CS Site Specific Factor--Head & Neck: If a lymph node dissection of the neck reveals that 1/24 lymph nodes is positive and the positive 5.6 cm lymph node extends throughout levels II-IV, how are the SSF 3 (status of levels I-III lymph nodes) and SSF4 (status of levels IV-V lymph nodes) fields 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.According to the CS Steering Committee, code 999 for SSF 3 and SSF 4. In this case, do not make assumptions about which level of lymph nodes were involved.
MP/H Rules/Multiplicity Counter--Lung: If metastatic tumors are not counted in this field, should the multiplicity counter be coded to 01 for a case with a primary left lower lobe of lung tumor with a satellite tumor in the left upper lobe?
For cases diagnosed 2007-2013:
No, code multiplicity counter to 02 [two tumors present]. According to the multiple primary rules, these two lung tumors are reported as a single primary. Record the number of tumors reported as a single primary in Multiplicity Counter.
Multiplicity Counter no longer required by SEER as of 1/1/2013.
Multiple primaries--Lymphoma: Is a splenectomy done for non-Hodgkin lymphoma diffuse large B-cell of the spleen a composite histology and a single primary if a perihilar lymph node with Hodgkin lymphoma classic type is found at the time of this surgery?
For cases diagnosed prior to 1/1/2010:This is two primaries -- Non-Hodgkin lymphoma (NHL) in the spleen and Hodgkin lymphoma (HD) in a lymph node.
Composite lymphoma is NHL and HD both in a single lymph node.
For cases diagnosed 1/1/10 and later, 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.
Histology--Lymphoma: How is a "lymphocytic lymphoma of follicular center cell origin" coded?
For cases diagnosed prior to 1/1/2010:Assign code 9690 [Follicular lymphoma, NOS]. According to the WHO Classification of Lymphoid tumors, follicular lymphoma is a neoplasm of follicle center B cells which has at least a partially follicular pattern.
Assign code 9695 for follicular lymphoma grade 1, 9691 for follicular lymphoma grade 2, and 9698 for follicular lymphoma grade 3.
For cases diagnosed 1/1/10 and later, 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.
EOD-Extension--Kidney: If a "tumor thrombus" in a renal vein is discontinuous from the primary tumor in the kidney, is it still coded to 60 [Tumor thrombus in a renal vein, NOS], rather than 85 [Metastasis]?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 60 [Tumor thrombus in a renal vein, NOS]. A thrombus can be a bolus of tumor cells within a large vein that may or may not still be connected/contiguous with the primary tumor. However, both a discontinuous and contiguous thrombus are coded to 60.
MP/H Rules/Multiple Primaries--Bladder: The new multiple primary rule M7 states that tumors diagnosed more than three years apart are multiple primaries. Does this apply to in situ bladder tumors that occur more than three years apart and to an in situ tumor that occurs three years after an invasive tumor?
For cases diagnosed 2007 or later, use the MP/H rules in order. Rule M6 comes before rule M7.
M6 states that bladder tumors with certain histologies are a single primary. It is a single primary regardless of timing if there is any combination of:
papillary carcinoma [8050]
transitional cell carcinoma [8120-8124]
papillary transitional cell carcinoma [8130-8131]
Rule M7 applies to bladder tumors with histologies other than those listed above. If you have such a case, rule M7 applies to in-situ tumors and to an in situ three years after an invasive.
Radiation Therapy--Breast: If hospital records indicate that a mammocyte intracavitary radiation therapy device was placed in the breast, but there is no follow-up documentation of radiation actually being given, should we code radiation 2 (implants) or 8 (recommended, unknown if given)?
Assign code 8 [recommended, unknown if administered]. Check this case periodically, and others coded 8. Update if further information becomes available.
Reportability--Prostate: According to the 2018 SEER Program Manual, a prostatic intraepithelial neoplasia (PIN) III is not reportable, but is an atypical small acinar proliferation (ASAP) PIN 4 reportable?
ASAP is not reportable. Patients with ASAP found on needle biopsy will likely undergo another biopsy.
Reportability: Is positive urine cytology (ex: malignant cells interpreted as carcinoma) by itself reportable? If so, is the case coded to bladder by default or is is coded to C689, urinary system, NOS?
Urine cytology positive for malignancy is reportable. Code the primary site to C689 in the absence of any other information.
However, if a subsequent biopsy of a urinary site is negative, do not report the case.
For 2013 diagnoses and forward, report these cases when they are encountered. Do not implement new/additional casefinding methods to capture these cases.
As always, do not report cytology cases with ambiguous terminology.
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