September 29, 2023
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.
- Code 1 is never used for Thyroid & Adrenal Cases.
- Code 2-4 can be used for any case, but these codes have different meanings for Thyroid & Adrenal Cases.
- For Example:
- Code 3 means Venous (large vessel) invasion only (V) for all cases except Thyroid & Adrenal cases.
- Code 3 means Angioinvasion for Thyroid and Adrenal Cases.
