Question: 20190062

Status


Final

Category


#1:   Solid Tumor Rules (2018)
#2:   Histology
#3:   Brain and CNS


References


Source 1:   2018 Solid Tumor Rules
pgs:  
Notes:   Malignant CNS, July 2019 Update
Source 2:   ICD-O-3
pgs:  
Notes:  


Question


Solid Tumor Rules (2018)/Histology--Brain: How is histology coded for a left frontal lobe mass when the final diagnosis is malignant neuroglial tumor and the diagnosis comment describes multiple possible histologies? See Discussion.



Discussion


Left frontal mass biopsy diagnosis comment states: Given the synaptophysin and patchy CD34 staining of these cells, the possibility of ganglioglioma and pleomorphic xanthoastrocytoma is raised. Astroblastoma and ependymoma were considered given the perivascular pseudorosettes, however GFAP staining is quite limited against these tumors. Reticulin stain shows limited perivascular reticulin staining however. Nevertheless, the necrosis, mitotic activity and elevated mitotic activity would point to a malignant neoplasm. Given the neural and limited GFAP staining, a generic classification of neuroglial is provided.
This is the only available information. Further clarification or discussion with the physician or pathologist is not possible. Therefore, is this diagnosis of neuroglial tumor equivalent to that described in SINQ 20091037?



Answer


Code to 8000/3. Use text fields to record the details.

The WHO Revised 4th Ed CNS Tumors includes a chapter for "Neuronal and mixed neuronal-glial tumors. This chapter lists 13 histologies in this category. Glioneuronal NOS is not listed. Do not assign 9505 because ambiguous terminology was used AND because of the numerous possible histologies discussed for this diagnosis.



History




Last Updated


08/08/2019

Date Finalized


09/04/2019