Scenario:
- 01/01/2023 LEFT HEPATIC DUCT STRICTURE BRUSHING, CYTOLOGY WITH CELL BLOCK: ADENOCARCINOMA
- Oncologist/GI Multidisciplinary Conference Stage IV (cT2N1M1) intrahepatic cholangiocarcinoma with pulmonary metastases, regional lymphadenopathy, and multifocal hepatic involvement
Question: How should the histology be assigned?
- 8140 Adenocarcinoma
- 8160 Cholangiocarcinoma
Answer: 8140 Adenocarcinoma
Rationale:
Solid Tumor Rules Other
- [New Note included in Solid Tumor Rules Other for 2023]
- Coding notes for Cholangiocarcinoma: Intrahepatic cholangiocarcinomas are almost exclusively adenocarcinomas and often diagnosed by cytology. Additional diagnostic molecular tests and clinical collaboration are needed to define a diagnosis of cholangiocarcinoma. Clinicians often indicate a clinical diagnosis of cholangiocarcinoma without pathologic confirmation. Per histology coding rules, pathology and cytology have priority over clinical/physician diagnosis. If the diagnosis of cholangiocarcinoma is made on a resected specimen, then code this histology.
Case also sent to Ask A SEER Registrar
- A diagnosis of cholangiocarcinoma must be made on tissue–scans cannot determine histologic type for this neoplasm. Physicians often use the term cholangiocarcinoma to indicate the tumor site rather than histology. The cytology has priority so code 8140/3. Code site to C221.
*This case will not be eligible for AJCC Stage with this site/histology combination; however, it is important to follow the rules for coding histology and not to code histology based on AJCC.
TIP: Be sure to review the change log Initial publication of Other Sites Solid Tumor Rules (For use with cases 1/1/2023 and forward). https://seer.cancer.gov/tools/solidtumor/revisions.html