]> C69.5 Lacrimal gland [excluding lacrimal sac, lacrimal duct] Note 1: CS Site-Specific Factor 25 is used to discriminate between lacrimal gland, staged by AJCC, and lacrimal sac, not staged by AJCC. Both sites are coded to ICD-O-3 code C69.5. Note 2: Laterality must be coded for this site. CS Tumor Size Note: Code the specific tumor size as stated in the medical record. Use code 992, 994, or 995 if the physician's statement about T value is the ONLY information available about the size of the tumor. (Refer to the CS Extension table for instructions on coding extension.) Code Description 000 No mass/tumor found 001-988 989 989 mm or larger 990 Microscopic focus or foci only and no size of focus given 991 Described as "less than 1 centimeter (cm)" 992 993 Described as "less than 3 cm," or "greater than 2 cm," or "between 2 cm and 3 cm" 994 995 996 Described as "greater than 5cm" 999 CS Extension Note 1: AJCC considers "in situ carcinoma of lacrimal gland" an impossible diagnosis. Any case so coded is mapped to TX for AJCC stage and in situ Summary Stage. Note 2: As noted by the AJCC, "As the maximum size of the lacrimal gland is 2 cm, T2 and greater tumors will usually extend into the orbital soft tissue." Note 3: Periosteum is a fibrous membrane that wraps the outer surface of bones. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 In situ, intraepithelial, noninvasive TX TX IS IS 100 Tumor confined to lacrimal gland ^ * L L 300 Localized, NOS ^ * L L 400 ERROR T3 RE RE 600 ^ T4 RE RE 610 Stated as T1 with no other information on extension ^ * L L 620 Stated as T2 with no other information on extension ^ * L L 630 Stated as T3 with no other information on extension ^ * L L 650 T4a * RE RE 700 T4b T4 RE RE 750 T4c T4 D D 800 Further contiguous extension T4c T4 D D 810 Stated as T4c with no other information on extension T4c T4 D D 815 Stated as T4 [NOS] with no other information on extension T4NOS T4 RE RE 950 No evidence of primary tumor T0 T0 U U 999 TX TX U U ^ For CS Extension codes 100, 300, and 600-630 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size as shown in the Extension Size AJCC 7 Table. * For CS Extension codes 100, 300, and 610-650 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size as shown in the Extension Size AJCC6 Table. &generalcstsexteval; &commonlymphnodeseye; &generalregnodeseval; &generalreglnpos; &generalreglnexam; &generalmetsatdx; &generalmetseval; CS Site-Specific Factor 1 Ki-67/MIB-1 Labeling Index (LI): Ophthalmic Note 1: Ki-67 antigen is a nuclear protein, expressed by cells in all phases of the active cell cycle (G1, S, G2, and M phase) and absent in resting cells (G0 phase). Tumor cells with positive staining for Ki-67 antibodies are actively growing or proliferating. The fraction of Ki-67-positive tumor cells (the Ki-67 labeling index, or LI) may correlate with the clinical course of cancer. The value is expressed as the percentage of carcinoma cells in the tissue sample with positive immunohistochemical staining for the Ki-67 protein. The staining may be performed with the MIB-1 monoclonal antibody, so the test may be referred to as either Ki-67 or MIB-1 Note 2: Code the LI fraction percentage using Ki-67 or MIB-1 when it is available in the pathology report for the primary tumor. The Ki-67 or MIB-1 LI may also be called the growth fraction or proliferative fraction. Note 3: Record the LI as an exact whole number (000-100). For example, if the LI level is recorded by the pathologist as 15%, assign code 015. If the percentage is documented as 13.7%, round up to 14% and assign code 014. If the percentage is documented as 13.2%, round down to 13% and assign code 013. If the percentage is documented as less than 0.5%, round down to 0% and code 000; if the percentage is documented as greater than 0.5% and less than 1%, round up to 1% and code as 001. Note 4: In the absence of a specific percentage value, use codes 110-140 for a stated range of the LI, or codes 991-993 for an interpretation of the LI. Code Description 000-100 110 Stated as Ki-67 growth fraction less than or equal to 5% 120 Stated as Ki-67 growth fraction greater than 5% or less than or equal to 10% 130 Stated as Ki-67 growth fraction greater than 10%,or less than or equal to 20% 140 Stated as Ki-67 growth fraction greater than 20% or less than or equal to 50% 150 Stated as Ki-67 growth fraction greater than 50% 888 988 991 Stated as low proliferation rate 992 Stated as increased proliferation rate 993 Stated as high proliferation rate 997 Ki-67 growth fraction study performed, results not available 998 Test not done (test not ordered and not performed) 999 CS Site-Specific Factor 2 Nuclear NM23 Staining Note 1: The NM23 gene located on chromosome 17 encodes the protein nucleoside diphosphate kinase. The presence of nuclear NM23 protein may be a good marker for predicting the metastatic potential of certain tumors. The value is expressed as the percentage of carcinoma cells in the tissue sample with positive nuclear staining for the NM23 protein. Note 2: Record whether nuclear NM23 staining is present as stated on the test report. Code Description 010 Positive for NM23 staining 020 Negative for NM23 staining 030 Borderline; undetermined if positive or negative 888 988 997 Test performed, results not available 998 Test not done (test not ordered and not performed) No histologic examination of primary site 999 CS Site-Specific Factor 3 Clinical Evaluation of Lymph Nodes Note 1: Code the method used to determine clinically positive regional lymph nodes. Code the type of clinical assessment, whether pathologic assessment of nodes was performed with either negative or positive results. Note 2: Use code 000 if physical or radiologic examination is documented with no statement of positive nodal involvement. Use code 010 or 020 if the results of either physical or radiologic examination are positive, whether or not the results of the other examination are documented. Use code 997 if documentation indicates either type of examination was performed but no results are available. Use code 999 if no documentation of physical or radiologic examination is available in the medical record. Code Description 000 No involvement of regional lymph nodes on physical and/or radiologic examination 010 Positive involvement of regional nodes on physical examination only 020 Positive involvement of regional nodes on radiologic examination only 030 Positive involvement of regional nodes on physical and radiologic examination 888 988 997 Physical and/or radiologic examination performed, results not available 998 No clinical evaluation of nodal involvement 999 CS Site-Specific Factor 4 Perineural Invasion Note: Code the presence or absence of perineural invasion as documented in the pathology report. Assign code 999 if histologic examination of the primary site is performed and perineural invasion is not mentioned. Code Description 000 Perineural invasion not present/not identified 010 Perineural Invasion present/identified 888 988 998 No histologic examination of primary site 999 CS Site-Specific Factor 5 Carcinoma ex Pleomorphic Adenoma, Invasion Beyond Capsule Note 1: Code only for cases described as arising from a benign pleomorphic adenoma. The diagnosis may be stated as carcinoma ex pleomorphic adenoma or carcinoma arising from a mixed tumor or mixed tumor of salivary gland type. The histology code assigned to the case may be 8941/3, or other codes for carcinoma. Extent of invasion beyond capsule is a prognostic factor for these glandular tumors. Note 2: Use code 000 for no invasion beyond capsule. Use codes 001-979 if specific measurement is given for invasion beyond capsule. Use code 990 if invasion is only described as "minimally invasive" or "less than 1.5mm" or "less than or equal to 1.5 mm". Note 3: Use code 987 for all cases with pathologic examination of primary site not described as arising from a benign adenoma. Use code 998 if no pathologic examination of primary site. Code Description 000 Noninvasive, confined within the capsule 001 002 003-979 980 98.0 mm or greater invasion beyond capsule 987 Not applicable: Histology not carcinoma ex pleomorphic adenoma 988 990 Minimally invasive Stated as "less than 1.5 mm invasion beyond capsule" Stated as "less than or equal to 1.5 mm invasion beyond capsule" 991 Stated as "greater than 1.5 mm invasion beyond capsule" 997 998 No pathologic examination of primary site 999 CS Site-Specific Factor 6 Adenoid Cystic Carcinoma - Presence of Basaloid Pattern Note 1: Code only for cases diagnosed as adenoid cystic carcinoma, histology code 8200/3. Note 2: Use code 987 for all other histologies. Use code 998 if no pathologic examination of primary site. Code Description 000 Basaloid pattern not present in adenoid cystic carcinoma 010 Basaloid pattern present in adenoid cystic carcinoma 020 888 987 Not applicable, histology not adenoid cystic carcinoma 988 998 No pathologic examination of primary site 999 CS Site-Specific Factor 7 Mucoepidermoid Carcinoma - Grade Note: Code only for cases diagnosed as mucoepidermoid carcinoma, histology code 8430/3. Note 2: Use code 987 for all other histologies. Use code 998 if no pathologic examination of primary site. Use code 999 if grade not stated on pathologic examination. Code Description 010 Low grade 020 High grade 987 Not applicable: Histology not mucoepidermoid carcinoma 988 998 No pathologic examination of primary site 999 CS Site-Specific Factor 8 Orbital Bone Note: Code removal of orbital bone during surgery of primary site. Code Description 000 Orbital bone not removed in surgery of primary site 010 Orbital bone removed in surgery of primary site 020 988 990 997 998 No surgery of primary site 999 ¬appnewssf9; ¬appnewssf10; ¬appnewssf11; ¬appnewssf12; ¬appnewssf13; ¬appnewssf14; ¬appnewssf15; ¬appnewssf16; ¬appnewssf17; ¬appnewssf18; ¬appnewssf19; ¬appnewssf20; ¬appnewssf21; ¬appnewssf22; ¬appnewssf23; ¬appnewssf24; &commonssf25lacrimal; &commonhistinclusioncarcinoma; &commonhistologyexclusions1; ¬appscsstageanytnm7; ¬appscsstageanytnm; &commonsummarystage; Extension Size AJCC 7 Table Note: For CS Extension codes 100, 300, and 600-630 ONLY, the T category is assigned based on the value of CS Tumor Size and CS Extension as shown in this table. CS Extension CS Tumor Size 000 0 CS Tumor Size 001-020 1 20 CS Tumor Size 021-040 21 40 CS Tumor Size 041-989 41 989 CS Tumor Size 990-991 990 991 CS Tumor Size 992-993 992 993 CS Tumor Size 994 994 CS Tumor Size 995 995 CS Tumor Size 996 996 CS Tumor Size 999 999 100 ERROR T1 T2 T3 T1 T1 T2 T3 T3 TX 300 ERROR T1 T2 T3 T1 T1 T2 T3 T3 TX 600 ERROR T1 T2 T3 T1 T1 T2 T3 T3 TX 610 ERROR T1 T2 T3 T1 T1 T1 T1 T3 T1 620 ERROR T1 T2 T3 T1 T2 T2 T2 T3 T2 630 ERROR T1 T2 T3 T1 T3 T3 T3 T3 T3 Extension Size AJCC 6 Table Note: For CS Extension codes 100, 300, and 610-650 ONLY, the T category is assigned based on the value of CS Tumor Size and CS Extension as shown in this table, CS Extension CS Tumor Size 000 0 CS Tumor Size 001-025 1 25 CS Tumor Size 026-050 26 50 CS Tumor Size 051-989 51 989 CS Tumor Size 990-991 990 991 CS Tumor Size 992-993 992 993 CS Tumor Size 994-995 994 995 CS Tumor Size 996 996 CS Tumor Size 999 999 100 ERROR T1 T2 T2 T1 T1 T2 T2 TX 300 ERROR T1 T2 T2 T1 T1 T2 T2 TX 610 ERROR T1 T2 T2 T1 T1 T1 T2 T1 620 ERROR T1 T2 T2 T1 T2 T2 T2 T2 630 ERROR T1 T2 T2 T1 T2 T2 T2 T2 650 ERROR T3a T3a T3b T3a T3a T3a T3b T3NOS