Report | Question ID | Question | Discussion | Answer | Year |
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20180032 | Reportability--Appendix: Is low grade appendiceal mucinous neoplasm (LAMN) reportable for 2018? It is staged as pTis(LAMN) AJCC 8th ed by pathologist. |
Low grade appendiceal mucinous neoplasm (LAMN) is not reportable in 2018. See page 6, https://20tqtx36s1la18rvn82wcmpn-wpengine.netdna-ssl.com/wp-content/uploads/2018/02/2018-ICD-O-3-Coding-Table-Alpha-order-.pdf. Use cancer registry reportability instructions to determine reportability. Do not use the AJCC TNM manual to determine reportability. |
2018 | |
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20180070 | Solid Tumor Rules (2018)/Histology--Lung: The Histology coding guidelines for lung cancer state to code histology when stated as type or subtype but not to code when described as pattern. How should the histology be coded (Adeno, NOS or Adeno, Mixed subtypes) if the College of Americal Pathologists Protocol of the pathology report lists the following: Histologic type: Adenocarcinoma, papillary (90%), lepidic (8%), and solid (2%) patterns? |
The term/modifier "patterns" is no longer allowed to code a specific histology according to the Lung Solid Tumor H rules. Disregard the papillary, lepidic, and solid patterns and code histology to adenocarcinoma, NOS (8140/3). |
2018 | |
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20180045 | Solid Tumor Rules (2018)/Histology--Breast: The Histology Coding Instructions for breast cancer indicate the term type is not used to code histology unless documented to be greater than or equal to 90% of the tumor. Does this also apply if the format of pathology reports submitted in the College of American Pathologists (CAP) protocol from a specific facility always describes the histology under the heading, Histologic type: ___? See Discussion. |
For certain facilities in our area, the breast pathology reports using a CAP protocol format are formatted as follows; the Final Diagnosis will state Infiltrating carcinoma with the following features. The features list the specific tumor characteristics required in the CAP protocol formatting. The histology is always displayed in the list form and specified as Histologic type: (for example, Histologic type: Ductal carcinoma). Is this specific histology really to be ignored because it is preceded by the word type even if this is just a consequence of the pathology report formatting? |
In the CAP protocol, the term Histologic Type is a label where the histology that corresponds to the largest carcinoma is collected. According to the CAP protocol for invasive breast cancer, the histologic type corresponds to the largest carcinoma. If there are smaller carcinomas of a different type, this information should be included under "Additional Pathologic Findings." The findings noted in the Final Diagnosis, Histologic Type, and Additional Path Findings of the protocol should be used to determine the histology. When there are multiple histologies and 1) the subtype or variant is listed as 90% when there is a Not Otherwise Specified/No Specific Type (NOS/NST) and a subtype, or 2) the subtype/variant histology reflects the majority of the tumor when there are two or more different histologies (two or more distinct subtypes) Code the subtype/variant; otherwise, use the Specific and Not Otherwise Specified/No Specific Type (NOS/NST) Terms and Code listed in Table 2 (columns 1 and 2) of the 2018 Solid Tumor Rules for Breast Cancer. |
2018 |
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20180023 | Reportability/Behavior: Is myxoinflammatory fibroblastic sarcoma (MIFS) reportable for 2018? This histology is on the 2018 ICD-O-3 histology update list with a behavior code of /1. See discussion. |
This will be a tough one for registrars to recognize as non-reportable since the terminology contains sarcoma, so we just want to double check. |
Myxoinflammatory fibroblastic sarcoma (MIFS) (C49._), 8811/1, is not reportable for 2018 based on the 2018 ICD-O-3 New Codes, Behaviors, and Terms list. This is a new histology/behavior not previously listed in ICD-O-3. According to the WHO 4th Ed Tumors of Soft Tissue & Bone, this histology has been given a benign (/1) behavior; however, if the pathologist and/or physician state the tumor is malignant or metastatic, report the case and assign behavior code /3. |
2018 |
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20180013 | Reportability--Brain and CNS: Are tuberous sclerosis cancers found in the brain reportable? See Discussion. |
I have searched ICD-O-3 for a histology listing but could not locate. I also searched the SEER Inquiry database for possible answers, but none were found. The patient underwent a pediatric MRI of the brain of which final impression was: 1) Subependymoma nodules, cortical tubers, and SEGAs are seen bilaterally consistent with tuberous sclerosis. |
SEGA (Subependymal giant cell astrocytoma) is reportable if diagnosed in 2004 or later. Tuberous sclerosis complex (TSC) is not a neoplasm and is not reportable. SEGA is a neoplasm that commonly occurs in TSC patients. Refer to the reportability instructions on pages 5-7 in the SEER manual, https://seer.cancer.gov/manuals/2016/SPCSM_2016_maindoc.pdf |
2018 |
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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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20180009 | Reportability--Head & Neck: Is dentinoameloblastoma reportable, and if so, what is the correct histology code? See Discussion. |
Mixed odontogenic tumor consistent with dentinoameloblastoma, 9.5 cm, See Note: Tumor involves maxillary bone including hard palate, alveolar ridges, nasal cavities and maxillary sinuses bilaterally and buccal soft tissue. Lymphovascular invasion not identified. Perineural invasion not identified. Margins: Tumor involves right posterior bone (alveolar) margin. All other margins negative. Note: This is a rare hybrid tumor showing features of ameloblastoma producing pre-dentin/osteodentin matrix. Submucosal tumor is seen in the nasal cavities and palate. A congo red stain shows that the acellular dentin-like matrix fluoresces similar to collagen after polarization. Immunohistochemistry shows that the tumor cells are diffusely and strongly positive for p63, focally positive for CK19, and negative for CK5/6, SOX10, S100 and calretinin. |
Dentinoameloblastoma is not reportable. It is a variant of ameloblastoma which produces dentin and/or osteoid. It is benign. It can extend locally in a rather aggressive fashion, but is not given a malignant designation unless it metastasizes. |
2018 |
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20180090 | Reportability--Ovary: Is an ovarian serous borderline tumor with microinvasion with serous tumor aggregates (3 mm in greatest dimension) in 2 of 10 pelvic lymph nodes reportable? See Discussion. |
SINQ 20170043 is a similar question about an ovarian mucinous borderline tumor with microinvasion, but the answer seems to be specifically referencing mucinous tumors only. It is unclear if that SINQ could be applied to this case. In addition, we were not sure how to interpret the nodal involvement. The physician assessment after surgery was low grade serous carcinoma, chemo not recommended and letrozole started. |
Ovarian serous borderline tumor with node implants is not reportable; it is a borderline neoplasm. However, if the oncologist believes he or she is dealing with a low grade serous carcinoma rather than a borderline tumor, this case is reportable. We recommend that you determine whether the diagnosis of low grade serous carcinoma, chemotherapy not recommended, is based on the pathological findings or on something else before reporting this case. |
2018 |
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20180105 | 2018 Solid Tumor Rules/Histology--Lung: What is the appropriate histology code for the case below in the Discussion section? Is there a difference between adenocarcinoma in situ (bronchioloalveolar carcinoma), non-mucinous type (8252/2) and adenocarcinoma in-situ, mucinous? See Discussion. |
Procedure: Wedge, resection specimen, Laterality: Right, Tumor site: Right upper lobe, Tumor size: 1.0 cm in greatest dimension, Histologic type: Adenocarcinoma in-situ, mucinous, Histologic grade: N/A, Visceral pleura invasion: Not identified, Tumor extension: N/A, Margins: Uninvolved, Lymphocytosis. |
Assign 8253/2 for adenocarcinoma in situ, mucinous. New codes were added in 2018 for mucinous adenocarcinoma in situ for lung cancer only as all cases were not invasive. Pathologist are discouraged from using the term BAC. In-situ lung tumors can now be identified as either mucinous or non-mucinous and the appropriate ICD-O code should be assigned based on diagnosis. |
2018 |
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20180104 | Reportability--Ambiguous terminology: Are the following terms reportable: almost certainly and until proven otherwise? See Discussion. |
Example 1: Physician states patient has an almost certain melanoma. Due to the patient's age, there is no plan to for any treatment or further workup. Almost certain is not listed as a reportable phrase, so typically we would not accession this case. Example 2: Imaging states a diagnosis of renal cell carcinoma until proven otherwise. No additional workup is available at this facility. This terminology is also not seen on the ambiguous reportable terminology list but we are seeing it more often and wanted confirmation. |
Use the ambiguous terminology list as a last resort. Consult with the physician and search for further information to assist with the decision. If no further information can be obtained, use the ambiguous terms list to decide; in this case, the terms are not on the list and these examples would not be reportable. |
2018 |