Semptember 2021 Revision History for the Solid Tumor Rules

General Changes
- Effective dates for “Other Sites” rules extended to 2022 throughout
Important Information for Coding Histology
- Information added about 2022 Guidelines for ICD-O-3.2 Histology Code and Behavior Update, effective for cases diagnosed 1/1/2022 forward

Terms that are NOT Equivalent or Equal
- Added: "Invasive carcinoma, NST with lobular features is not equivalent to invasive carcinoma with ductal and lobular features"
Table 3: Specific Histologies, NOS/ NST, and Subtypes/Variants
- Carcinoma NST 8500 row:
  - Synonyms added:
    - Carcinoma/carcinoma NST with neuroendocrine features
    - DCIS of high nuclear grade 8500/2
    - DCIS of intermediate nuclear grade 8500/2
    - DCIS of low nuclear grade 8500/2
    - Duct/ductal carcinoma with neuroendocrine features
    - Invasive carcinoma with medullary features 8500/3
    - Invasive carcinoma with neuroendocrine features 8500/3
    - Invasive mammary carcinoma NST with neuroendocrine features 8500/3
  - Subtype/variants added:
    - Ductal carcinoma in situ, solid type/intraductal carcinoma, solid type 8230/2
    - Solid carcinoma/solid adenocarcinoma 8230/3
  - Synonym added for cribriform carcinoma 8201/3:
    - Ductal carcinoma, cribriform type
- Lobular carcinoma 8520 row:
  - Synonym added:
    - Florid lobular carcinoma 8520/2
- Papillary carcinoma 8503 row:
  - Synonyms added:
    - Invasive ductal papillary carcinoma 8503/3
    - Papillary carcinoma of breast, NOS 8503/3
  - Subtype/variant added:
    - Tall cell carcinoma with reverse polarity 8509/3
- Sarcoma NOS 8800/3 row:
  - Angiosarcoma note modified: “Hemangiosarcoma” removed from note (it is not a subtype of angiosarcoma, it is a synonym)
  - Synonym added for angiosarcoma 9120/3:
    - Epithelioid angiosarcoma
Histology Rules
- H rule: Code metaplastic carcinoma, NOS, or subtype/variant of metaplastic carcinoma, NOS when invasive carcinoma …
  - "Or invasive lobular carcinoma" added to rule statement

Equivalent or Equal Terms
- Clarification added for "Carcinoma; Adenocarcinoma":
  - "A histology type must be stated for these terms to be equal"
  - Example added: "Mucinous carcinoma and mucinous adenocarcinoma are both coded 8480"
Terms that are NOT Equivalent or Equal
- Carcinoma, NOS 8010 is not equivalent to adenocarcinoma, NOS 8140
Table 1: Specific Histologies, NOS/ NST, and Subtypes/Variants
- Adenocarcinoma row:
  - "High grade appendiceal mucinous neoplasm (HAMN)/Low grade appendiceal mucinous neoplasm 8480- see Note 3" added
  - Note 3 added: "Effective 1/1/2022, LAMN becomes reportable and is coded 8480/2, unless the pathologist indicates invasive behavior, which is coded 8480/3. HAMN can be either /2 or /3 depending on the pathologist statement of behavior."
Table 2: Histologies Not Reportable for Colon, Rectosigmoid and Rectum
- New polyp terminologies added:
  - Adenomatous polyp, high grade dysplasia 8210/2
  - Intestinal-type adenoma, high grade 8144/2
  - Serrated dysplasia, high grade 8213/2
  - Tubular adenoma, high grade 8211/2
  - Villous adenoma, high grade 8261/2
- LAMN row:
  - Note added: "Note: LAMN is non-reportable for cases diagnosed prior to 1/1/2022. Beginning 1/1/2022, LAMN becomes a reportable neoplasm- See Table 1"
Histology Rules
- New rule: "Code low grade appendiceal mucinous neoplasm (LAMN) and high grade appendiceal mucinous neoplasm (HAMN) 8480/2 when…"
- Mucinous Adenocarcinoma rule:
  - LAMN/HAMN terminology added
- Anastomosis rules:
  - Timing interval changed from 24 to 36 months

New for 2022
- New section added
Equivalent or Equal Terms:
- Terms added:
  - Squamous cell carcinoma, HPV-negative; squamous cell carcinoma, HPV-independent (8086)
  - Squamous cell carcinoma, HPV-positive; squamous cell carcinoma, HPV-associated; squamous cell carcinoma, HPV-related (8085)
Table 1: Tumors of Nasal Cavity, Paranasal Sinuses and Skull base
- Non-keratinizing squamous cell carcinoma 8072 row deleted; histology moved to the subtype/variant column of the SCC row
- Squamous cell carcinoma 8070 row:
  - Synonyms added:
    - Squamous cell carcinoma, usual type 8070/3
    - Conventional Squamous cell carcinoma NOS
    - Epidermoid carcinoma, NOS 8070/3
    - Epidermoid carcinoma in situ, NOS 8070/2
    - Squamous carcinoma 8070/3
    - Squamous cell carcinoma in situ, NOS 8070/2
    - Squamous cell epithelioma 8070/3
    - Intraepithelial squamous cell carcinoma 8070/2
  - Subtypes/variants added:
    - Squamous cell carcinoma, large cell, nonkeratinizing/Squamous cell carcinoma, nonkeratinizing, NOS 8072
    - Schneiderian carcinoma/cylindrical cell carcinoma 8121
    - Sarcomatoid squamous cell carcinoma/spindle cell squamous cell carcinoma (SC-SCC) 8074
  - Synonyms added for keratinizing squamous cell carcinoma 8071:
    - Epidermoid carcinoma, keratinizing
    - Squamous cell carcinoma, large cell, keratinizing
Table 2: Tumors of Nasopharynx
- Squamous cell carcinoma row 8070:
  - Subtypes/variants added:
    - Lymphoepithelial carcinoma 8082
    - Undifferentiated carcinoma/Undifferentiated carcinoma with lymphoid stroma 8020
Table 3: Tumors of Pyriform Sinus, Hypopharynx, Larynx, Trachea, and Parapharyngeal Space
- Squamous cell carcinoma 8070 row:
  - Synonym added:
    - "Non-keratinizing squamous cell carcinoma 8072" added as a subtype/variant
Table 4: Tumors of Oral Cavity and Mobile Tongue
- C024 Lingual tonsil removed from Table 4 and moved to Table 5
- Synonym added:
  - Conventional Squamous cell carcinoma NOS
Table 5: Tumors of the Oropharynx, Base of Tongue, Tonsils, Adenoids
- C024 Lingual tonsil added to Table 5
- Instructions added for coding SCC HPV+ and SCC HPV-
- Squamous cell carcinoma row 8070:
  - Notes added:
    - "Beginning 1/1/2022, keratinizing squamous cell carcinoma, HPV negative is coded 8086 for sites listed in Table 5 only. A diagnosis of keratinizing squamous cell carcinoma, NOS is coded 8071."
    - "Beginning 1/1/2022, non-keratinizing squamous cell carcinoma, HPV positive is coded 8085 for sites listed in Table 5 only. A diagnosis of non-keratinizing squamous cell carcinoma, NOS is coded 8072."
  - Synonym added:
    - Conventional Squamous cell carcinoma NOS
  - Instructions added to column 3 regarding coding SCC HPV+ and SCC HPV-
Table 6: Tumors of Salivary Glands
- Squamous cell carcinoma row 8070:
  - Synonym added:
    - Conventional Squamous cell carcinoma NOS
Table 10: Paired Sites
- Tonsil changed to "C098, C099"

Table 1: Specific Histologies, NOS/ NST, and Subtypes/Variants
- Renal cell carcinoma row:
  - Note 3 added: "Continue coding sarcomatoid renal cell carcinoma as 8312 until otherwise indicated."
  - "Succinate dehydrogenase-deficient renal cell carcinoma (SDHS) 8311* (reportable beginning 1/1/2022)" added as a subtype/variant
- Sarcoma row:
  - Spindle cell/sclerosing rhabdomyosarcoma 8912/3 moved to be indented under Rhabdomyosarcoma 8900/3 (error fix)
Multiple Primary Rules
- Rule M7: Abstract multiple primaries when separate/non-contiguous tumors are two or more different subtypes/variants in Column 3, Table 1 in the Equivalent Terms and Definitions
  - Note 2 added regarding combinations of 8311

Table 2: Combination/Mixed Histology Codes
- Combined small cell carcinoma row 8045:
  - "(includes large cell neuroendocrine carcinoma)" added to third bullet
Multiple Primary Rules
- M Rule: Abstract a single primary when there are simultaneous multiple tumors…
  - Note added to emphasize that the tumors must be diagnosed simultaneously
- M Rule: Abstract multiple primaries when there is a single tumor in each lung…
  - Note 6 added: "Tumors do not need to be diagnosed at the same time (simultaneous or synchronous)."

Introduction
- Clarification added: "See the Non-malignant CNS Rules when the primary site is optic nerve and the diagnosis is either optic glioma or pilocytic astrocytoma. The behavior for these tumors is non-malignant and coded 9421/1."
Table 3: Specific Histologies, NOS, and Subtypes/Variants
- Malignant peripheral nerve sheath tumor 9540 row:
  - Added as a subtype/variant: "Epithelioid malignant peripheral nerve sheath tumor 9542"

Terms that are Not Equivalent or Equal
- Added: Papillary growth pattern is not equivalent to papillary urothelial carcinoma
Coding Histology
- Instruction #4: DO NOT CODE histology when described as:
  - "Configuration" removed from list
  - "Growth pattern" added to list

Multiple Primary Rules
- Same row rule:
  - Removed text "Tumors must have the same laterality" (was unnecessary)
- Last resort rule:
  - Note removed: "When an invasive melanoma follows an in situ melanoma within 60 days, abstract as a single primary." (note was unnecessary and misleading)
Histology Rules
- Rule H1: Code the histology when only one histologic type is identified.
  - Note added: "When the histology includes the term regressing or regression, continue through the rules."
  - Note added: "When the histology includes the term lentigo maligna melanoma, continue through the rules."

Table 2: Mixed and Combination Codes
- Gyn malignancies with two or more of the histologies in column 2 row:
  - Note added: "First refer to ICD-O-3.2 and ICD-O updates to confirm if the mixed histology has a specific code. Example: papillary serous adenocarcinoma is coded 8460 per ICD-O."
Histology Rules
- H Rule: Rule H4 Code the most specific histologic term when the diagnosis is…
  - Bullet added: "Sarcoma, NOS (8800) and a specific sarcoma"

September 2021 Revision History for the Solid Tumor Rules

General Instructions

Breast

Colon

Head and Neck

Kidney

Lung

Malignant CNS

Urinary

Melanoma

Other Sites