Tumor Tip of the Week-09-28-2023 Clearing up Confusion on LVI -Thyroid and Adrenal vs All Other Primaries

Scenario #1

Colon Resection:

  • Lymphovascular Invasion: Large vessel (venous), extramural
Scenario#2

Thyroidectomy:

  • Angioinvasion (Vascular Invasion): Present
  • Lymphatic Invasion: Not Identified
Question: How will you Code LVI?

  • 1 Lymphovascular Invasion Present/Identified (NOT used for thyroid and adrenal)

 

  • 2 Lymphatic and small vessel invasion only (L)

OR

Lymphatic invasion only (thyroid and adrenal only)

 

  • 3 Venous (large vessel) invasion only (V)

OR

Angioinvasion (thyroid and adrenal only)

 

  • 4 BOTH lymphatic and small vessel AND venous (large vessel) invasion

OR

BOTH lymphatic AND angioinvasion (thyroid and adrenal only)

Question: How will you Code LVI?

  • 1 Lymphovascular Invasion Present/Identified (NOT used for thyroid and adrenal)

 

  • 2 Lymphatic and small vessel invasion only (L)

OR

Lymphatic invasion only (thyroid and adrenal only)

 

  • 3 Venous (large vessel) invasion only (V)

OR

Angioinvasion (thyroid and adrenal only)

 

  • 4 BOTH lymphatic and small vessel AND venous (large vessel) invasion

OR

BOTH lymphatic AND angioinvasion (thyroid and adrenal only)

Answer: 3 Venous (large vessel) invasion only (V)

 

Answer: 3 Angioinvasion (thyroid and adrenal only)

Discussion:  We have noticed some confusion lately, some have the notion that the codes 2,3,4 are only to be used for Thyroid & Adrenal Cases.

This just isn’t the case.   It may look confusing in the drop-down menu of your software, but the actual manual makes it a little bit easier to see the differences.