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    Texas Cancer Registry Cancer Reporting Handbook

    July 2012 A-111

    Appendix C18.1

    CS Site-Specific Factor 2

    Clinical Assessment of Regional Lymph Nodes

    Note 1: Only include information from imaging and physical examination in this item. Do not

    include information on regional lymph nodes that is based on surgical observation or diagnostic

    lymph node biopsy.Note 2: In the rare instance that the number of clinically positive nodes is stated but a clinical N

    category is not stated, code 1-3 nodes as 100 (N1), and 4 or more nodes as 200 (N2).

    Note 3: If there is no diagnostic work-up to assess regional lymph nodes, use code 999. Do not

    apply the inaccessible nodes rule that presumes unmentioned nodes to be negative.

    See page A-13

    Code Description

    000Nodes not clinically evident; imaging of regional nodes performed and nodes not

    mentioned

    100Metastasis in 1 - 3 regional lymph nodes, determined clinically

    Stated as clinical N1

    200Metastasis in 4 or more regional lymph nodes, determined clinically

    Stated as clinical N2

    400 Clinically positive regional nodes, NOS

    988

    Not applicable: Information not collected for this case

    (May include cases converted from code 888 used in CSv1 for "Not applicable" or

    when the item was not collected. If this item is required to derive T, N, M, or anystage, use of code 988 may result in an error.)

    999 Regional lymph node(s) involved pathologically, clinical assessment not stated

    Unknown if regional nodes clinically evident

    Not documented in patient record

    Appendix C18.1

    CS Site-Specific Factor 11

    Histopathologic Grading

    Note 1: Histologic grading is used to distinguish between IVA and IVB anatomic stage/prognosticgroups. It is considered to be of particular importance for mucinous carcinomas (morphology codes

    8480, 8481, and 8490).

    Note 2:Select the code for the highest grade from the most representative sample of primary tumor

    tissue as described on the pathology report.

    Note 3: The term "undifferentiated" should not apply to mucinous tumors because a tumor that

    makes mucin is, by definition, differentiated into mucin-producing tumor cells.

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    Texas Cancer Registry Cancer Reporting Handbook

    July 2012 A-113

    Code Description

    998 No pathologic confirmation of primary site tumor

    999Unknown or no information

    Not documented in patient record

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    Texas Cancer Registry Cancer Reporting Handbook

    July 2012 A-114

    Carcinoid Appendix C18.1

    CS Site-Specific Factor 2

    Clinical Assessment of Regional Lymph Nodes

    Note 1: Only include information from imaging and physical examination in this item. Do not

    include information on regional lymph nodes that is based on surgical observation or diagnostic

    lymph node biopsy.

    Note 2: Use code 400 if regional lymph nodes are involved clinically but there is no indication of the

    number of nodes involved.

    Note 3: If there is no diagnostic work-up to assess regional lymph nodes, use code 999. Do not

    apply the inaccessible nodes rule that presumes unmentioned nodes to be negative.

    Code Description

    000Nodes not clinically evident; imaging of regional nodes performed and nodes not

    mentioned

    100Metastasis in 1 3 regional lymph nodes, determined clinically

    Stated as clinical N1

    200Metastasis in 4 or more regional lymph nodes, determined clinically

    Stated as clinical N2

    400 Clinically positive regional nodes, NOS

    988

    Not applicable: Information not collected for this case

    (May include cases converted from code 888 used in CSv1 for "Not applicable" or

    when the item was not collected. If this item is required to derive T, N, M, or any

    stage, use of code 988 may result in an error.)

    999

    Regional lymph node(s) involved, clinical assessment not stated

    Unknown if regional nodes clinically evident

    Not documented in patient record

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    Texas Cancer Registry Cancer Reporting Handbook

    July 2012 A-115

    GISTAppendix C18.1

    CS Site-Specific Factor 11

    Mitotic Count

    Note 1: The mitotic rate the count of mitoses per 50 high-power fields (HPF), reflects the potential

    aggressiveness or prognosis of gastrointestinal stromal tumors (GIST) and is used alone to determine

    their histologic grade (low or high). The mitotic rate is also a factor in assigning the AJCC 7anatomic stage/prognostic group. This site-specific factor presumes the denominator of 50 HPF or its

    equivalent, so just the numerator (the mitotic count) is coded here. For other schemas in which

    mitotic count is collected, the denominator may vary.

    Note 2: A HPF usually has a magnification objective of 40 (a 40x field). As described in the AJCC

    chapter on GIST, 50 HPF are equivalent to viewing a total area of 5 square millimeters (mm) at 40x

    magnification.

    Note 3: Record mitotic count, to the nearest tenth of a mitosis, as documented in the pathology

    report. For example, a mitotic count of 6/50 HPF, or 6 per 5 square mm, would be coded 060.

    Note 4: Code the specific mitotic count only per 50 HPF or 5 square mm; assume the denominator is

    50 HPF or 5 square mm if not specified. Use code 996 only if the mitotic count is expressed with a

    specific denominator other than 50 HPF or 5 square mm.See page A-14

    Code Description

    000 0.0 mitoses per 50 HPF (40x fields)

    0.0 mitoses per 5 square mm

    Mitoses absent

    No mitoses present

    001-0080.1 - 0.8 mitoses per 50 HPF (40x fields)

    0.1 - 0.8 mitoses per 5 square mm

    009

    0.9 mitoses per 50 HPF (40x fields)

    0.9 mitoses per 5 square mm

    Stated as less than 1 mitosis per 50 HPF (40x fields)

    Stated as less than 1 mitosis per 5 square mm

    010-1001 - 10 mitoses per 50 HPF (40x fields)

    1 - 10 mitoses per 5 square mm

    11011 or more mitoses per 50 HPF (40x fields)

    11 or more mitoses per 5 square mm

    988

    Not applicable: Information not collected for this case

    (If this information is required by your standard setter, use of code 988 may result

    in an edit error.)

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    Texas Cancer Registry Cancer Reporting Handbook

    July 2012 A-116

    Code Description

    990

    Specific number not stated, described as less than or equal to 5 mitoses per 50

    HPF (40x fields)

    Specific number not stated, described as less than or equal to 5 mitoses per 5

    square mm

    Stated as low mitotic count or rate with no specific number

    991Specific number not stated, described as more than 5 mitoses per 50 HPF (40x

    fields)

    Specific number not stated, described as more than 5 mitoses per 5 square mm

    Stated as high mitotic count or rate with no specific number

    996Mitotic count described with denominator other than 50 HPF (40x field)/5 square

    mm

    998 No histologic specimen from primary site

    999Unknown or no information

    Not documented in patient record


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