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Report Produced: 04/21/2026 17:21 PM

Report Question ID Question Discussion Answer Year
20110090 MP/H Rules/Histology/Behavior--Ovary: How are these fields coded for a 20 cm borderline mucinous tumor with a 0.3 cm minor focus of intraepithelial carcinoma of the ovary that the pathologist stages as T1a?

According to the MP/H rules, code histology to 8010/2 [intraepithelial carcinoma] for cases diagnosed 2007-2014. Borderline mucinous tumor is not reportable to SEER.

The steps used to arrive at this decision are:

Go to the Other Sites Histo rules found in the Multiple Primary and Histology Coding Rules Manual.

Start at the SINGLE TUMOR: IN SITU ONLY module, rule H1. Code the histology when only one histologic type is identified. The only reportable histology in this case is intraepithelial carcinoma [8010/2].

2011
20110041 Histology--Heme & Lymphoid Neoplasms: How is this field coded when the final diagnosis for excisional biopsy of two cervical lymph nodes shows classical Hodgkin lymphoma, histologic subtype cannot be determined, but the COMMENT section of the report indicates there are features of both lymphocyte rich and nodular sclerosis subtypes?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Per Rule PH28, code histology to 9650/3 [Classical Hodgkin lymphoma]. This rule states to code the non-specific (NOS) histology when the diagnosis is one non-specific (NOS) histology and two or more specific histologies.

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. http://seer.cancer.gov/seertools/hemelymph.

2011
20110047

Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are to be abstracted when a patient is diagnosed with NHL, large B-cell lymphoma in 3/2010 followed by a "recurrence of previously diagnosed" NHL per a 12/2010 liver biopsy? See Discussion.

Are there timing rules related to the comparison of slides from a subsequent hematopoietic primary diagnosis to the slides from the original hematopoietic primary diagnosis that impact the number or primaries reported?

For example, how many primaries are reported for a patient was diagnosed in 3/2010 with large B-cell lymphoma who underwent 7 rounds of chemo. Per 10/2010 PET scan, there was no evidence of disease. In 12/2010 a liver biopsy revealed, "features consistent with recurrence of previously diagnosed non-Hodgkin lymphoma." The pathologist did not compare slides to the original, but several immunoperoxidase stains were done to obtain the final diagnosis in 12/2010.

Does timing or comparison to the original slides matter for Heme & Lymphoid Neoplasms? Is a comparison of slides needed as required for solid tumor "recurrences"?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This case should be accessioned as one primary per Rule M15, 9680/3 [diffuse large B-cell lymphoma]. Per Rule M15 one is to use the Heme DB Multiple Primaries Calculator to determine the number of primaries for all cases that do not meet the criteria of M1-M14. The 12/2010 liver diagnosis of NHL, NOS [9591/3] is the same primary per the Multiple Primaries Calculator.

There are no timing rules for lymphoma other than rules M8-M13 which deal with the timing of chronic and acute diagnoses.

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.

 2011
20110062 Histology--Heme & Lymphoid Neoplasms: Is diffuse large B-cell lymphoma, germinal cell type coded to diffuse large B-cell lymphoma?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph..

Per Rule PH30, use the Heme DB, determine the histology when rules PH1-PH29 do not apply. Code diffuse large B-cell lymphoma, germinal cell type to 9680/3 [diffuse large B-cell lymphoma (DLBCL)][9680/3]. Under the Alternate Names section of the Heme DB, these two terms are synonyms that share the same histology code.

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.

2011
20110003 MP/H Rules/Histology--Colon: Which MP/H rule applies and what is the histology code for a "large cell neuroendocrine carcinoma (arising in adenocarcinoma)"? See Discussion.

Per the pathology report COMMENT section, "In addition to usual adenocarcinoma, a significant portion of this tumor displays features consistent with large cell neuroendocrine carcinoma, an aggressive neoplasm which has a poorer prognosis than adenocarcinoma of comparable stage."

Is histology coded to 8574/3 [adenocarcinoma with neuroendocrine differentiation] for this case?

For cases diagnosed 2007 or later:

Code histology to 8244/3 [composite carcinoid]. Rule H9 applies: Code 8244 [composite carcinoid] when the diagnosis is adenocarcinoma and carcinoid tumor. WHO describes these tumors as "mixed adenoneuroendocrine carcinoma (MANEC)." They have components of adenocarcinoma mixed with high-grade neuroendocrine carcinoma (NEC), which can be either small cell or large cell.

The next version of the MP/H rules for colon will make this clear by adding a note regarding this issue to Rule H9.

2011
20110035 Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded when both a lymph node biopsy and peripheral blood are positive for CLL/SLL? See Discussion. Per Module 3, Rules PH5 and PH6 in the Hematopoietic Manual, it states that CLL has peripheral blood involvement and SLL does not.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the primary site to C421 [bone marrow] and histology to 9823/3 [CLL/SLL]. Per Rule there may be involvement of bone marrow AND lymph node(s), lymph node region(s), organ(s), or tissue(s) but as long as the peripheral blood and/or bone marrow are involved, the primary site is bone marrow (C421).

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.

2011
20110002 Surgery of Primary Site--Penis: How is CO2 laser treatment coded for penile cancer? Assign code 14 [laser] for CO2 laser treatment given for primary penile cancer. The CO2 is the method used to deliver the laser. 2011
20110011 Reportability--Heme & Lymphoid Neoplasms: Is a 2010 diagnosis of "thrombocytopenia of unknown etiology" reportable? See Discussion.

No exact match returned after entering the term "thrombocytopenia of unknown etiology" in the Heme DB. However, the program does indicate there are 17 results that could be displayed that show any of the 4 terms entered. Clicking on the search label indicates there are no matches either.

The only result returned after entering "thrombocytopenia" into the search box is "refractory thrombocytopenia."

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

"Thrombocytopenia of unknown etiology" is not reportable. Thrombocytopenia refers to a low platelet count which causes bleeding. Thrombocytopenia can be caused by viral infections, excessive alcohol usage, HIV, and other causes (including chemotherapy). If the diagnosis is not "refractory thrombocytopenia" the case is not reportable. Appendix F lists this term as non-reportable.

If you do not see the term in the Heme DB under either the Name column or the Alternative Names section for the results returned, it is not reportable. The only reportable term that contains the word thrombocytopenia is refractory thrombocytopenia. Therefore, thrombocytopenia of unknown etiology is not reportable.

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.

2011
20110020 Heme & Lymphoid Neoplasms: How is cancer status to be coded when a patient diagnosed with MDS, undergoes treatment, but the MDS subsequently transforms to AML? If the bone marrow no longer shows evidence of MDS, the cancer status for the MDS is disease-free. When cancer status is coded as disease-free (NED), it means that currently there is no clinical evidence of this disease (MDS). 2011
20110074 First course treatment/Date therapy initiated--Breast: How is the Date of Initiation of Hormone Therapy field coded when a patient undergoes "Tamoxifen blunting" to achieve better MRI imaging after a biopsy but prior to definitive surgery which is followed by adjuvant Tamoxifen therapy? See Discussion. Patients are prescribed two weeks of "Tamoxifen blunting" to achieve better MRI imaging after biopsy confirmation of an ER/PR positive breast carcinoma. The Tamoxifen is subsequently discontinued and the patient has definitive surgery. Following surgery, maintenance Tamoxifen is initiated. Which date should be recorded for the Date of Initiation of Hormone Therapy field? Is it the first date when Tamoxifen blunting started or the post-surgical date when maintenance Tamoxifen is initiated? Use the post-surgical start date of maintenance Tamoxifen to code the Date of Initiation of Hormone Therapy field. The actual hormone treatment begins after surgery when Tamoxifen blunting was performed. The low dose administered prior to surgery does not affect the cancer. 2011