V.4.3 Lymph-Vascular Invasion

Coding Instructions:

• Lymph-Vascular Invasion (LVI) status is required by the CCR for all sites when available.

• LVI is required by the CCR for primary sites penis (C60.0; C60.8-C609.) and testis (C62.0-C62.1) for cases diagnosed 1/1/2010 and forward.  

• The primary source of this information is the College of American Pathologists (CAP) synoptic report or checklist.  If the CAP is not available, code this data item from the pathology report or a physician’s statement within the medical record, in that order of priority.

• Perineural invasion is not coded in this field.

• Information to code this field can be taken from any specimen (biopsy or resection) from the primary tumor.

• Benign or borderline tumors are to be coded if lymph-vascular invasion is documented in the medical record. If not documented, code to unknown.

• For cases treated with neoadjuvant therapy, refer to table below in order to code this field. However, if documentation in the medical record indicates information that conflicts with this table, code lymph-vascular invasion with the documentation in the medical record.

• Use code 0:

• When the pathology report indicates no lymph-vascular invasion.

• Purely in situ carcinoma, which biologically has no access to lymphatic or vascular channels below the basement membrane.

• Use code 1, when the pathology report indicates lymph-vascular invasion is present.

• Use code 8 for the following sites:

• Hodgkin and Non-Hodgkin lymphoma

• Leukemia’s

• Hematopoietic and reticuloendothelial disorders

• Myelodysplastic syndromes including refractory anemias and refractory cytopenias

• Myeloproliferative disorders

• Use code 9 when:

• There is no microscopic examination of a primary tissue specimen

• The primary site specimen is a cytology or fine needle aspiration

• The biopsy is only a very small tissue sample

• It is not possible to determine whether lymph-vascular invasion is present.

• The pathologist states the specimen is insufficient to determine lymph-vascular invasion.

• Lymph-vascular invasion is not mentioned in the pathology report

• Primary site is unknown.

• This field is to be left blank for cases diagnosed before 2010.

Codes:

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