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Question: 20120092 |
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Status Final References Source 1: 2007 MP/H Rules pgs: Notes: Source 2: pgs: Notes: Question MP/H Rules/Multiple Primaries/Recurrence: Can we use the statement of “recurrence” by the pathologist who reviewed all slides to code a single primary if a diagnosis of “squamous cell carcinoma” of the LUL lung is followed three years later by pneumonectomy diagnosis of “adenocarcinoma”? See discussion. Discussion 7/12/07 LUL lobectomy found squamous cell carcinoma. The patient then had a left lung completion pneumonectomy on 3/9/10 with final path dx of adenocarcinoma, histologic subtype: predominantly acinar. The diagnosis COMMENT on the pathology report indicates that the previous lobectomy specimen from 2007 was reviewed and “there are areas that appear histologically similar to the current neoplasm. Thus, the findings are most compatible with recurrence.” Should a single primary be coded in this case per MP/H Coding Rules, General Instructions, Multiple Primaries for Solid Malignant Tumors, General Information instruction #7 because a pathologist did refer to the 3/9/10 diagnosis as a “recurrence” of the 7/12/07 diagnosis after reviewing the original slides in spite of reporting different histologies for each tumor? Answer This is a single primary diagnosed in 2007. The 2010 diagnosis is not a new primary because the physician compared the 2007 and 2010 slides and made this determination. History Last Updated 01/16/2013 Date Finalized 01/16/2013 |