Question: 20180112

Status


Final

Category


#1:   Solid Tumor Rules (2018)
#2:   Histology
#3:   Lung


References


Source 1:   2018 Solid Tumor Rules
pgs:  
Notes:   Lung, 10/12/2018
Source 2:  
pgs:  
Notes:  


Question


Solid Tumor Rules (2018)/Histology--Lung: What is the histology code of a non-small cell lung cancer (NSCLC), NOS as this is not on the AJCC list of histologies?  See Discussion. 



Discussion


A question was posted to CAnswer forum 9/26/18 and answered stating that 8046 is not on the AJCC list of histologies for the lung chapter in the 8th edition. If the final diagnosis on the pathology report is just NSCLC, NOS with no subtype/variant, what histology/solid tumor rule would I use? In this situation, I am not able to query the pathologist. Would I code the histology to 8010 as per AJCC post?



Answer


Code NSCLC to 8046/3.

Do not change a histology code simply to assign TNM to the case. AJCC does not determine histology coding.  While pathologists are no longer encouraged to use NSCLC, it does not mean the term and code are obsolete. NSCLC could be any number of histologies such as adenocarcinoma or squamous carcinoma. A diagnosis of NSCLC indicates that the initial exam of the tissue did not identify a more specific type of NSCLC. Additional immunohistochemical testing is needed to determine the histology. Update the case if better information becomes available from subsequent tests/review. 

When analyzing the data, researchers and physicians will be able to identify the cases where the pathologist was unable to or did not perform further testing to determine a specific histology which drives treatment and survival.



History




Last Updated


12/20/2018

Date Finalized


02/14/2019