FIELD E ; Tumor Code 



Columns 18, 19, 20, 21, 



22, 23, 24, and 25 



Part IV (unit seven of the tumor symbol) is used for the final distinction of any tumor type, 

 whenever preceding units of the symbol have been inadequate. It is used very loosely and without a 

 strict definition , since it is thereby more useful from the standpoint of providing unique symbols - 

 Examples will explain best the use of the seventh unit: 



A. Tumors of glandular epithelium, unspecified (i. e. , when the type of gland is not specified, 



nor is the glandular organ specified, Symbol S0011 ) have been distinguished as unspecified 



adenocarcinoma, unspecified adenoma, and unspecified papilloma by using the seventh unit: 

 S001101-, S001102-, andS001103-, respectively. This does not mean that it is intended that all 

 adenocarcinomas are designated by Symbol 1 as the seventh unit, nor all papillomas by Symbol 3 as 

 the seventh unit. (Pulmonary adenocarcinoma C4461, e.g. , is S21 112^1, Pulmonary Carcinoma 



MT8 is S21112_31. ) Instead, it serves in this particular case to modify the specific symbol, S0011 



(i. e. , distinguishing three types of tumors described by the specific symbol, S00 11). 



B. Consider the epithelial tissue tumors of the lung. Here the seventh unit has been used to 

 distinguish pulmonary adenomatosis (S2 1 1 12_1_-), pulmonary adenocarcinoma (S211122^), pulmonary 

 carcinoma (S211122-). and pulmonary adenoma (S211124-). It does not mean that all adenocarcinomas 

 are designated by Symbol 2 as the seventh unit (though all pulmonary adenocarcinomas are distinguished 

 by it) nor all carcinomas by Symbol 3 as the seventh unit, etc. 



C. Note the two symbols, S5A1 1 1 1 and S5A1 1 12, both of which represent endocrine gland 



tumors ( 111--) of the ovary (-5A ). It happens that the ovary contains more than one tissue 



that is described as endocrine and tumors may arise from each. Thus, the seventh unit is used to 

 distinguish ovarian endocrine granulosa cell tumors (S5A11H-) and ovarian endocrine luteomas 

 (S5A1112-). 



D. The seventh unit has been used to distinguish any aleukemic form of leukemia (S--21-2-) 

 from the more common type in which there is a great increase in blood leukocyte numbers (S--21-J_-). 



The seventh unit has an additional use, peculiar to plant tumor symbols, in distinguishing 

 galls relative to their causative agents, such as microorganisms, insects, or chemicals. This factor 

 of the causative agent has perhaps more significance relative to classification of galls than it has 

 relative to classification of animal tumors and therefore one unit, the seventh, has been allotted this 

 coding function in making symbols for galls. For example, Symbol SS6N001- is interpreted as: a 



chemically- induced ( _1~) tumor (S ) of mixed tissues ( NOP --) of a plant leaf (-S6 ). 



In coding such a plant tumor, the specific causative agent (in the example above, a specific gall- 

 producing compound) must be included in the written abstract portion of Field E. 



In the case of animal tumors, the seventh unit has no special meaning or significance other 

 than as a modifier. In other words, it is not reserved for especially indicating, for example, 

 malignancy, tumor form, special tissue, nor special organ, though it may modify and provide specificity 

 of the organ- tissue origin on the basis of any of these. For this reason, an arrangement of the Tumor 

 Code items in a sequence according to Part IV (the seventh unit) would be meaningless (except that 

 for plant galls the arrangement would be by causative agents). 



6. Part V of the tumor symbol (eighth unit, Column 25): designation for specific, named, and 

 transmissible tumors 



The eighth unit provides a final, distinguishing part for specific , named tumors. For example, 

 there are included several specific ovarian granulosa cell tumors, all with units 1-7 being S5A1111-; 

 the symbol for each of these specific tumors is completed by assigning a final, eighth, sequential 

 unit determined merely by the arbitrary way of its being listed or added to the list. Thus, ovarian 

 granulosa cell tumors 18C57, 0L, and E4478 are given the following unique CBCC code symbols: 

 S5A111U, S5A11112, and SSAllll^. A non- specific ovarian granulosa cell tumor would be coded by 

 Symbol S5A1111 (no eighth unit). In the case of plant galls , there are anticipated but few symbols 

 with an eighth unit indicating a specific gall, since individual galls are seldom named and maintained 

 as specific tumors, in the way certain experimental animal tumors are. In plant tumor symbols, 

 nevertheless, the eighth unit is left open for any that might be so individually named and maintained. 



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