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Reportability--Stomach: Is a well-differentiated neuroendocrine tumor of the stomach reportable?
Well-differentiated neuroendocrine tumor (NET) of the stomach is reportable. The WHO classification of digestive system tumors uses the term NET G1 (grade 1) as a synonym for carcinoid and well-differentiated NET, 8240/3.
CS Site Specific Factor 1--Colon: If the registrar did not support the CEA code recorded with the appropriate text documentation, should the central registry accept the registrars coding or change the value to 999?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Accept your registrars' codes at your discretion. It is encouraged, but not required, to enter text for CS data elements. These cases do not automatically default to code 999.
Primary Site: For malignant gastrointestinal tumors (GISTs), how should the primary site be coded and which Collaborative Stage and TNM staging schemes should be used for disease found in the stomach, small intestine or other locations?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Code the primary site to the location where the GIST originated. If the primary site cannot be determined, assign code C809 [Unknown primary site].
GIST of gastrointestinal hollow viscera cannot be staged in TNM.
In Collaborative Staging, use the stomach scheme for GIST of the stomach. Use the small intestine scheme for GIST of the small intestine. For GIST of other primary sites, use the CS scheme for the specific site.
Histology--Leukemia: How is a "plasmacytoid dendritic cell leukemia/lymphoma" coded when it is discovered on a bone marrow biopsy for a patient who presented with multiple enlarged lymph nodes and the discharge diagnosis was Type 2 plasmacytoid dendritic cell leukemia?
For cases diagnosed prior to 1/1/2010:
The best code currently available for this entity is 9727/3 [precursor cell lymphoblastic leukemia].
The WHO classification refers to this as "Blastic NK-cell lymphoma." The 2005 WHO-EORTC classification for cutaneous lymphomas states that blastic NK-cell lymphoma may be derived from a plasmacytoid dendritic cell precursor. They suggest more appropriate terms for this condition may be "CD4+/CD56+ hematodermic neoplasm," and "early plasmacytoid dendritic cell leukemia/lymphoma." According to WHO, this is a rare form of lymphoma.
Willemze, et al. WHO-EORTC classification for cutaneous lymphomas. Blood, 15 May 2005. Volume 105, Number 10.
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
Radiation--Choroid: How do you code treatment involving a "radioactive iodine plaque" for choroidal melanomas?
Code the Radiation field to 2 [Radioactive implants]. Codes for radiation are based on HOW the radiation is delivered, rather than the particular type of radioactive material used.
Radioactive eye-plaques contain rice-sized iodine-125 or palladium-103 seeds which emit low energy photons. They are sewn or glued into the eye. The plaque remains for 5 to 7 days and is then removed.
Grade--Heme & Lymphoid Neoplasms: Is the phrase "aberrant T-cell expression" enough to code the grade field to T-cell when the final diagnosis on the pathology report is "AML with aberrant T-cell antigen expression"?
Yes. Code grade to 5 [T-cell]. The T cell receptor, or TCR, is a molecule found on the surface of T lymphocytes (or T cells).
EOD-Extension--Urinary Tract: Can the rules used to code bladder extension involving the term "no involvement of muscularis/and no mention of subepithelium/submuscosa" be used to code extension for other urinary tract primaries, such as ureter?
For cases diagnosed 1998-2003:
No. The inferred descriptions of noninvasion apply to bladder cases only.
EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank?
For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.
Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis.
Reportability--Head & Neck: What are the correct site and histology codes if a glomus tympanicum tumor of the middle ear is reportable?
Glomus tympanicum tumors of the middle ear are not reportable. The 2005 WHO Classification of Head and Neck Tumors classified these tumors as a borderline [/1] behavior and recorded them in the ICD-O-3 with histology code 8690 [glomus jugulare tumor, NOS].
According to WHO, "the distinction between jugular and tympanic paragangliomas can easily be made in the patient by modern imaging methods ... the jugular neoplasm is identified as arising from the jugular bulb region ... while the tympanic neoplasm is confined to the middle ear." Benign and borderline neoplasms of the middle ear [C301] are not reportable. The middle ear is not a reportable CNS site for benign and borderline tumors.
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