Revision Archive for the Solid Tumor Rules

2018 Changes

General Instructions

8/2/2018

• How to Use the Solid Tumor Rules
  • #1: Non-malignant CNS added to list of site-specific rules to use for cases diagnosed 2018+. (It had been erroneously omitted).

Breast

8/20/2018

• Table 3
  • Comedocarcinoma deleted (term no longer recommended by WHO)
  • Cribriform carcinoma 8201/2 moved to column 3 as a subtype/variant of Carcinoma NST
  • Pleomorphic carcinoma 8022/3 added as a subtype/variant of Carcinoma NST

7/19/2018

• Changes from 2007 MPH Rules
  • 3A: Added a clarification: "Subtypes/variant, architecture, pattern, and features ARE NOT CODED. The majority of in situ tumors will be coded to DCIS 8500/2."
• Rule H4: Code comedocarcinoma, in situ/non-infiltrating 8501/2 when the diagnosis is non-infiltrating/in situ comedocarcinoma and any other in situ carcinoma.
  • Rule deleted
• Rule H5: Code the combination code using Table 2 in the Equivalent Terms and Definitions when two histologies are present within the tumor.
  • Rule deleted

6/25/2018

• Equivalent or Equal Terms
  • Clarified synonyms of simultaneous
• Rule M7: Abstract a single primary when the diagnosis is Paget disease with underlying in situ or invasive carcinoma NST (duct/ductal).
  • Second bullet was deleted which stated that "in situ or invasive lobular carcinoma" was included in the rule.
• Rule M9: Abstract a single primary when simultaneous multiple tumors are carcinoma NST/duct and lobular
  • Note added to clarify that histologies must be the same behavior
• Rule M11: Abstract a single primary when separate/non-contiguous tumors are on the same row in Table 3 in the Equivalent Terms and Definitions.
  • New rule
• Rule H9: Code cribriform carcinoma 8201/3 when cribriform is mixed with any other carcinoma AND…
  • Two bullets updated to clarify when to code cribriform carcinoma
• Rule H12: Code the subtype/variant (specific histology) ONLY when there is a NOS/NST and a subtype/variant AND the subtype/variant is documented to be greater than or equal to 90% of the tumor.
  • Note added which clarifies the use of the term "component"
• Rule H15: Code a combination code when there are two histologies (two components) within a single tumor and the majority histology is unknown/not documented.
  • Note added which clarifies the use of the term "component"

Colon

8/8/2018

• M Rule: Abstract multiple primaries when there are separate, non-contiguous tumors in sites with ICD-O site codes that differ at the second CXxx and/or third CxXx character.
  • Fourth character C18X deleted from this rule
• M Rule: Abstract multiple primaries when there are separate, non-contiguous tumors in sites with ICD-O site codes that differ at the fourth characters C18X.
  • New rule added after the anastomotic site rules
• M Rule: Abstract a single primary when separate/non-contiguous tumors are on the same row in Table 1 in the Equivalent Terms and Definitions.
  • Rule moved after the clinically disease-free timing rule

7/3/2018

• Table 1: GIST behavior code corrected to /3
• Table 2: GIST (non-reportable) histology code added: 8936/1

Kidney

7/19/2018

• Table 1: "Sarcomatoid" added as a synonym for renal cell carcinoma NOS 8312. Two notes added under RCC regarding sarcomatoid carcinoma.

Lung

10/12/2018

• Coding Multiple Histologies section: Following clarifications were made:
  • Note 2 was added under term “predominant” to identify histologies which are preceded by the word predominant in the CAP protocol with reference to Table 3 for coding.
  • Note 2 added to define acceptable usage of ambiguous terminology. Examples added.
• Table 3: Histology terms that include “predominant” were added to Column 3 for Adenocarcinoma, NOS. These include:
  • Adenocarcinoma, acinar predominant 8551
  • Adenocarcinoma, micropapillary predominant 8265
  • Adenocarcinoma, papillary predominant 8260
  • Adenocarcinoma, solid predominant 8230
• New Histology Rule added to "Single Tumor" and "Multiple Tumors Abstracted as a Single Primary":
  Code the specific histology when the diagnosis is non-small cell lung carcinoma (NSCLC) consistent with (or any other ambiguous term) a specific carcinoma (such as adenocarcinoma, squamous cell carcinoma, etc.) when:
  
  
  • Clinically confirmed by a physician (attending, pathologist, oncologist, pulmonologist, etc.)
  • Patient is treated for the histology described by an ambiguous term
  • The case is accessioned (added to your database) based on ambiguous terminology and no other histology information is available/documented

8/23/2018

• M7 Rule: Abstract a single primary when separate/non-contiguous tumors in the same lung are on the same row in Table 3.
  • Clarification added: Tumors must be in the same lung

6/28/2018

• 8250/3 removed
• Removed statement that non-mucinous adenocarcinoma is equivalent to adenocarcinoma

Malignant CNS and Peripheral Nerves

10/12/2018

• Added Spinal cord C720 to reportable primary sites list, Table 2, and Rule M8

8/16/2018

• M Rule: Abstract a single primary when the patient has bilateral optic gliomas/glioblastomas 9440.
  • Rule deleted
• M Rule: Abstract multiple primaries when there are multiple CNS tumors, one of which is malignant /3 and the other is non-malignant /0 or /1...and there was resection.
  • Rule moved; is now the first rule in the Multiple Tumors Module

Non-Malignant CNS Tumors

10/12/2018

• Added Spinal cord C720 to reportable primary sites list, Table 2, and Rule M12

8/13/2018

• Hygroma 9173/0 removed from Table 6 (Specific Histologies) and added to Table 4 (Non-Reportable Histologies). Hygroma is not reportable.

8/8/2018

• M Rule: Abstract a single primary when there is a NOS and a subtype/variant of that NOS in the same CNS site (same second, third and fourth digit CXXX).
  • Rule deleted
• M Rule: Abstract a single primary when two or more separate, non-contiguous meningiomas arise in the cranial meninges.
  • Rule moved
• M Rule: Abstract a single primary when there are separate/non-contiguous tumors in the brain (multicentric/multifocal) with the same histology XXXX.
  • Rule moved

Other Sites

9/11/2018

• Rule M13: A frank in situ or malignant adenocarcinoma and an in situ or malignant tumor in a polyp are a single primary
  • Rule was inadvertently deleted. The Other Sites 2018 Rules should match the 2007 MPH version.
  • ACTION: Rule M13 has been reinserted into the M rules. This change resulted in renumbering of previous M13-M17 to current M14-M18 as posted.

Urinary Sites

8/8/2018

• M Rule: Abstract a single primary when multifocal/multicentric urothelial carcinoma NOS 8120 OR any subtypes/variants of urothelial carcinoma NOS are diagnosed simultaneously in two or more of the following sites…
  • Rule deleted
• M Rule: Abstract a single primary when tumors are diagnosed in the bladder C67_ and one or both ureter(s) C669 AND tumors are noninvasive in situ /2 urothelial carcinoma (flat tumor) 8120/2.
  • Removed reference to subtypes of 8120/2
• M Rule: Abstract a single primary when there is a NOS and a subtype/variant of that NOS
  • Rule deleted

7/31/2018

• Changes in Hierarchy for all Multiple Primary Rules
  • Refer to updated PDF for changes
• M Rule: Abstract a single primary when tumors are diagnosed in the bladder C67_ and one or both ureter(s) C669 AND tumors are noninvasive in situ /2 urothelial carcinoma (flat tumor) 8120/2.
  • Removed reference to subtypes of 8120/2
• M Rule: Abstract a single primary when there is a NOS and a subtype/variant of that NOS
  • Rule deleted

7/19/2018

• Rule M6: Abstract a single primary when separate/non-contiguous tumors are on the same row in Table 2.
  • Added Note 1: The tumors must be the same behavior. When one tumor is in situ and the other invasive, continue through the rules.