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20100064 | Histology--Heme & Lymphoid Neoplasms: How is histology to be coded for acute lymphoblastic leukemia (ALL) and/or precursor B acute lymphoblastic leukemia (Pre-B ALL) for cases diagnosed 2010 and later? The Heme Database has two histology codes for this disease, both 9811/3 and 9836/3, which is the correct histology code? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code histology to 9811/3 [B lymphoblastic leukemia/lymphoma, NOS].
See the Abstractor Notes section in the Heme DB, when determining how to code histology for a case. It indicates the code 9811/3 is effective for cases diagnosed 2010 and forward. The 9836/3 is listed as obsolete and refers you to code 9811/3. Make sure to check for a specific subtype of B lymphoblastic leukemia/lymphoma [9812/3 - 9818/3] before assigning the NOS code [9811/3].
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. |
2010 | |
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20100095 | MP/H Rules/Multiple primaries--Kidney, renal pelvis: In a patient who was never disease free because of multiple recurrences of invasive transitional cell carcinoma of the bladder originally diagnosed in 2004, is an invasive high grade urothelial carcinoma of the renal pelvis diagnosed in 2010 a new primary? See Discussion. |
Patient has invasive TCC of the bladder diagnosed in 2004, and has never been disease free. In 2/18/10 a left renal pelvis wash showed urothelial carcinoma, high grade. On 4/7/10 a nephroureterectomy revealed high grade urothelial carcinoma with sarcomatous and squamous differentiation invading through pelvic wall and perihilar soft tissue. Is this a new renal pelvis primary? |
For cases diagnosed 2007 or later, the renal pelvis is a new primary per rule M7. M7 will be better explained in the revised MP/H rules, but the rationale is that no field effect was present for more than 3 years. Although the bladder CA continued to recur, there were no other organs involved until 2010. M7 is intended to make the renal pelvis a new primary because there was no field effect (no organs other than bladder involved) for more than 3 years. |
2010 |
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20100054 | MP/H Rules/Multiple primaries--Breast: How many primaries are accessioned if a pathology specimen reveals an infiltrating mammary carcinoma with mixed tubular and lobular features, 2.3 cm, low grade cribriform in situ ductal carcinoma, and Paget disease of the overlying skin with ulceration? See Discussion. | According to SINQ 20081134 the histology would be 8524 if this is one primary. | For cases diagnosed 2007 or later, this is a single primary.
In order to determine whether this case represents a single or multiple primary, you must first determine the correct histology code for the underlying tumor. Using rule H9, ignore the DCIS.
See Table 3 in the equivalent terms and definitions. Infiltrating lobular, tubular, and Paget are coded to a single histology code (8524/3). Our current multiple primary rules do not say infiltrating lobular and tubular and Paget are a single primary. This was an omission and will be corrected in a future revision. Thank you for bringing this omission to our attention. |
2010 |
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20100109 | Reportability--Ovary: Does the ICD-O-3 term "stromal endometriosis" [8931/3] always imply a reportable malignant disease process if the pathologist also states there is "no evidence of carcinoma" in the same report? See Discussion. | ROS Final Diagnosis: LSO: Ovary with an endometriotic cyst (1.2 cm) and stromal endometriosis with multifocal papillary syncytial eosinophilic, clear cell and tubal metaplasia, no evidence of carcinoma.
COMMENT: There is extensive endometriosis involving the ovarian stroma and the ovarian surface. The ovarian stroma contains multiple cystic endometrial glands and surrounding endometrial type stroma with variable amounts of hemorrhage. There are non-cystic foci of endometriosis comprised of small, irregular glandular structures within the stroma. The lining of larger cyst/cysts is involved by a single layer of cuboidal to columnar cells with markedly eosinophilic cytoplasm in areas of serous (tubal) metaplasia and papillary projections suggestive of papillary syncytial metaplasia. Within these areas there is epithelial tufting and stratification, raising the consideration of proliferative/borderline change (which we cannot entirely exclude), however, given the background of endometriosis and morphologic similarity to papillary syncytial metaplasia in the endometrium, we favor that this is a non-neoplastic reactive change. There is no evidence of carcinoma. |
This case is not reportable. The pathologist states that there is no evidence of carcinoma. The ICD-O-3 matrix system applies, giving the pathologist the final say on behavior. | 2010 |
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20100050 | Reportability--Colon: Would a carcinoid tumor, NOS, of the appendix with perineural or angiolymphatic invasion be reportable if there is no mention of malignancy in the pathology report? |
Carcinoid, NOS, of the appendix diagnosed in 2015 or later is reportable.
For cases diagnosed prior to 2015
Carcinoids of the appendix are reportable when they meet any of the following conditions.
Note that the implants/involvement must be designated as malignant. Many benign tumors will spawn implants that are also benign. If implants are benign, this is not a reportable tumor. |
2010 | |
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20100038 | Surgery of Primary Site--Prostate: Is a prostate saturation biopsy coded under diagnostic biopsy or surgery? | A prostate saturation biopsy is a transperineal template-guided stereotactic saturation prostate biopsy that typically produces 30 to 80 core biopsies. This is an alternative biopsy technique used for some high-risk patients including men with persistently elevated PSA, those who have atypia on prior prostate biopsies, or men with biopsies showing high-grade prostate intraepithelial neoplasia (PIN). Although this is a different procedure, it is still a diagnostic biopsy. Do not code prostate saturation biopsy under Surgery of Primary Site. | 2010 | |
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20100031 | First course treatment--Anus: Is the topical application of trichloroacetic acid to an anal condyloma with AIN III first course treatment coded to 10 [Local tumor destruction, NOS] in the Surgery of Primary Site field? |
Code the trichloroacetic acid treatment of reportable AIN III in the "Other Therapy" field. Assign code 1 [Other]. |
2010 | |
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20100077 | Multiple primaries--Heme & Lymphoid Neoplasms: Would it be correct to apply rule M5 for a recurrence and abstract a single primary when a patient has a history of Hodgkin disease diagnosed in 2005 followed by a diagnosis of "recurrent Hodgkin and EBV+ Diffuse large B-cell lymphoma" in 2010? See Discussion. | Does Rule M5 only apply if both diseases are present at the original diagnosis, or does it also take into account a recurrence of an old disease? The answer to this question makes a difference between stopping at rule M5 and abstracting as one disease, or going on to rule M15 to query the Hematopoietic Database to determine whether the patient has two separate primaries.
Example: Patient had Stage II Hodgkin disease in 2005 (all lymph nodes above diaphragm, supraclavicular LN biopsied at diagnosis), treated and patient achieved complete remission. In 2010, the patient is admitted for suspected recurrence. A supraclavicular lymph node biopsy showed, "Recurrent Hodgkin" AND "EBV+ Diffuse Large B-cell Lymphoma," both in the same lymph node. Applying rule M5, this is a single primary and states not to query the DB. However, this doesn't seem correct as it does not account for the new DLBCL. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
You must first determine the histology codes for each occurrence of lymphoma. The 2005 diagnosis was stated to be Hodgkin disease (NOS) [9650/3]. The 2010 diagnosis was Hodgkin and EBV + diffuse large B-cell lymphoma (two histologies). Per Rule M5 the 2010 diagnosis is a single primary because the Hodgkin and the non-Hodgkin (DLBCL) were simultaneously present in the same lymph node. Per Rule PH14, a Hodgkin and non-Hodgkin simultaneously present in the same location should be coded to 9596/3 [B-cell lymphoma, unclassifiable].
Ultimately, there is a diagnosis of 9596/3 in 2010 that followed a diagnosis of 9650/3 in 2005. Per Rule M15, use the Multiple Primary Calculator to determine the number of primaries, which indicates the 9596/3 is a new primary.
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. https://educate.fhcrc.org/LandingPage.aspx. |
2010 |
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20100070 | Histology--Heme & Lymphoid Neoplasms: How is this field coded for a follicular lymphoma, grade 2 of 3, predominantly nodular? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code histology to 9691/3 [Follicular lymphoma, grade 2]. Nodular lymphoma is an obsolete term once used to describe follicular lymphoma. (See Appendix A, Table A3)
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. |
2010 | |
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20100013 | Reportability--Lymphoma: Should a December 2008 diagnosis of in situ follicular lymphoma be accessioned? See Discussion. |
Patient with mesenteric lymphadenopathy had a biopsy. Consult supports original pathology findings: The histologic and immunophenotypic findings represent what has been referred to in the literature as "in situ follicular lymphoma." The oncology assessment states, "At this point the patient has no other obvious evidence of other disease. ...no hepatosplenomegaly...no peripheral adenopathy...no significant abnormalities on PET scan to suggest active lymphoma." No treatment is planned at this time. The patient will only be monitored. |
Do not report in situ lymphoma at this time. Currently, lymphoma cannot be reported with a behavior code of in situ (/2) and it would be incorrect to abstract in situ lymphoma as a /3.
It is true that this is a recently identified pathologic entity. Our experts say that there is still some controversy to be ironed out regarding the criteria for identifying an in situ lymphoma. Their recommendation was to wait until clear guidelines had been established for the pathologists before we start collection of in situ lymphomas. We anticipate collecting these entities in the future. |
2010 |
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