states: "In summary, the tumor appears to be a difficult to classify non-infiltrating glial/glioneuronal neoplasm without definitive high-grade features."

Patient was diagnosed with DCIS of the left breast in June 2014. The patient had a simple mastectomy with 2 axillary lymph nodes removed. The final diagnosis was intermediate to high grade ductal carcinoma in situ, predominantly micropapillary type, forming a 1.4 cm mass. No invasive carcinoma identified. Margins negative. In April 2017, the patient was found to have parietoccipital bone lesions, which were resected. The resulting diagnosis was metastatic carcinoma, morphologically consistent with breast primary " See Comment: The previous breast lesion is not available for review at the time of signout. However, the tumor is morphologically compatible with a breast primary.

SINQ 20110111 would not make this is new primary. However, it seems that rule M8 might apply. An invasive tumor following an in situ tumor more than 60 days after diagnosis is a multiple primary. See Note 2: Abstract as multiple primaries even if the medical record/physician states it is recurrence or progression of disease.