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2004 SEER Manual Errata/CS Lymph Nodes--Head & Neck: On page C-353, in the supraglottic larynx schema, there is no mention of Level IV nodes in the CS Lymph Node codes.
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.The CS Steering Committee is aware of this issue and is working to resolve it.
EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: How are these fields coded if radiation to the primary site and/or regional lymph nodes is performed prior to surgery?
For cases diagnosed 1998-2003:
Code the EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined fields per the information in the pathology report(s). Radiation to the primary site would not affect the status of the lymph node involvement. Radiation to the regional lymph node region may or may not affect the pathologic status of the lymph nodes. However, for these fields code the best information available about the status of the lymph nodes which is reflected in the pathology report(s).
Reportability--Brain and CNS: Is pseudotumor cerebri reportable?
Pseudotumor cerebri is not reportable. It is not a neoplasm. The pressure inside the skull is increased and the brain is affected in a way that appears to be a tumor, but it is not a tumor.
EOD-Extension--Lung: If a CT scan indicates that a patient has evidence of "long-standing pneumonia," is that synonymous with "pneumonitis" for the purposes of coding extension for lung primaries?
No. These terms are not synonymous. For cases diagnosed 1998-2003, disregard the pneumonia and use the other available information to code extension.
Reportability--Heme & Lymphoid Neoplasms: Is EBV-positive hemophagocytic lymphohistiocytosis (HLH) reportable when diagnosed in a 5 year old child and resulted in death in less than two months?
Hemophagocytic lymphohistiocytosis (HLH) is not a reportable disease because it is not listed in the Heme DB.
Per our expert pathologist consultant, "HLH is a lymphocyte driven hemophagocytic syndrome which may be either genetically based or caused by over-activated lymphoid cells, often in response to a viral infection. It is an abnormal immune response and is not considered a malignant disease, and is, therefore, not reportable. It is not synonymous with EBV-positive T-cell lymphoproliferative disease of childhood (9724/3)."
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.
CS Extension/CS Mets at Dx--Pineal Gland: In Collaborative Stage, how is positive cerebral spinal fluid coded?
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.Assign CS Mets at DX code 40 [Distant metastases] for a pineal gland primary with positive cerebral spinal fluid.
Reportability/Diagnostic Confirmation: If a physician signs a case out as "precancerous melanosis of the face" (8741/2) and there is no microscopic confirmation of the disease, is this a reportable clinical diagnosis?
This case is reportable because the diagnosis of precancerous melanosis was stated by a recognized medical practitioner. Precancerous melanosis meets the reportable diagnosis criteria (See 2007 SEER Manual page 1).
Reportability--Anus: Is a final diagnosis on a pathology report of "squamous cell carcinoma of the anus, NOS" assumed to be a skin of anus primary or a primary of the anus?
Squamous cell carcinoma of the anus is reportable unless known or stated to be skin of anus.
MP/H Rules/Histology--Head & Neck: Please clarify rule H3. The first statement is "Do not code terms that do not appear in the histology description". The second statement is "Do not code...unless the words...appear in the final diagnosis"
One of our pathology labs frequently will state "keratinizing squamous cell" in the microscopic description (histologic description), but only state "squamous cell carcinoma" in the final diagnosis. May we code from the histologic description if it's not in the final diagnosis?
Follow rule H3 and code squamous cell carcinoma for these cases unless you can obtain confirmation that these cases should be coded keratinizing squamous cell carcinoma from the lab and/or pathologist. Document this confirmation in your policies and procedures.
The MP/H rules were written with input from leading pathologists in each specialty area. Based on their expert opinion, we instruct registrars to code histology based on the information in the final diagnosis. The microscopic description may contain other terms, but the pathologist lists only the pertinent terms in the final diagnosis.
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