84874-7 Perforation into peritoneal cavity

Term Description

Surgeon's assessment on the presence of perforation by the tumor into the peritoneal cavity. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Perforation into peritoneal cavity

Property

Find

Time

Pt

System

Tumor

Scale

Ord

Method

Basic Attributes

Class

ONCOLOGY

Type

Clinical

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Example Answer List LL3950-4

Member of these Panels

Language Variants Get Info

Related Names

• Cancer
• Finding
• Findings
• ONCOLOGY
• Ordinal
• Perf into peritoneal cavity
• Point in time
• QL
• Qual
• Qualitative
• Random
• Screen
• tumors
• tumour
• tumours

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

84875-4 Tumor perforation [Type]

Term Description

The surgeon's assessment of the nature of the perforation through the tumor. The type of tumor perforation is a prognostic factor in determining postoperative mortality and long-term survival. Perforation away from the tumor, related to colonic obstruction by the tumor, should be distinguished from perforation through the tumor. Perforation occurring during the course of surgery should be differentiated from the colonic obstructon and should be identified as such by the surgeon. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Tumor perforation

Property

Type

Time

Pt

System

Tumor

Scale

Nom

Method

Basic Attributes

Class

ONCOLOGY

Type

Clinical

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Preferred Answer List LL4070-0

Member of these Panels

Language Variants Get Info

Related Names

• Cancer
• Nominal
• ONCOLOGY
• Point in time
• Random
• tumors
• tumour
• tumours
• Typ

84876-2 Obstruction of Bowel [Presence]

Term Description

The presence of bowel obstruction due to tumors or other causes as assessed by the surgeon. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Obstruction

Property

Find

Time

Pt

System

Bowel

Scale

Ord

Method

Observed

Basic Attributes

Class

ONCOLOGY

Type

Clinical

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Example Answer List LL3950-4

Member of these Panels

Language Variants Get Info

Related Names

• Cancer
• Finding
• Findings
• ONCOLOGY
• Ordinal
• Point in time
• QL
• Qual
• Qualitative
• Random
• Screen

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

84877-0 Synchronous tumor site Cancer

Term Description

Patients presenting with more than one histologically distinct malignancy may be classified as having synchronous tumors. Multiple primary malignancies (MPMs) are divided into 2 categories: 'synchronous', when tumors arise independently and within 6 months from the primary malignant tumor or 'metachronous', when the interval is longer (greater than 6 months). This term is used to report the location of the other synchronous tumor(s). This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Synchronous tumor site

Property

Anat

Time

Pt

System

Cancer.XXX

Scale

Nom

Method

Basic Attributes

Class

ONCOLOGY

Type

Clinical

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Preferred Answer List LL1690-8

Member of these Panels

Language Variants Get Info

Related Names

• Anatomy
• CA
• Cancer
• Misc
• Miscellaneous
• Nominal
• ONCOLOGY
• Other
• Point in time
• Random
• Spec
• To be specified in another part of the message
• Unspecified

33748-5 Distance from anal verge

Fully-Specified Name

Component

Distance from anal verge

Property

Len

Time

Pt

System

Specimen

Scale

Qn

Method

Basic Attributes

Class

PATH.PROTOCOLS.GENER

Type

Laboratory

First Released

Version 2.09

Last Updated

Version 2.70 (MIN)

Change Reason

Removed method of "CAP cancer protocols" because this term is not a CAP cancer protocol-specific concept and can be used across various cancer protocols.

Order vs. Observation

Observation

Member of these Panels

Language Variants Get Info

Related Names

• Dist from anal verge
• Length
• Pathology
• PATHOLOGY PROTOCOLS
• PATHOLOGY PROTOCOLS general
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Spec

Example Units

29300-1 Procedure type

Fully-Specified Name

Component

Procedure

Property

Type

Time

Pt

System

^Patient

Scale

Nom

Method

Basic Attributes

Class

H&P.PX

Type

Clinical

First Released

Version 2.03

Last Updated

Version 2.73 (MIN)

Common Test Rank Get Info

2979

Member of these Panels

Language Variants Get Info

Related Names

• H+P
• H+P.PX
• Nominal
• P prime
• Point in time
• Random
• Typ

29554-3 Procedure Narrative

Term Description

Procedure records the descriptions of the procedure with an extensive narrative and may include procedure site preparation, pertinent details related to measurements and markings, procedure times, instrumentation, and vital signs and other monitoring data.

Fully-Specified Name

Component

Procedure

Property

Type

Time

Pt

System

^Patient

Scale

Nar

Method

Basic Attributes

Class

H&P.PX

Type

Clinical

First Released

Version 2.03

Last Updated

Version 2.40 (MIN)

Member of these Panels

Language Variants Get Info

Related Names

• H+P
• H+P.PX
• Narrative
• P prime
• Point in time
• Random
• Report
• Typ

81167-9 Cancer treatment --preoperative

Term Description

Preoperative treatment or therapy (chemotherapy, radiotherapy, chemo-radiotherapy) administered to a cancer patient.

Fully-Specified Name

Component

Cancer treatment^preoperative

Property

Type

Time

Pt

System

^Patient

Scale

Nom

Method

Basic Attributes

Class

H&P.HX

Type

Clinical

First Released

Version 2.56

Last Updated

Version 2.56 (MIN)

Order vs. Observation

Observation

Example Answer List LL3942-1

Member of these Panels

Language Variants Get Info

Related Names

• H+P
• H+P.HX
• Nominal
• P prime
• Point in time
• Pre-Op
• Random
• Tx
• Typ

81169-5 Residual tumor [Interpretation] Cancer Narrative --postoperative

Term Description

The surgeon's opinion on the existence of local residual cancer following an operative procedure. The interpretation may contain the overall completeness of resection of the tumor, including evidence of residual disease at surgical margins or within regions in which resection has not been attempted.

Fully-Specified Name

Component

Residual tumor^postoperative

Property

Imp

Time

Pt

System

Cancer.XXX

Scale

Nar

Method

Basic Attributes

Class

SURG

Type

Clinical

First Released

Version 2.56

Last Updated

Version 2.58 (MIN)

Order vs. Observation

Observation

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Impression
• Impression/interpretation of study
• Impressions
• Interp
• Interpretation
• Misc
• Miscellaneous
• Narrative
• Oncology
• Other
• Point in time
• Random
• Report
• Spec
• SURG
• To be specified in another part of the message
• Unspecified

81168-7 Site of adjacent organ or tissue involvement Cancer specimen

Term Description

Tumor stages are based on the extent of the involvement of adjacent tissues or organs, such as skin, liver, spleen, or pancreas as well as distal spread (i.e., metastasis). This term is used to report which adjacent tissue or organ(s) the tumor has spread to from the primary organ involved.

Fully-Specified Name

Component

Site of adjacent organ or tissue involvement

Property

Anat

Time

Pt

System

Cancer specimen

Scale

Nom

Method

Basic Attributes

Class

CLIN

Type

Clinical

First Released

Version 2.56

Last Updated

Version 2.61 (MAJ)

Change Reason

Changed System from "Stomach cancer" to "Cancer.XXX" since this observation can be used for various cancers.; Updated System from "Cancer.XXX" to clarify that the test is performed on a cancer specimen.

Order vs. Observation

Observation

Example Answer List LL3943-9

Member of these Panels

Language Variants Get Info

Related Names

• Adj org or tiss involved
• Anatomy
• CA
• Ca spec
• CLIN
• Nominal
• Point in time
• Random
• Spec

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

84878-8 Recurrence or distant metastases details Cancer Narrative

Term Description

Surgeon's description of regional (local) recurrence and/or distant metastasis. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Recurrence or distant metastases details

Property

Find

Time

Pt

System

Cancer

Scale

Nar

Method

Basic Attributes

Class

ONCOLOGY

Type

Clinical

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Cancer
• Finding
• Findings
• Narrative
• ONCOLOGY
• Point in time
• Random
• Recur or distant metast details
• Report

42071-1 Accession number and class of case and sequence number override flag Cancer case

Term Description

Some computer edits identify errors. Others indicate possible errors that require manual review for resolution. To eliminate the need to review the same cases repeatedly, over-ride flags have been developed to indicate that data in a record (or records) have been reviewed and, while unusual, are correct.

This over-ride is used with the following edit in the NAACCR Metafile of the EDITS software:
Accession Number, Class of Case, Seq Number (COC)... NAACCR Data Standards and Data Dictionary Version 11

Fully-Specified Name

Component

Accession number & class of case & sequence number override flag

Property

Arb

Time

Pt

System

Cancer case.XXX

Scale

Ord

Method

Basic Attributes

Class

TUMRRGT

Type

Clinical

First Released

Version 2.16

Last Updated

Version 2.73 (MIN)

Common Test Rank Get Info

16584

Normative Answer List LL152-0

Member of these Panels

Language Variants Get Info

Related Names

• Access num
• Arbitrary
• Ascn/class/seq O/R
• CA
• Misc
• Miscellaneous
• No
• Num
• Oncology
• Ordinal
• Other
• Point in time
• QL
• Qual
• Qualitative
• Random
• Screen
• Spec
• To be specified in another part of the message
• TUMOR REGISTRY(NAACCR)
• Unspecified

Related Codes

33723-8 Specimen length

Fully-Specified Name

Component

Specimen length

Property

Len

Time

Pt

System

Specimen

Scale

Qn

Method

Basic Attributes

Class

PATH.PROTOCOLS.GENER

Type

Laboratory

First Released

Version 2.09

Last Updated

Version 2.70 (MIN)

Change Reason

Removed Method since this term is not specific to CAP cancer protocols.

Order vs. Observation

Observation

Member of these Panels

Language Variants Get Info

Related Names

• Len
• Length
• Pathology
• PATHOLOGY PROTOCOLS
• PATHOLOGY PROTOCOLS general
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Spec

Example Units

33725-3 Tumor site

Term Description

The site in the body where the tumor is located. For example, in colorectal cancers, the tumor sites include the cecum, ascending or descending colon, hepatic flexure, splenic flexure, or rectum.

Fully-Specified Name

Component

Tumor site

Property

Anat

Time

Pt

System

Specimen

Scale

Nom

Method

Basic Attributes

Class

PATH.PROTOCOLS.GENER

Type

Laboratory

First Released

Version 2.09

Last Updated

Version 2.73 (MIN)

Change Reason

Removed method of "CAP cancer protocols" because this term is not a CAP cancer protocol-specific concept and can be used across various cancer protocols.

Order vs. Observation

Observation

Common Test Rank Get Info

10199

Example Answer List LL4310-0

Member of these Panels

Language Variants Get Info

Related Names

• Anatomy
• Nominal
• Pathology
• PATHOLOGY PROTOCOLS
• PATHOLOGY PROTOCOLS general
• Point in time
• Random
• Spec

33728-7 Size.maximum dimension in Tumor

Fully-Specified Name

Component

Size.max.dimension

Property

Len

Time

Pt

System

Tumor

Scale

Qn

Method

Basic Attributes

Class

PATH.PROTOCOLS.GENER

Type

Laboratory

First Released

Version 2.09

Last Updated

Version 2.70 (MIN)

Change Reason

Removed method of "CAP cancer protocols" because this term is not a CAP cancer protocol-specific concept and can be used across various cancer protocols

Order vs. Observation

Observation

Member of these Panels

Language Variants Get Info

Related Names

• Cancer
• Largest
• Length
• Maximal
• Maximum
• Pathology
• PATHOLOGY PROTOCOLS
• PATHOLOGY PROTOCOLS general
• Peak
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• tumors
• tumour
• tumours

Example Units

81175-2 Distance of tumor from closest margin [Length] in Specimen by Macroscopy

Term Description

In a specimen, the distance from the tumor to the nearest proximal or distal margin (cut end) is recorded. The tumor distance to margins is based on macroscopic assessment and confirmed or amended on microscopy ([LOINC: 81182-8] or [LOINC: 81183-6]), especially when the macroscopic size is difficult to assess (i.e. in early gastric carcinoma and diffuse carcinoma).

Fully-Specified Name

Component

Distance of tumor from closest margin

Property

Len

Time

Pt

System

Specimen

Scale

Qn

Method

Macroscopy

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.56

Last Updated

Version 2.56 (MIN)

Order vs. Observation

Observation

Member of these Panels

Language Variants Get Info

Related Names

• Length
• Pathology
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Spec

Example Units

81176-0 Distance of tumor from circumferential resection margin [Length] in Specimen by Macroscopy

Term Description

The distance between the tumor and circumferential resection margin (CRM) is recorded for tumors of the gastric cardia. This measurement is facilitated by horizontal sectioning through the tumor. To increase accuracy, the distance between the tumor and the CRM is subsequently measured microscopically [LOINC: 81184-4]. Involvement of the circumferential resection margin is an indicator of poor prognosis.

Fully-Specified Name

Component

Distance of tumor from circumferential resection margin

Property

Len

Time

Pt

System

Specimen

Scale

Qn

Method

Macroscopy

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.56

Last Updated

Version 2.56 (MIN)

Order vs. Observation

Observation

Member of these Panels

Language Variants Get Info

Related Names

• Distance Tumor from CRM
• Length
• Pathology
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Spec

Example Units

84879-6 Tumor perforation [Presence] by Macroscopy

Term Description

The macroscopic finding for the presence or absence of perforation through the tumor. Perforation through the tumor into the peritoneal cavity is a well established adverse prognostic factor in colonic and rectal cancer. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Tumor perforation

Property

PrThr

Time

Pt

System

Tumor

Scale

Ord

Method

Macroscopy

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Example Answer List LL3950-4

Member of these Panels

Language Variants Get Info

Related Names

• Cancer
• Ordinal
• PATHOLOGY
• Point in time
• PR
• QL
• Qual
• Qualitative
• Random
• Screen
• tumors
• tumour
• tumours

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

96115-1 Level of tumor invasion [Type] in Colorectal cancer specimen by Haggitt

Term Description

The Haggitt classification for tumor invasion is a 0-4 level system developed to assess depth of invasion in pedunculated polyps compared to sessile polyps. In level 0, the carcinoma is confined to the mucosa. Levels 1 through 3 represent varying degrees of invasion into the polyp stalk. Level 4 represents invasion into the submucosa. All sessile malignant polyps are level 4 by definition. PMID: 4007423

Fully-Specified Name

Component

Level of tumor invasion

Property

Type

Time

Pt

System

Colorectal cancer specimen

Scale

Nom

Method

Haggitt

Basic Attributes

Class

PATH.HISTO

Type

Laboratory

First Released

Version 2.69

Last Updated

Version 2.69 (ADD)

Order vs. Observation

Observation

Normative Answer List LL5687-0

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Ca spec
• CRC spec
• Levels
• Levl
• LV
• LVL
• Nominal
• Oncology
• PATH.HISTO
• PATHOLOGY
• Point in time
• Random
• Spec
• Tumor invasion level
• Typ

84880-4 Position of rectal tumor in relation to anterior peritoneal reflection [Anatomy] in Tumor

Term Description

For rectal tumors, the relationship of the tumor in relation to the anterior peritoneal reflection may be classified as entirely above, astride (at), or entirely below the level of the anterior peritoneal reflection. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Position of rectal tumor in relation to anterior peritoneal reflection

Property

Anat

Time

Pt

System

Tumor

Scale

Nom

Method

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Preferred Answer List LL4072-6

Member of these Panels

Language Variants Get Info

Related Names

• Anatomy
• Cancer
• Nominal
• Pathology
• Point in time
• Pos rec tumor to ant peri relect
• Random
• tumors
• tumour
• tumours

33730-3 Resection completeness in Mesorectum Qualitative by Macroscopy

Term Description

This term represents the macroscopic completeness of the surgical mesorectum excision in patients undergoing surgery for rectal cancer. Complete excision, known as total mesorectal excision or TME, is associated with decreased risk of local recurrence and increased rate of 5-year survival. PMID: 27697315

Fully-Specified Name

Component

Resection completeness

Property

Find

Time

Pt

System

Mesorectum

Scale

Ord

Method

Macroscopy

Basic Attributes

Class

PATH.PROTOCOLS.GENER

Type

Laboratory

First Released

Version 2.09

Last Updated

Version 2.61 (MAJ)

Change Reason

Removed Method of "CAP cancer protocol" and copyright because this is not a CAP-specific concept and added "Method" of macroscopy. Also added an answer list and term description.

Order vs. Observation

Observation

Example Answer List LL4568-3

Member of these Panels

Language Variants Get Info

Related Names

• Finding
• Findings
• Ordinal
• PATHOLOGY
• PATHOLOGY PROTOCOLS
• PATHOLOGY PROTOCOLS general
• Point in time
• QL
• Qual
• Qualitative
• Random
• Screen

96116-9 Anterior surgical resection [Type] in Lower GI tract

Term Description

The type (e.g. high, low, ultralow) of anterior surgical resection procedure performed. In patients with low rectal cancers, the ultralow anterior resection (uLAR) may be performed. Post surgery, these patients often experience major bowel dysfunctions that affect their quality of life. PMID: 29990965

Fully-Specified Name

Component

Anterior surgical resection

Property

Type

Time

Pt

System

Lower GI tract

Scale

Nom

Method

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.69

Last Updated

Version 2.70 (MAJ)

Change Reason

Release 2.70: SYSTEM: Updated System from Rectum+Colon for consistency across Lower GI terms;

Order vs. Observation

Observation

Example Answer List LL5678-9

Member of these Panels

Language Variants Get Info

Related Names

• Anterior surg resection
• LGI
• Low
• Nominal
• Pathology
• Point in time
• Random
• Surg
• Typ

21894-1 Regional lymph nodes examined [#] Specimen

Term Description

Records the total number of regional lymph nodes that were removed and examined by the pathologist. Beginning with tumors diagnosed on or after January 1, 2004, this item is a component of the Collaborative Stage system. Tumors diagnosed from 1988 through 2003, this item is a part of the 10-digit EOD [779], detailed site-specific codes for anatomic EOD.

This data item serves as a quality measure of the pathologic and surgical evaluation and treatment of the patient... NAACCR Data Standards and Data Dictionary Version 11

Fully-Specified Name

Component

Regional lymph nodes examined

Property

Num

Time

Pt

System

Specimen

Scale

Qn

Method

Basic Attributes

Class

TUMRRGT

Type

Clinical

First Released

Version 1.0m

Last Updated

Version 2.56 (MAJ)

Change Reason

Changed the system from "Cancer.XXX" to "Specimen".

Member of these Panels

Language Variants Get Info

Related Names

• Cnt
• Count
• LN exam
• Number
• Oncology
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Reg LN examined
• Spec
• TUMOR REGISTRY(NAACCR)

Example Units

Related Codes

84881-2 Polyps [Presence] in Specimen

Term Description

The presence or absence of polyps in the specimen. If present, the number, diameter range and gross appearance of polyps is recorded separately. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Polyps

Property

PrThr

Time

Pt

System

Specimen

Scale

Ord

Method

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Order vs. Observation

Observation

Example Answer List LL3950-4

Member of these Panels

Language Variants Get Info

Related Names

• Ordinal
• PATHOLOGY
• Point in time
• PR
• QL
• Qual
• Qualitative
• Random
• Screen
• Spec

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

96117-7 Resection adequacy of non-malignant polyp in Specimen Qualitative

Term Description

The adequacy of resection of non-malignant polyp should be reported where the polyp is received intact and where the margin of resection is unequivocally seen.

Fully-Specified Name

Component

Resection adequacy of non-malignant polyp

Property

Find

Time

Pt

System

Specimen

Scale

Ord

Method

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.69

Last Updated

Version 2.69 (ADD)

Order vs. Observation

Observation

Example Answer List LL5677-1

Member of these Panels

Language Variants Get Info

Related Names

• Finding
• Findings
• Malig
• Ordinal
• PATHOLOGY
• Point in time
• QL
• Qual
• Qualitative
• Random
• Resection adeq non-malig polyp
• Screen
• Spec

81178-6 Tissue block description and site Narrative

Term Description

The description of the tissue block and site from which it was taken. Following the macroscopic description, dissection and block selection is performed.

Fully-Specified Name

Component

Tissue block description and site

Property

Desc

Time

Pt

System

Specimen

Scale

Nar

Method

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.56

Last Updated

Version 2.73 (MIN)

Order vs. Observation

Observation

Common Test Rank Get Info

7509

Member of these Panels

Language Variants Get Info

Related Names

• Description
• Narrative
• Pathology
• Point in time
• Random
• Report
• Spec

84883-8 Deepest extent of tumor invasion [Type] in Colorectal cancer specimen

Term Description

The deepest extent or maximum degree of local tumor invasion into or through the bowel wall. Results are based on the T component of the TNM staging system, as outlined in the AJCC Cancer Staging Manual. PMID: 20180029 Invasion depths include submucosa (pT1), muscularis propria (pT2), through muscularis propria into pericolorectal tissues (pT3), penetrating the visceral peritoneum (pT4a), and directly invading or adherent to other organs or structures (pT4b). This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Deepest extent of tumor invasion

Property

Type

Time

Pt

System

Colorectal cancer specimen

Scale

Nom

Method

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Change Reason

This term is still in Trial status and upon further review, the System was updated from 'Specimen' to reflect that this concept is specific to the colorectal cancer reporting protocol. In addition, the Scale was corrected from Ord to Nom.

Order vs. Observation

Observation

Preferred Answer List LL4074-2

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Ca spec
• Clark level
• Clarks level
• CRC spec
• Deepest tumor invasion
• Nominal
• Pathology
• Point in time
• Random
• Spec
• Typ

84882-0 Histologic type in Colorectal cancer specimen by WHO classification

Term Description

Colorectal cancer histologic type based on the current World Health Organization (WHO) classification. Colonrectal tumor types include adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, small cell carcinoma, squamous cell carcinoma, adenosquamous carcinoma, medullary carcinoma, and others. [https://publications.iarc.fr/Book-And-Report-Series/Iarc-Handbooks-Of-Cancer-Prevention/Colorectal-Cancer-Screening-2019]

Fully-Specified Name

Component

Histologic type

Property

Type

Time

Pt

System

Colorectal cancer specimen

Scale

Nom

Method

WHO classification

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.72 (MIN)

Change Reason

Release 2.72: DefinitionDescription: updated the url;

Order vs. Observation

Observation

Preferred Answer List LL4073-4

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Ca spec
• CRC spec
• Histo type
• Nominal
• Pathology
• Point in time
• Random
• Spec
• Typ
• World Heatlth Organization

84884-6 Distal AndOr proximal margin involvement [Presence] in Colorectal cancer specimen

Term Description

Involvement of the proximal and/or distal resection ('cut-end') margins. This term was created for, but not limited in use to, the Colorectal Cancer Structured Reporting Protocol (2nd Edition, 2012) developed by the Royal College of Pathologists of Australasia (RCPA).

Fully-Specified Name

Component

Distal &or proximal margin involvement

Property

PrThr

Time

Pt

System

Colorectal cancer specimen

Scale

Nom

Method

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Change Reason

This term is still in Trial status and upon further review, we added "Microscopy.light" as method to align with similar terms and since this cancer pathology observation is detected by light microscopy.

Order vs. Observation

Observation

Preferred Answer List LL4075-9

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Ca spec
• CRC spec
• Distal/proximal marg invlmnt
• Margin involved
• Nominal
• Pathology
• Point in time
• PR
• Random
• Spec

84888-7 Intramural vein invasion [Presence] in Colorectal cancer specimen by Light microscopy

Part Descriptions

LP222091-3   Intramural vein invasion
Venous invasion (VI) is a well-established prognostic indicator in colorectal cancers and associated with an increase in risk of distant metastases. PMID: 26933769 VI can be classified as either intramural venous invasion (IMVI) or extramural venous invasion (EMVI). IMVI is when a tumor cells are confined to veins within the bowel wall. EMVI is when tumor cells are present in veins outside the bowel wall. Either one or both may be present. The presence of EMVI is a strong predictor of adverse outcome. PMCID: PMC4283716 Source: Regenstrief LOINC

Fully-Specified Name

Component

Intramural vein invasion

Property

PrThr

Time

Pt

System

Colorectal cancer specimen

Scale

Ord

Method

Microscopy.light

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Change Reason

This term is still in Trial status and upon further review, we added "Microscopy.light" as method to align with similar terms and since this cancer pathology observation is detected by light microscopy.

Order vs. Observation

Observation

Example Answer List LL748-5

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Ca spec
• CRC spec
• LM
• Micro
• Micros
• Microscopic
• Ordinal
• PATHOLOGY
• Point in time
• PR
• QL
• Qual
• Qualitative
• Random
• Screen
• Spec
• Ven
• Venous

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

84889-5 Extramural vein invasion [Presence] in Colorectal cancer specimen by Light microscopy

Part Descriptions

LP222092-1   Extramural vein invasion
Venous invasion (VI) is a well-established prognostic indicator in colorectal cancers and associated with an increase in risk of distant metastases. PMID: 26933769 VI can be classified as either intramural venous invasion (IMVI) or extramural venous invasion (EMVI). IMVI is when a tumor cells are confined to veins within the bowel wall. EMVI is when tumor cells are present in veins outside the bowel wall. Either one or both may be present. The presence of EMVI is a strong predictor of adverse outcome. PMCID: PMC4283716 Source: Regenstrief LOINC

Fully-Specified Name

Component

Extramural vein invasion

Property

PrThr

Time

Pt

System

Colorectal cancer specimen

Scale

Ord

Method

Microscopy.light

Basic Attributes

Class

PATH

Type

Laboratory

First Released

Version 2.58

Last Updated

Version 2.71 (MIN)

Change Reason

This term is still in Trial status and upon further review, we added "Microscopy.light" as method to align with similar terms and since this cancer pathology observation is detected by light microscopy.

Order vs. Observation

Observation

Example Answer List LL748-5

Member of these Panels

Language Variants Get Info

Related Names

• CA
• Ca spec
• CRC spec
• LM
• Micro
• Micros
• Microscopic
• Ordinal
• PATHOLOGY
• Point in time
• PR
• QL
• Qual
• Qualitative
• Random
• Screen
• Spec
• Ven
• Venous

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.