SEER Inquiry System - Report
Produced: 11/25/2024 7:35 AM
Question 20081141
Inquiry Details
References:
2007 SEER Manual, C-527, C-531. Appendix C
Question:
MP/H Rules--Lung: How do we interpret 'spiculated opacities?' How many primaries do we abstract for this patient? See Discussion.
Discussion:
Patient admitted for CT scan of chest. Impression: A small subpleural spiculated opacity is noted in the left upper lobe measuring 9.7x7.7mm. Right upper lobe spiculated nodular opacity measures 13.9x5.9mm. Right lower lobe scattered faint alveolar nodular opacities are noted. The lungs are otherwise clear. Abnormal soft tissue density mass is noted of the right hilum surrounding the distal main right pulmonary artery. Bronchoscopy/mediastinoscopy done: rare malignant cells present consistent with small cell carcinoma, specimen submitted as brushing of right bronchus intermedius. The tumor in the lymph node is metastatic small cell carcinoma. Patient discharged to hospice; died 5 weeks later.
Do the MP/H rules pertain only to the measured opacities in each lung and not to the RLL scattered faint alveolar nodular opacities? The right side was cytologically confirmed. But if we abstract the left lung, what is the histology...8041 or 8000?
Answer:
For cases diagnosed 2007 or later:
Because there was cytologic confirmation of cancer, for this case only count the spiculated opacities as tumors. Abstract as a single primary using Rule M1. Note 2 under lung rule M1 applies to this case.
Code the histology as 8041 [small cell carcinoma] per rule H10.