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History: the Patient Is a 79-Year-Old Male with Dyspepsia and Weight

Question 1061

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History: The patient is a 79-year-old male with dyspepsia and weight loss. A recent supraclavicular lymph node biopsy revealed signet-ring cell adenocarcinoma.
Specimen site: Stomach
Gross description: Received in formalin is a 10.0- × 6.5- × 3.2-cm segment of stomach, with a palpable firm 4.0- × 2.2-cm mass on the designated lesser curvature. The external surface of the specimen is unremarkable and inked black. The cut surfaces demonstrate the mass and adjacent firm areas of nodularity. The remainder of the gastric mucosa is unremarkable. Six lymph node candidates and representative sections of the stomach are submitted.
Microscopic description: Microscopic examination was performed. See synoptic report. The uninvolved stomach shows chronic inactive gastritis with intestinal metaplasia.
Diagnosis: Stomach (proximal) : Invasive adenocarcinoma
Comment: Signet-ring cell carcinomas are not typically graded but are high-grade and would correspond to grade 3.
Select the appropriate ICD-10-CM and CPT code(s) :


A) C16.9, K30, 88309 x2
B) C16.5, 88309, 88307
C) C16.9, 88309, 88307 x6
D) C16.9, K30, R63.4, 88309

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