嗜铬细胞瘤/副神经节瘤ICD-10编码探讨

Discussion On ICD-10 Coding of Pheochromocytoma And Paraganglioma

嗜铬细胞瘤/副神经节瘤是一类起源于神经嵴的神经内分泌肿瘤,2017年新版WHO《内分泌器官肿瘤分类》认为所有的PPGL都具有转移潜能,并全部定性为恶性。《肿瘤学国际疾病分类》(ICD-O)将旧版分类中PPGL原有的肿瘤动态编码/0和/1都改成了/3。根据这些重要更新以及编码规则和步骤,通过对5例病例进行分析,PPGL编码为:肾上腺嗜铬细胞瘤编码为C74.1肾上腺髓质恶性肿瘤、M8700/3嗜铬细胞瘤,恶性;肾上腺外(如腹膜后)副神经节瘤编码为:C48.0腹膜后腔恶性肿瘤,M8693/3肾上腺外节旁体瘤,恶性;颈动脉体瘤编码为C75.4颈动脉体恶性肿瘤,M8692/3颈动脉体瘤,恶性;鼓室体瘤的编码为C75.5主动脉体和其他节旁体恶性肿瘤,M8690/3颈静脉球瘤,恶性;脑继发嗜铬细胞瘤(副神经节瘤)编码为C79.3脑和脑膜继发恶性肿瘤,M8700/6(M8693/6)转移性嗜铬细胞瘤(副神经节瘤)。需要时,使用附加编码E27.5儿茶酚胺分泌过多标明肿瘤的功能活性。

Pheochromocytoma/paraganglioma is a class of neuroendocrine tumors originating from the neural crest.In 2017,the new WHO"Classification of Tumors of Endocrine Organs"considered that all PPGLs had the potential to metastasize and were all classified as malignant."International Classification of Diseases in Oncology"(ICD-O)changed the original tumor dynamic codes/0 and/1 of PPGL in the old version of the classification to/3.According to these important updates and coding rules and steps,through the analysis of 5 cases,PPGL coding is adrenal pheochromocytoma coded as C74.1 adrenal medullary malignant tumor,M8700/3 pheochromocytoma,malignant.Extra-adrenal(e.g.,retroperitoneal)paragangliomas are coded as:C48.0 Malignant neoplasm of the retroperitoneal space,M8693/3 Extra-adrenal paraganglioma,malignant.Carotid body tumors are coded as C75.4 Malignant neoplasm of carotid body,M8692/3 Carotid body tumor,malignant.Tumors of the tympanic body are coded as C75.5 Malignant neoplasms of aortic body and other paraganglionic bodies,M8690/3 Glomus jugular tumor,malignant.Secondary pheochromocytoma(paraganglioma)of the brain is coded as C79.3 Secondary malignant neoplasm of brain and meninges,M8700/6(M8693/6)Metastatic pheochromocytoma(paraganglioma).When required,the additional code E27.5 catecholamine hypersecretion is used to indicate the functional activity of the tumor.