CTR Abstracting & Coding 3 — Questions and Answers
Question 1: When the primary site of a tumor cannot be determined after thorough workup, which ICD-O-3 topography code is assigned?
- C76.0
- C80.9 (Correct answer)
- C77.9
- C26.9
Correct answer: C80.9
C80.9 is assigned for unknown primary site when no primary site can be identified despite workup.
Question 2: Which of the following is the correct sequence for assigning the primary site when a biopsy is taken from a lymph node and the pathology shows metastatic squamous cell carcinoma of unknown primary?
- Code the lymph node as the primary site (C77.x)
- Code C80.9 unknown primary (Correct answer)
- Code the most common site for squamous cell carcinoma
- Code based on the region of the lymph node
Correct answer: Code C80.9 unknown primary
When the primary site cannot be established, C80.9 is used regardless of histology or lymph node location.
Question 3: What does the AJCC TNM suffix 'yp' indicate when documented on a pathology report?
- The staging was done at autopsy
- The staging reflects post-neoadjuvant therapy pathologic findings (Correct answer)
- The tumor was staged years after initial diagnosis
- The pathologist disagreed with clinical staging
Correct answer: The staging reflects post-neoadjuvant therapy pathologic findings
The 'yp' prefix in AJCC TNM staging denotes pathologic staging performed after neoadjuvant (pre-surgical) therapy.
Question 4: A registrar reviews a case where surgery removed a colon tumor and 18 lymph nodes were examined, with 3 positive. How should the regional lymph node fields be coded?
- Number examined: 18, number positive: 3 (Correct answer)
- Number examined: 3, number positive: 18
- Number examined: 0, number positive: 3
- Number examined: 18, number positive: 0
Correct answer: Number examined: 18, number positive: 3
Both the total nodes examined and the number of positive nodes are recorded separately to support accurate N-category staging.
Question 5: Which source document takes PRIORITY when there is a conflict between the operative report and the pathology report regarding tumor size?
- Operative report
- Pathology report (Correct answer)
- Radiology report
- Physician progress notes
Correct answer: Pathology report
The pathology report takes priority over the operative report for tumor size, as it provides the definitive microscopic measurement.
Question 6: When abstracting a case of non-Hodgkin lymphoma, which staging system is preferred over AJCC TNM?
- Durie-Salmon staging
- Ann Arbor staging (Correct answer)
- FIGO staging
- Binet staging
Correct answer: Ann Arbor staging
The Ann Arbor staging system (Lugano modification) is the standard staging system for Hodgkin and non-Hodgkin lymphomas.
Question 7: A tumor registrar encounters the term 'Gleason score 7 (3+4)' on a prostate pathology report. Which grade group does this correspond to?
- Grade Group 1
- Grade Group 2 (Correct answer)
- Grade Group 3
- Grade Group 4
Correct answer: Grade Group 2
Gleason score 7 (3+4) corresponds to Grade Group 2 in the 2016 WHO/ISUP Grade Group system for prostate cancer.
CTR Abstracting & Coding 3
When the primary site of a tumor cannot be determined after thorough workup, which ICD-O-3 topography code is assigned?