| ID | Status | Question | Discussion | Answer | Last Updated |
| 20091102 | Final | MP/H Rules/Histology--Thyroid: What
is the correct histology for these thyroid tumors? In each case, the path report reads, "Papillary sclerosing carcinoma." In one case, the results are in CAP protocol format and next to 'Encapsulation of tumor' it says 'No.' In the other case, it is not in CAP format, but the microscopic description says, 'encapsulation of tumor - no.' Is the correct code 8350? |
Code 8350 [Nonencapsulated
sclerosing carcinoma] per MPH Other Site Rule H11. The definition for 8350 in the Morphology section of ICD-O-3 includes nonencapsulated as well as diffuse sclerosing papillary carcinoma. When the pathologist states 'No' for encapsulated, that means nonencapsulated. |
10/01/09 | |
| 20091100 | Final | MP/H Rules/Histology--Melanoma:
Path: Melanoma in situ, lentiginous type, skin rt lower leg. Is this the same as acral lentiginous melanoma (8744)? To code to 8744, do we specifically have to see the word "acral" lentiginous melanoma? Please see discussion. |
In researching this, acral
lentiginous melanoma is observed on the palms, soles and under the nails. |
Assign 8742/2 [lentigo maligna]
to "melanoma in situ, lentiginous type." Acral lentiginous melanoma is not the same as melanoma, lentiginous type. "Acral lentiginous melanoma," 8744, should be used only if the report states acral lentiginous melanoma or malignant melanoma, acral lentiginous type.
Acral lentiginous melanoma |
10/01/09 |
| 20091096 | Final | MP/H Rules/Multiple primaries--Breast:
When an in situ diagnosis is followed by an invasive diagnosis in the same breast 1.5 years later, is it a new primary? See discussion. |
Pt had a core bx 1/07 that showed
DCIS. Pt refused resection, followed by chemo and/or XRT. A year and a half later (6/08) the pt returns for a MRM which shows infiltrating duct ca and positive LNS. The 6/08 information came in as a Correction Record. The comment in the Correction Record stated “Per MD, pt didn’t see any urgency and delayed surgery 1.5 year after diagnosis. The patient did not have any rx in that time period. Not specifically stated that pt had progression – only info is that pt had no adenopathy 1/07 and then 6/08 had positive LNS. Is the 6/08 a new primary? |
Abstract the 6/08 invasive diagnosis
as a separate primary according to rule M8. Rule M8 applies whether or not the later diagnosis in this case is progression of disease. |
10/01/09 |
| 20091036 | Final | CS Mets at DX--Ovary:
Regarding carcinomatosis; is it always captured in CS Mets? Can the term carcinomatosis be used to describe peritoneal implants as well? Please see discussion. |
Path text: 1/18/06: CT guided biopsy
of abdominal mass & ant peritoneum nodule. Extensive carcinomatosis affecting the paracolic gutters, liver surface & pelvis. 6 cm tumor mass was visibly engulfing the small bowel & tube; poorly differentiated adenoca, mullerian derived, shows attributes of clear cell ca, high grade (FIGO III), 2.5 cm size. does not involve fallopian tube. R&L abdominal wall & mesentery, mets adenoca. CA 125= 17 OP TEXT: 1/18/06: CT guided bx of abdominal mass & ant peritoneum nodule. extensive carcinomatosis affecting the paracolic gutters, liver surface & pelvis. 6 cm tumor mass was visibly engulfing the small bowel 5/31/06: tumor debulking with right salpingo-oophorectomy. Final DX: Poorly differentiated adenoca, clear cell type, rt ovary (FIGO III), stage IV per MD |
In the case of ovarian cancer, the
term carcinomatosis may refer to peritoneal implants, especially when the implants are numerous. It does not refer to distant metastases in this context. This issue has been forwarded to the CS version 2 committee. |
10/01/09 |