12-12-2025
Scenario: {Snip from TURB Path report}
- Final Diagnosis
- Urinary bladder, transurethral resection: High grade urothelial carcinoma, with extensive invasion into lamina propria. No definitive Lymphovascular invasion identified. No muscularis propria for evaluation.
- Snip from synoptic
- Histologic Type: Urothelial carcinoma, invasive (conventional)
- Histologic Grade: High-grade
- Tumor Extent:Invades lamina propria (subepithelial connective tissue): Extensive
- Lymphatic and / or Vascular Invasion: Cannot be determined
- Tumor Configuration: Ulcerated
- Muscularis Propria (detrusor muscle): Not identified
Question: How would you code Lymphovascular Invasion?
- 0 Lymphovascular Invasion stated as Not Present
- 9 Unknown/Indeterminate/not mentioned in path report
Answer: 9 Unknown/Indeterminate/not mentioned in path report {The synoptic takes priority.}
SEER Program Coding & Staging Manual/STORE
a. The primary source of information about lymphovascular invasion is the pathology check list (synoptic report) developed by the College of American Pathologists. If the case does not have a checklist or synoptic report, code from other sections of the pathology report or a physician’s statement, in that order.
Code from pathology report(s). If not available, code the absence or presence of lymphovascular invasion as described in the medical record.
