{
  "resourceType": "CodeSystem",
  "id": "npcr-tissue-source",
  "url": "https://npcr.se/fhir/CodeSystem/npcr-tissue-source",
  "version": "0.1.0",
  "name": "NPCRTissueSource",
  "title": "NPCR Tissue/Cell Source",
  "status": "draft",
  "experimental": true,
  "publisher": "NPCR / Karolinska Institutet (thesis project)",
  "description": "Local CodeSystem representing the 6 tissue/cell source options used in NPCR Anmälan form (variable D_Vavn). The numeric codes (1-6) correspond directly to the values stored in the NPCR database as defined in variabelbeskrivning_npcr.\n\nThis CodeSystem is introduced to provide complete terminological coverage of NPCR's diagnosis method options, including cases where no KVÅ activity code is defined (Cystoprostatektomi, Adenomenukleation, Annat från metastas).\n\nSource: variabelbeskrivning_npcr (D_Vavn variable definition).\n\nRelationship to KVÅ codes (urn:oid:1.2.752.116.1.3.2.1.4):\n- Code 1 (Mellannålsbiopsi prostata) maps to KVÅ KEB00, TKE10, or TKE20 (many-to-one)\n- Code 2 (TUR-P) maps to KVÅ KED22\n- Code 3 (Finnålsaspirat prostata) maps to KVÅ TKE05\n- Codes 4, 5, 6 have no corresponding KVÅ codes in the NPCR info specification\n\nDesign rationale: numeric codes are used to maintain direct correspondence with the NPCR database storage format (Variabelbeskrivning). Since D_Vavn has no standardized representation at the NKRR interface level (the interface uses KVÅ codes which only cover 3 of 6 options), the database-level numeric codes serve as the most stable identifier for the full set of D_Vavn options.\n\nUsage: this CodeSystem is used alongside KVÅ in the NPCRDiagnosisMethodProcedure profile, where both the NPCR tissue source (this CodeSystem) and the KVÅ activity code (when available) can be represented as parallel codings.",
  "caseSensitive": true,
  "content": "complete",
  "count": 6,
  "concept": [
    {
      "code": "1",
      "display": "Core needle biopsy of prostate",
      "designation": [
        {
          "language": "sv",
          "value": "Mellannålsbiopsi prostata"
        }
      ],
      "definition": "Core needle biopsy of the prostate, typically transrectal. In NKRR, this corresponds to KVÅ codes KEB00 (generic prostate biopsy), TKE10 (transrectal needle biopsy), or TKE20 (transrectal fusion biopsy)."
    },
    {
      "code": "2",
      "display": "Transurethral resection of prostate (TUR-P)",
      "designation": [
        {
          "language": "sv",
          "value": "TUR-P"
        }
      ],
      "definition": "Transurethral resection of prostate. Histology-based diagnosis from resected tissue. In NKRR, corresponds to KVÅ code KED22. Per 2024-06-13 rule update, only valid when T-stage is T1a or T1b."
    },
    {
      "code": "3",
      "display": "Fine needle aspiration of prostate",
      "designation": [
        {
          "language": "sv",
          "value": "Finnålsaspirat prostata"
        }
      ],
      "definition": "Fine needle aspiration cytology of the prostate. Cytology-based diagnosis. In NKRR, corresponds to KVÅ code TKE05."
    },
    {
      "code": "4",
      "display": "Other source, e.g. tissue from metastasis",
      "designation": [
        {
          "language": "sv",
          "value": "Annat, t ex från metastas"
        }
      ],
      "definition": "Other tissue source, typically tissue from a metastasis where examination shows prostate cancer. No corresponding KVÅ code in the NPCR info specification; populated manually by registrar."
    },
    {
      "code": "5",
      "display": "Cystoprostatectomy",
      "designation": [
        {
          "language": "sv",
          "value": "Cystoprostatektomi"
        }
      ],
      "definition": "Cystoprostatectomy specimen, used when prostate cancer was unknown before surgery and diagnosis is established on the cystoprostatectomy specimen. Gleason grades are reported. No corresponding KVÅ code in the NPCR info specification; populated manually by registrar."
    },
    {
      "code": "6",
      "display": "Adenoma enucleation",
      "designation": [
        {
          "language": "sv",
          "value": "Adenomenukleation"
        }
      ],
      "definition": "Adenoma enucleation specimen, used when prostate cancer was unknown before surgery and diagnosis is established on the enucleation specimen. Gleason grades are reported. No corresponding KVÅ code in the NPCR info specification; populated manually by registrar."
    }
  ]
}