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Question: 20130192 Status
Final

References
Source 1:   2007 MP/H Rules
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Notes:  
Source 2:  
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Question
MP/H Rules/Histology--Pleura: How is histology coded when a Final Diagnosis is “malignant neoplasm, compatible with malignant mesothelioma” if the COMMENT section of the pathology report indicates the tumor has a mixed epithelial and sarcomatoid pattern? See discussion.

Discussion
This case was discussed with a pathologist, who feels the correct histology should be biphasic mesothelioma (9053/3) because there are both epithelial and sarcomatoid components to this tumor. However, when you apply the current MP/H Rules, the histology is coded to 9050/3 (mesothelioma, NOS) because the term "pattern" cannot be used to code a more specific histologic type for invasive tumors. If this really is a biphasic mesothelioma, that data is lost for researchers, because the current MP/H Rules fail to allow us to capture this information. Should the term pattern be used to code the more specific histology in this case?

Answer
Apply the MP/H rules as written until they are revised. The word "pattern" and other terms will be reconsidered for the next iteration of the rules.

History


Last Updated
10/22/2013

Date Finalized
02/05/2014