Page History
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Code | Label | Description |
|---|---|---|
0 | Benign (Reportable for intracranial and CNS sites only) | Benign |
1 | Borderline (Reportable for intracranial and CNS sites only) | Uncertain whether benign or malignant |
Borderline malignancy | ||
Low malignant potential | ||
Uncertain malignant potential | ||
2 | In situ and/or carcinoma in situ | Adenocarcinoma in an adenomatous polyp with no invasion of stalk |
Clark level 1 for melanoma (limited to epithelium) | ||
Comedocarcinoma, noninfiltrating (C50._) | ||
2 | Synonymous with in situ | Behavior code ‘2’ |
| Bowen disease (not reportable for C440-C449) | ||
Clark level I for melanoma (limited to epithelium) | ||
Confined to epithelium | ||
Hutchinson melanotic freckle, NOS (C44_) | ||
Intracystic, noninfiltrating (carcinoma) | ||
Intraductal (carcinoma) | ||
Intraepidermal, NOS (carcinoma) | ||
Intraepithelial neoplasia, Grade III (e.g., AIN III, LIN III, SIN III, VAIN III, VIN III) | ||
Intraepithelial, NOS (carcinoma) | ||
Involvement up to, but not including the basement membrane | ||
Lentigo maligna (C44._) | ||
Lobular, noninfiltrating (C50._) (carcinoma) | ||
Noninfiltrating (carcinoma) | ||
Non-invasive (carcinoma) | ||
No stromal invasion/involvement | ||
Papillary, noninfiltrating, or intraductal (carcinoma) | ||
Precancerous melanosis (C44._) | ||
Stage 0 (except Paget’s disease (8540/3) of breast and colon or rectal tumors confined to the lamina propria) | ||
3 | Invasive | Malignant |
Primary site Invasive or microinvasive | ||
Microinvasive | ||
Focus of invasion |
Coding Instructions
General
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Code the behavior as malignant (/3) if any portion of the primary tumor is invasive no matter how limited, i.e., microinvasion.
Example: Pathology from mastectomy: Large mass composed of intraductal carcinoma with a single
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focus of invasion. Code the behavior as malignant (/3).
Re-code the behavior as malignant (/3) when metastases are attributed to a tumor originally thought to be in situ.
Example: Right colon biopsy reveals tubulovillous adenoma with microfocal carcinoma in situ; right
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hemicolectomy is negative for residual disease. Later core liver biopsy consistent with metastatic
adenocarcinoma of gastrointestinal origin. Oncologist states most likely colon primary. Change the
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behavior code for the colon primary from /2 to /3. There were no other colon primaries in this case.
ICD-O-3.2 Histology/Behavior Code Listing
Behavior is the fifth digit of the morphology code after the slash (/). The standard reference for coding behavior is the ICD-O-3.2. Pages 27 through 30 in ICD-O-3 discuss behavior. The following general rules
are found on pages 29-30 in ICD-O-3.
• Usually a histologic term carries a clear indication of the likely behavior of the tumor, whether
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malignant or benign, and this is reflected in the behavior code assigned to it in the ICD-O
• Although only a few histologic types of in situ neoplasms are actually listed in the ICD-O, the
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behavior code /2 could be attached to any histology code if an in situ form of the neoplasm is
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diagnosed
• If the pathologist disagrees with the ICD-O behavior assignment in a particular case, code the
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behavior according to the pathologist’s description of the behavior even if that histology/behavior
combination is not listed in the ICD-O
The pathologist has the final say on the behavior of the tumor. ICD-O-3 may have only one
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behavior code, in situ (/2) or malignant (/3), listed for a specific histology. If the pathology report
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describes the
histology as in situ and the ICD-O-3 histology code is listed only with a malignant
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behavior code (/3), assign the in situ behavior code (/2). If the pathology report describes histology
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as malignant and the
ICD-O-3 histology code is listed only with an in situ behavior code (/2),
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assign the malignant behavior code (/3). See the Morphology and Behavior Code Matrix
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discussion on page 29 in ICD-O-3.
Example: The pathology report says large cell carcinoma in situ. The ICD-O-3 lists large cell
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carcinoma only with a malignant behavior (8012/3). Code the histology and behavior as 8012/2 as
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specified by the pathologist.
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