Wiki Lymph node metastasis

[gabetteyoung@yahoo.com]

If a pathology report comes back and in the "left axillary contents" section it states the total number of nodes examined was 7 and 3 were involved by tumor cells, would that be coded to lymph node metastasis (C77.3)?

 

[trarut]

Does the patient have a known primary and the type of cells in the lymph nodes match the morphology of the primary tumor? For example, the patient has a known adenocarcinoma of the colon and the lymph node biopsy shows adenocarcinoma cells that are the same as the original tumor?

Generally speaking, I would say yes, this would be a lymph node metastasis. However, if they're biopsying because a patient has lymphoma and the cells are lymphoma cells, it's not a metastatic site and would be coded as an additional site of lymphoma. (Lymphoma doesn't metastasize, you simply code all the current locations of disease.)

 

[gabetteyoung@yahoo.com]

I'm sorry...I really didn't give you enough information. The patient has known invasive ductal carcinoma of the breast and had a mastectomy. The axillary contents were removed at the time of the mastectomy. The pathology report doesn't state specifically what type of tumor cells are shown in the lymph nodes, but the breast tissue and lymph nodes are all on the same pathology report.

 

[trarut]

I would consider the lymph nodes to be metastatic disease since they were clearly collected at the time of the biopsy/mastectomy.

 

[EverythingCoding]

I would consider the lymph nodes to be metastatic disease since they were clearly collected at the time of the biopsy/mastectomy.

I want to know, would you keep coding this Metastatic lymph node code (for example C77.3) after mastectomy just like the Breast cancer code? until the patient is actively being treated for Breast cancer or no?
thank you for your input.

 

[trarut]

Apologies - it's been busy and I haven't been on the forum. Yes, I would code the primary and metastatic site while the patient is in active treatment. It's still metastatic disease even after surgery and treatment for metastatic disease is different from that for non-metastatic disease.