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Welcome to the SEER Inquiry System (SINQ). SINQ is a collection of questions that cancer registrars have had while coding cancer cases. Click Search to look for specific questions or to select questions for a Report.

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MP/H Rules/Histology: What is the proper histology code -- mucin producing adenocarcinoma or cholangiocarcinoma for the following case? See discussion.

Final Feb 26 2015

Reportability--Skin: Is this case not reportable if the intranasal polyp is covered with cutaneous epithelium (essentially skin) or, is it reportable as a primary intranasal basal cell carcinoma? I have found one article regarding primary intranasal basal cells, which are described as being "very rare". But, I am not sure whether, in those cases, cutaneous epithelium was found.

FINAL DIAGNOSIS: (A) Nasal cavity, polyp, excision: Sinonasal inflammatory polyp with overlying cutaneous epithelium showing foci of superficial (noninvasive) basal cell carcinoma

Final Jan 27 2015

Reportability/Behavior: Is the following reportable, and if so, what is the histology code? Final Diagnosis (on multiple conjunctive excisions): Conjunctiva - primary acquired melanosis with atypia (see note). Note: "In all 3 specimens the process extends to the margins of excision. Complete extirpation is recommended (primary acquired melanosis with atypia is considered melanoma in situ).

Final Jan 20 2015

Reportability--Bladder: Please explain the reportability of UroVysion for bladder cancer in the following circumstances.

1. Patient has positive UroVysion test and follow up biopsy is negative. Is this case reportable with a diagnosis date the date of the UroVysion?

2. Patient has positive UroVysion test and follow up biopsy is positive for cancer. Is the diagnosis date of the date of the positive UroVysion or the date of the positive biopsy? Thank you.

Final Jan 08 2015

Reportability/Histology: Would a histology reading "Well-differentiated neuroendocrine neoplasm" of the appendix be reportable? Since the word "tumor NOS" and "neoplasm NOS" both code to 8000, I would assume they would be interchangeable but just wanted to verify.

According to SINQ 20130027 & 20140002 a "Well-differentiated neuroendocrine tumor" of the appendix IS reportable.

Final Jan 07 2015

MP/H Rules/Histology--Endometrium: What is the correct histology code for an endometrial cancer described as "Adenocarcinoma with areas of squamous differentiation?"

Final Dec 18 2014

Multiple primaries--Heme & Lymphoid Neoplasms: Should the 2014 diagnosis be abstracted as a new primary since it is not mantle cell lymphoma and all of the types listed in the differential diagnosis would be a new primary? See discussion.

Final Nov 19 2014

Reportability--GIST: The 2014 SEER Program Coding and Staging Manual and the answer to SINQ 20100014 appear to conflict with respect to reporting GIST cases. The manual states (p.5, exception 1) that we are to accession the case if the patient is treated for cancer. However, the patient in Example #7 in the SINQ discussion is receiving chemotherapy, but is deemed not reportable. This is a problematic issue in our area, as pathologists prefer using the NCCN “Risk Stratification of Primary GIST by Mitotic Index, Size and Site” table rather than stating whether the tumor is benign or malignant. Although they tell us that moderate or high risk should receive treatment, they will not characterize them as malignant.

Final Nov 19 2014

MP/H Rules/Multiple primaries--Ampulla of vater: Is this a new primary? Patient has intramucosal adenocarcinoma in a tubulovillous adenoma of the ampula of vater in Sept. of 2011. In May of 2012, patient has another ampullary adenoma with intraepithelial carcinoma (pTis) and an area suspicious for invasion. This is coded 8263/3.

Rule M14, Multiple in situ and/or malignant polyps are a single primary, precedes rule M15, An invasive tumor following an in situ tumor more than 60 days after diagnosis is a multiple primary, per the MP rules for 'Other sites',

Final Nov 17 2014

MP/H Rules/Multiple primaries--Colon: Does rule M7 apply here (A frank malignant or in situ adenocarcinoma and an in situ or malignant tumor in a polyp are a single primary)? Can the frank malignant adenocarcinoma be any specific type of adenocarcinoma for this rule to apply?

A patient has 2 synchronous tumors in the ascending colon. The first is grade 3 adenocarcinoma with signet ring differentiation and focal mucinous features (8255/3). The second is grade 2-3 adenocarcinoma in a tubulovillous adenoma (8263/3).

Final Nov 17 2014

Histology--Heme & Lymphoid Neoplasms: Should the 1995 diagnosis be changed to plasmacytoma? A 1995 case on the central registry database indicates that MRI and bone surveys revealed a pubic ramus lesion that was biopsied. There are no other bone lesions. A bone marrow biopsy was negative. The pathologist's diagnosis at that time was "Plasma Cell Myeloma". In 2013 there was a positive bone marrow biopsy and a diagnosis of Plasma Cell Myeloma. In 2013, a history of "sequential plasmacytomas since 1995" was mentioned. Since the 1995 diagnosis was only a solitary bone lesion with no marrow involvement, it certainly seems to fit a diagnosis of plasmacytoma better than myeloma.

Final Nov 12 2014

MP/H Rules/Multiple primaries--Thyroid: How many primaries should be reported when a complete thyroidectomy specimen shows two tumors: 1.8 cm papillary carcinoma with tall cell features (8344/3) and a 0.4 cm papillary thyroid carcinoma (8260/3)? See discussion.

Final Nov 05 2014

MP/H Rules/Histology--Testis: How should histology be coded for a testicular teratoma with somatic type malignancy (adenocarcinoma)? See discussion.

Final Oct 24 2014

Reportability/Histology--Heme & Lymphoid Neoplasms: Is primary erythrocytosis equivalent to primary polycythemia and thus reportable? See discussion.

Final Oct 24 2014

Behavior--Breast: Is behavior for encapsulated papillary carcinoma (EPC) of the breast coded as noninvasive or invasive?

Final Sep 16 2014

Laterality: Why is a code 5 for laterality midline only allowed for certain sites of brain and skin? I have a nasal cavity tumor and the path report specifically says "Tumor laterality: midline". What is the correct laterality code here?

Final Sep 10 2014

Surgery of Primary Site--Bladder: Is any mention of cautery in the gross description of pathology for a TURBT specimen sufficient to code 22 (excisional biopsy with electrocautery), or does there need to be a statement in the operative report that electrocautery was performed? See discussion.

Final Aug 29 2014

MP/H Rules/Histology/Multiple primaries--GE junction: How is histology coded for a goblet cell carcinoma in the GE junction? See discussion.

Final Aug 18 2014

Surgery of Primary Site--Brain and CNS: What procedure code would be used for NeuroBlate Laser Interstitial Thermal Therapy? This procedure was used for a Glioblastoma of the brain.

Final Jul 25 2014

Reportability--Head & Neck: Would this be reportable and if so what histology would be coded? Soft tissue mass left cheek excision reveals Carcinoma Ex Pleomorphic Adenoma Non-Invasive with focal vascular invasion. Margins clear.

Final Jul 25 2014

Reportability--Lung: One of our facilities has a case they are not really sure how to report.

This patient came in for a double lung transplant due to COPD which occurred on 1/27/14. At time of transplant, the team found out the donor hospital had identified a small nodule in the right lower lobe donor lung, which they biopsied and deemed negative. However, the slides were reviewed and felt to represent adenocarcinoma. The team performed a right lower lobe lobectomy of the donor lung before transplanting into the patient.

So, we are not really sure how to handle this case. The adenocarcinoma actually belongs to the donor patient from another hospital, however, they actually didn’t identify it at that facility as their pathology was negative for a malignancy.

Final Jul 25 2014

Reportability--Pancreas: Is this reportable? Is this benign? If reportable, what histology code and behavior code should be used? A final pathology diagnosis reads: "Cystic pancreatic endocrine neoplasm (CPEN)".

Final Jul 25 2014

MP/H Rules/Histology--Kidney, renal pelvis: How would you code this histology: Renal cell carcinoma, clear and eosinophilic cell type?

Final Jul 25 2014

Surgery of Primary Site--Corpus uteri: What is the correct surgery code to assign for dilation and curettage (D&C) for an in-situ endometrium (C541) primary? The code to use for the cervix uteri (C530-C539) is specified, but not for the corpus uteri (C540-C549).

Final Jul 25 2014

MP/H/Histology--Kidney, renal pelvis: What is the histology code for renal cell carcinoma translocation type?

Final Jul 25 2014

First course treatment: When a patient has a Haplo bone marrow transplant, is this coded as an allogenic bone marrow transplant since part of his marrow was used in addition to a donor?

Final Jul 25 2014

Summary Stage 2000--Melanoma: How should Summary Stage 2000 be coded for 2014+ diagnosed melanoma cases with satellite nodules or in transit metastases? See discussion.

Final Jul 24 2014

Reportability--Testis: Is a mature teratoma of the testis reportable? See discussion.

Final Jul 24 2014

MP/H Rules--Histology: How is histology coded when a metastatic site is biopsy positive for adenocarcinoma, but the physician clinically states this is cholangiocarcinoma? See discussion.

Final Jul 21 2014

MP/H Rules/Multiple Primaries--Lung: Does lung MP/H Rule M6 apply to synchronous tumors only, metachronous tumors only, or both? See discussion.

Final Jul 21 2014

Primary Site/In Situ: How is primary site coded for an in situ carcinoma arising in a mucinous cystadenoma with ovarian stroma (focal) located in the right lobe of the liver? See discussion.

Final Jul 21 2014

MP/H Rules/Histology--Lung: What is the correct histology code for this lung tumor? FINAL PATHOLOGIC DIAGNOSIS: CT-guided Rotex and Franseen needle biopsies: Positive for malignancy, consistent with adenocarcinoma. Comment: the adenocarcinoma present also shows rare CD56 staining which indicates a neuroendocrine component.

Is this a mixed histology? 8045/3? 8244/3?

Final Jul 21 2014

Primary site--Bladder: What is the primary site for bladder tumor biopsy: invasive adenocarcinoma, enteric type favor urachal origin, stage III

Final Jul 18 2014

Reportability--Pancreas: Is a solid pseudopapillary neoplasm of the pancreas reportable?

Final Jan 15 2015

MP/H Rules/Histology--Bladder: What is the correct histology code for a diagnosis of urothelial plasmacytoma carcinoma of the bladder per pathology report?

Final Jul 18 2014

MP/H--Bladder: Are 8130 and rule H12 correct for this case? Bladder with papillary urothelial carcinoma with squamous cell differentiation.

Final Jul 18 2014

Reportability--Heme & Lymphoid Neoplasms: Is this a reportable case and if so what codes would be used for the primary site and histology?

Lymph node flow cytometry and bone marrow biopsy revealed involvement by a low-grade B-cell lymphoproliferative disorder. Medical oncologist states monoclonal gammopathy, question marginal zone B cell lymphoma versus lymphoplasmacytic lymphoma/lymphoproliferative disorder.

Final Jul 18 2014

MP/H/Multiple primaries--Stomach: How should I report this case? I reviwed both the MP/H and the Heme Rules and could not determine whether or not this case is multiple primaries in a single site but two histologies and therefore needing two separate abstracts.

Path Diagnosis: Gastric Mass Biopsy: 1) Signet Ring Cell Carcinoma. 2) Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT Lymphoma). 3) Mild Intestinal Metaplasia and Marked Fundic Gland Atrophy, Negative for H Pylori. Comments: Biopsy shows presence of both signet ring carcinoma and MALT Lymphoma.

Final Jul 18 2014

Multiple primaries--Heme & Lymphoid Neoplasms: Is this abstracted as one primary or two?

5/2/13 Bone Marrow biopsy: myelodysplastic syndrome with approaching to acute myeloid leukemia with del 5q and 7q deletions. FISH: deletion of chromosome 5q and deletion of chromosome 7q detected.

I checked the Heme DB manual and there is no term "With approaching to". I checked the Multiple Primary calculator and it says new primary. My interpretation is that the myelodysplastic syndrome is in the process of transforming to acute myeloid leukemia.

Final Jul 18 2014

Reportability/Histology: Is this reporatable? If so, what is the correct histology?

2012 duodenal nodule biopsy, pathology positive for well differentiated neuroendocrine neoplasm.

Final Jul 18 2014

MP/H Rules/Histology--Sarcoma: What would be the morphology code for a low grade myofibroblastic sarcoma of the left distal forearm? I tried several different combinations but the closest I could come up with is myosarcoma.

Final Jul 18 2014

Reportability--Brain and CNS: Is Tuberculum sellae meningioma reportable? Is it same as sphenoidale meningioma?

Path: Brain tuberculum tumor resection: Meningioma, WHO grade I.

Final Jul 18 2014

MP/H Rules/Histology--Sarcoma: Is 8811/3 the correct code for myxofibrosarcoma (myxoid malignant fibrous histiocytoma) high-grade (grade 3/3)?

Final Jul 18 2014

MP/H/Multiple primaries--Urinary: In Aug 2008 Patient was diagnosed with Noninvasive Bladder Cancer. In Oct 2013 Patient was diagnosed with Transitional Cell Carcinoma of Right Ureter involving lamina propria, Noninvasive Transitional Cell Carcinoma Left Ureter and Invasive Transitional Cell Carcinoma of Prostatic Urethra. Is this a new primary and what is the primary site?

Final Jul 18 2014

MP/H/Multiple Primaries--Urinary: Is this one primary with a C689 primary code and morphology 8130/3? Or is this 2 primaries: 1. C679 8130/3 and 2.C680 8120/2. See discussion.

Final Jul 18 2014

Reportability/Primary Site--Lip: Is a right lower lip (NOS) squamous cell carcinoma reportable when the microscopic description states the tumor arises from the epidermis and extends through the dermis? See discussion.

Final Jul 11 2014

Reportability--Heme & Lymphoid Neoplasms: Is a statement of "JAK-2 positive polycythemia" reportable? See discussion.

Final Jul 11 2014

MP/H Rules/Multiple Primaries--Urinary: How many primaries are there and which MP rules apply in this scenario? See discussion.

Final Jul 07 2014

Grade--Prostate: How is Grade coded if hormone therapy is given prior to a prostate biopsy that confirms Gleason score 9 (4+5) adenocarcinoma? See Discussion.

Final Jun 05 2014

MP/H Rules/Multiple primaries--Prostate: Is duct carcinoma of the prostate the same as an adeno/acinar carcinoma of the prostate? Specifically, does rule M3 apply when there is an adenocarcinoma of the prostate followed by a duct carcinoma of the prostate or a duct carcinoma followed by adenocarcinoma?

Final May 15 2014

Reportability/MP/H Rules/Histology: Is this kidney tumor diagnosis reportable? If so, what is the correct histology? See discussion.

Final May 05 2014

Reportability--Ovary: Can you clarify when widely metastatic borderline histologies of the ovary and various other sites are reportable? See discussion.

Final Apr 22 2014

Reportability/Ambiguous Terminology--Prostate: Can you clarify why a prostate biopsy diagnosis of “highly suspicious for, but not diagnostic of adenocarcinoma, suggest another biopsy” is not reportable while a biopsy diagnosis of “atypical glands suspicious for adenocarcinoma with insufficient atypia to establish a definitive diagnosis of malignancy” is reportable? See discussion.

Final Apr 22 2014

Histology--Breast: Please confirm the morphology code for a diagnosis of "encapsulated papillary carcinoma" of the breast. Several articles on the internet lead me to believe it is the same as an intracystic carcinoma, code 8504/2 (our case shows no evidence of invasion).

Final Apr 08 2014

MP/H Rules: Regarding rules for Renal Pelvis, ureters, bladder & urethra - Please clarify Rule M8. Rule M8 references Table 1, but table 1 is a table of histologies not primary sites, Rule M8 also seems to contradict Table 2 and Rule M10. Does it matter where the first primary is, ie bladder then urethra or bladder then renal pelvis?

Final Apr 08 2014

MP/H Rules/Multiple primaries--Bladder: Is this a single primary or multiple primaries? Transurethral resection of the bladder identifies two bladder tumors. Pathology states one is high grade papillary carcinoma (8130/3) and the other is lymphoepithelioma-like urothelial carcinoma (8082/3). Lymphoepithelioma-like is listed as a urothelial type in Table 1 but rule M6 does not include it in the list of histologies and we are not told to refer to Table 1. M8 refers to Table 1 but does not include multiple bladder tumors (C67_). Specify which rule would apply and why.

Final Apr 08 2014

MP/H Rules/Histology-Urinary: 1) What is the correct ICD-O-3 morphology code for conventional renal cell carcinoma? Is this clear cell carcinoma or does conventional refer to the general diagnosis?

2) If a patient was diagnosed with invasive papillary urothelial carcinoma of the bladder in May 2011 and returns in February 2013 with invasive urothelial carcinoma of the bladder, what is the correct ICD-O-3 morphology code?

Final Apr 08 2014

MP/H Rules/Histology--Bladder: What is the correct histology for the following bladder case and how do you determine? See discussion.

Final Apr 08 2014

Histology: Are all well differentiated neuroendocrine carcinomas (carcinoid) tumors coded to 8240 or 8246? When do you use code 8246?

Final Apr 08 2014

Grade--Heme & Lymphoid Neoplasms: Why isn't "T-cell granular lymphocytic leukemia" (9831/3) coded as "5 T-cell" instead of "9" as specified in the Heme database? My path department did not specify any type of grade, but since "T-cell" is part of the name, wouldn't you code it to "5"?

Final Apr 08 2014

MP/H Rules/Histology--Bladder:What is the correct histology code for the following bladder histology? High grade urothelial cancer with extensive neuroendocrine differentiation.

Final Apr 08 2014

MP/H Rules/Kidney, renal pelvis--How many primaries are there for this case? Should we stop at rule M8 making this all one primary (C689) even though there were right and left renal pelvis tumors? Rule M3, which contains laterality, does not apply because there is also a bladder tumor. See discussion.

Final Apr 08 2014
20140021 Reportability--Breast: Is an inflammatory myofibroblastic tumor of the breast with metastasis to the lung reportable? Final Mar 31 2014
20140020 Reportability--Breast: Is ADH/DCIS reportable? Final Dx for left Breast biopsy: Atypical epithelial proliferation (ADH/DCIS). Comment: Sections show small focus of atypical epithelial proliferation with features of atypical duct hyperplasia/low grade duct carcinoma in-situ. Final Mar 18 2014
20140019 Reportability--Breast: Is this reportable as 8520/2? Final Diagnosis: Atypical Lobular Hyperplasia (ALH/LCIS). We are seeing this diagnosis quite often. Final Mar 17 2014

Multiple Primaries--Heme & Lymphoid Neoplasms: 2012 path report for removal of an "axillary mass" which consists of 80% diffuse large B-cell lymphoma (DLBCL) and 20% follicular lymphoma. In the original manual, Module 6 instructed us to code as a single primary, DLBCL. However, the multiple primary calculator says each disease is a separate primary. When I looked them up in the data base, I did not get an option to review a current manual. Can you please advise?

Final Feb 21 2014
20140016 MP/H Rules/Histology--Bladder: What is the correct histology code for this situation? See discussion. Final Feb 17 2014
20140015 Primary site--Heme & Lymphoid Neoplasms: Is there an instruction missing under Rule PH22 of the 2014 Heme Manual that addresses when it might be appropriate to code primary site to C779 for a Stage II lymphoma? See discussion. Final Feb 10 2014
20140014 First course treatment/Surgery of Primary Site--Anus: Would infrared coagulation be coded as treatment for AIN III of the anus/anal canal? See discussion. Final Feb 10 2014
20140013 Primary site--Brain and CNS: How should primary site be coded for a medulloblastoma described as a "posterior fossa mass” and “centered within the fourth ventricle"? See discussion. Final Feb 10 2014
20140012 MP/H Rules/Histology--Breast: What is the correct histology code for this final diagnosis of a breast tumor: INVASIVE POORLY DIFFERENTIATED DUCTAL CARCINOMA WITH SQUAMOUS DIFFERENTIATION (METAPLASTIC FEATURES)? Final Feb 05 2014
20140011 MP/H Rules/Multiple primaries--Breast: Is the diagnosis of Paget disease two years after a diagnosis of infiltrating duct carcinoma of the same breast a new primary? See discussion. Final Jan 24 2014
20140010 Multiple primaries--Heme & Lymphoid Neoplasms: Is this one primary or two? Follicular lymphoma grade 1 (9695/3) on 8/23/12 from an abdominal lymph node. On 1/6/14 an abdominal lymph node biopsy showed diffuse large b cell lymphoma arising from high grade follicle center cell lymphoma. Patient has been on observation. Final Jan 22 2014
20140009 Primary site: What primary site do I assign to a Squamous Cell Carcinoma of the parapharyngeal space when there is no other info available regarding a more definitive site within the parapharyngeal space? Each physician involved with the case states the primary site is the parapharyngeal space. This is a patient who was diagosed and treated elswhere and was seen at our hospital several months later for a radical neck dissection for suspected lymph node mets. Final Jan 22 2014
20140008 Primary site: If text supports a pancreatobiliary primary with no other information what primary site code would be assigned? C249 biliary tract NOS, or C269 GI tract nos, or C809 unknown? Final Jan 22 2014
20140007 Surgery of Primary Site--Lung: How is surgery coded when a patient undergoes a mediastinoscopy with mediastinal lymph node sampling and then a later upper lobectomy? See discussion. Final Jan 15 2014
20140006 Date Therapy Initiated--Corpus Uteri: How should this field be coded for an endometrial primary when the patient undergoes a hysteroscopic polypectomy on 01/08/2014 (Surgery code 25), followed by a TAH/BSO on 02/07/2014 (Surgery code 50)? See discussion. Final Jan 15 2014
20140005 Primary site--Testis: In the absence of a specific statement that the patient's testicle(s) are descended, should the primary site for a testicular tumor be coded as C621 (Descended Testis) when the mass is palpable on physical exam or demonstrated on scrotal ultrasound? See discussion. Final Jan 15 2014
20140004 Grade--Liver: How should grade be coded for a liver lesion treated with radio frequency ablation (RFA) followed by a transplant showing moderately differentiated hepatocellular carcinoma? See discussion. Final Jan 15 2014
20140003 Surgery of Primary Site/Surgical Procedure of Other Sites--Endometrium: How are these fields coded for an endometrial primary when the patient undergoes a radical tumor cytoreduction including modified radical hysterectomy, BSO, omentectomy, resection of intra-abdominal and intrapelvic implants, and partial cystectomy? See discussion. Final Jan 15 2014
20140002 Reportability--Appendix: Is a pathologic final diagnosis of an appendix with "well-differentiated neuroendocrine tumor (carcinoid)" reportable? See discussion. Final Jan 15 2014
20140001 Grade--Brain and CNS: How should grade be coded for a pineal parenchymal tumor of “intermediate differentiation”? See discussion. Final Jan 10 2014
20130222 MP/H Rules/Histology--Bladder: How is the histology coded for a single bladder tumor showing invasive urothelial carcinoma with extensive divergent differentiation including small cell carcinoma, micropapillary carcinoma, and squamous cell carcinoma features? See Discussion. Final Jun 25 2014
20130221 MP/H Rules/Multiple primaries--Prostate: How many primaries are accessioned for a diagnosis of metastatic small cell neuroendocrine carcinoma of the prostate following a previous diagnosis of adenocarcinoma of the prostate? See Discussion. Final Jun 25 2014
20130220 Reportability--Thyroid: Is a hyalinizing trabecular neoplasm of the thyroid reportable? See Discussion. Final Jun 25 2014
20130219 Date of diagnosis/Ambiguous terminology--Breast: Can a mammogram BIRADS 4 or 5 assessment be used to assess reportability and can the date of the mammogram be used to code the date of diagnosis? See Discussion. Final Jun 30 2014
20130218 Final Dec 10 2013

Primary site--Heme & Lymphoid Neoplasms: Need help determining primary site for Diffuse Large B-Cell Lymphoma 9680/3 confirmed pathologically in right ovary and soft tissue left adnexa. No lymph nodes examined pathologically. Patient treated outside and no access to notes. See discussion.

Final Dec 09 2013
20130215 Reportability--Heme & Lymphoid Neoplasms: Is hemophagocytic lymphohistiocytosis synonymous with an EBV-associated lymphoproliferative disorder in children considered reportable? See Discussion. Final Jun 30 2014
20130214 Primary site--Heme & Lymphoid Neoplasms: Does Rule PH20 apply if a patient with lymphoma has bilateral axillary and bilateral inguinal lymph node involvement? Final Jun 30 2014
20130213 Primary site--Heme & Lymphoid Neoplasms: How do you code the primary site for a marginal zone lymphoma involving bilateral axillary lymph nodes and inguinal lymph nodes, bone marrow and bilateral orbits that the physician refers to as a bilateral orbital lymphoma, Stage IV? See Discussion. Final Jun 30 2014
20130212 Reportability--Heme & Lymphoid Neoplasms: Is a case reportable in which the pathology report is negative for plasmacytoma but a subsequent physician’s clinical diagnosis is plasmacytoma? Final Jun 30 2014
20130211 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are reported if a bone marrow shows low grade mature B cell lymphoma with IgM paraprotein - macroglobulinemia? See Discussion. Final Jun 30 2014

Primary site--Heme & Lymphoid Neoplasms: Does Rule PH27 apply meaning that primary site is coded to C809 or would it be more appropriate to code to C269 GI Tract NOS since all disease involves the GI tract and this is more specific?

Extranodal lymphoma first diagnosed in the stomach (fundus and antrum) which upon further investigation also involved the small bowel (MALT Lymphoma) in the absence of lymph node findings. MD staged this IIE. Initial thought was Gastric, but PET/CT indicated abnormal uptake involving loop of distended small bowel in the pelvis.

Final Dec 06 2013
20130209 Multiple primaries--Heme & Lymphoid Neoplasms: Is a new bone marrow diagnosis of acute myelogenous leukemia that follows a 2007 treated diagnosis of a JAK-2 positive polycythemia vera considered a new primary? Final Jun 30 2014

Histology--Heme & Lymphoid Neoplasms: How is histology coded when a bone marrow shows slightly hypercellular marrow with acute myeloid leukemia, non-M3 type and the flow cytometry is also consistent with acute myeloid leukemia, non-M3 type?

Final Jun 30 2014
20130207 Multiple primaries--Heme & Lymphoid Neoplasms: Is a new primary reported for the diagnosis of plasmacytoma associated with a pathological fracture if it follows a diagnosis five years ago of multiple myeloma? See Discussion. Final Jun 30 2014
20130206 Primary site--Heme & Lymphoid Neoplasms: What rule applies to code a primary site for a peripheral blood diagnosis of marginal zone lymphoma that has a positive flow cytometry/FISH analysis when no biopsies are performed, scans show no evidence of disease, exam indicates no lymph nodes are palpable and the physician’s clinical diagnosis "marginal zone lymphoma, unspecified site, stage 1"? See Discussion. Final Jun 30 2014
20130205 MP/H Rules/Multiple primaries--Breast: How many primaries are reported and what is the histology for each in a case of infiltrating duct and lobular carcinoma of the breast (8522) with Paget disease of the same breast? Final Jun 25 2014
20130204 MP/H Rules/Histology--Kidney, renal pelvis: How is histology coded for a tubulocystic renal cell carcinoma? See Discussion. Final Jun 25 2014
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