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Report Produced: 04/23/2026 14:24 PM

Report Question ID Question Discussion Answer Year
20081035 MP/H Rules/Histology--Breast: What histology code is used for a single tumor, micropapillary carcinoma with components of mixed ductal and lobular carcinoma?

For cases diagnosed 2007 or later, use rule H16 and assign code 8522 [Duct and lobular carcinoma].

Micropapillary is specific duct type (see Table 1).

 2008
20081061 Histology--Breast: What is the histology code for a 2007 diagnosis of basal-type breast carcinoma?

Code basal-type breast carcinoma to 8500/3 [Infiltrating duct carcinoma, NOS].

Basal-type breast carcinoma is a subtype of infiltrating duct carcinoma thought to have a poorer prognosis. There is no specific ICD-O-3 code for basal-type breast carcinoma.

 2008
20081067 CS Extension--Lymphoma: When does the coding change take effect that is referred to in SEER edit IF195, that states localized lymphoma in primary sites C024, C090-099, C111, C142, C172, C181, and C379 must be coded to CS extension 10, and cannot be coded to extension 11? See Discussion. CS version 1.04 does have a new note 1 in the lymphoma scheme that appears this coding change. In the past, we used code 11 with these sites for localized lymphoma and SINQ 20061088 confirms this line of thinking.

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.

This change was made with the release of CS version 01.04.00 on October 31, 2007. The rules went into effect for cases diagnosed January 1, 2008 and later. A note was added to SINQ 20061088 stating that the answer pertains to cases diagnosed prior to January 1, 2008.

 2008
20081126

MP/H Rules--Brain and CNS: Are stigmata of neurofibromatosis in the brain reportable neurofibromatosis lesions? See Discussion.

Reference: SINQ 20051108; SINQ 20061018 Three year old patient with history of neurofibromatosis 1. 3/05 MRI of the brain showed right optic nerve glioma. It also showed heterogeneous high t2 signal in the middle cerebellar peduncles and near the genu of the internal capsules bilaterally are stigmata of neurofibromatosis type I. 3/08 MRI showed new mass suspicious for glioma in the hypothalamus. Clinical diagnosis is benign glioma secondary to diagnosis of neurofibromatosis. How many primaries are to be accessioned for this patient? Should the matrix principle be invoked for the second glioma? Should the behavior code for the glioma be 0?

For cases diagnosed 2007 through 2017

Accession NF (9540/1) when there is CNS tumor -- a glioma or some other intracranial/intraspinal tumor. Stigmata of NF are reportable when the stigmata themselves are reportable tumors. For example, glioma, or another intracranial/intraspinal tumor. Do not report sitgmata that are only termed "stigmata seen on MRI," for example, without other reportable terminology.

Do NOT accession NF (9540/1) when there is only peripheral nerve/nervous system involvement.

Accession the neurofibromatosis itself only once per patient. Accession any initial neoplasm in the CNS separately. Abstract and code any subsequent CNS neoplasms according to the multiple primary brain rules.

Accession three primaries for the case described above.

  1. Neurofibromatosis (C729 9540/1)
  • Optic nerve glioma (C723 9421/3)--> see below.
  • Hypothalamus glioma (C710 9380/0)

--> Optic nerve gliomas associated with NF are pilocytic astrocytomas. Code pilocytic astrocytoma as 9421/3 in North America.

For cases diagnosed 2018 or later

See the 2018 Solid Tumor Rules for Non-Malignant CNS tumors.

 2008
20081090 MP/H Rules: Does the presence of metastases affect the application of the MP/H rules? See Discussion. Single lung tumors presenting in each lung but the patient also presents with bone mets? Would rule M6 apply? Or do the bone mets represent additional tumors?

For cases diagnosed 2007 or later, the MP/H rules do not apply to metastases. Ignore metastases when applying the rules.

For the case above, use rule M6 and abstract as two primaries (right lung and left lung). The bone mets are ignored.

 2008
20081007 CS Extension--Lung: How is "subpleural extension" 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.Subpleural extension means that the tumor extends to the subpleural space, but the pleura itself is not involved. Assign the appropriate extension code based on the other facts for the case. Do not code pleural involvement.

 2008
20081054

First course treatment: Is subsequent treatment with R-ICE first course or second course therapy if the patient underwent ABVD x2 cycles and subsequent imaging showed no response to treatment and evidence of progression [new adenopathy] for a lymphoma case? See Discussion.

Patient was initially diagnosed with Hodgkin Lymphoma, Nodular Sclerosing on 3/3/06.

Patient received ABVD x 2 cycles. Had disease reassessed in May, 2006, no response to treatment, showed evidence of progression (new adenopathy). Patient's pathology from 3/06 was sent for consult: Diagnosis was Hodgkin with some overlapping features of B-cell Non Hodgkin Lymphoma. Treated 5/18/06 with R-ICE FOR NHL.

The R-ICE treatment in this case is not part of the first course. Documentation of treatment failure and/or disease progression signifies the end of the first course of treatment.

 2008
20081062 MP/H Rules/Date of Diagnosis/Behavior--Brain and CNS: How many primaries would be reported when a December 2004 MRI shows a pineal region mass with the major differential consideration being pineocytoma; a November 2007 MRI that shows the mass has almost tripled in size; and the December 2007 resection final diagnosis is consistent with pineoblastoma? How would diagnosis date[s] and behavior code[s] be coded? See Discussion.

Dec. 2004 MRI of brain: Pineal region mass. The major differential consideration given patient's gender, age group, and imaging characteristics is pineocytoma. The differential includes pineoblastoma or germ cell line tumor. These are felt less likely.

Nov. 2005 MRI brain: stable exam since last MRI. No change in size.

Nov. 2007 MRI studies: pineal mass has almost tripled in size.

Dec. 2007 Surgical resection of pineal tumor: High grade (WHO Grade IV) pineal parenchymal neoplasm consistent with pineoblastoma.

For cases diagnosed 2007 or later:

Abstract as separate primaries:

  • 12/2004 pineocytoma (9361/1)

  • 12/2007 pineoblastoma (9362/3)

    • Complete two abstracts when a previously diagnosed non-malignant tumor transforms or progresses to a malignancy. Refer to the CDC/NPCR guidelines for Data Collection of Primary Central Nervous System Tumors, 2004. Malignant transformation is discussed on page 50.

    		2008
    		20081066 Multiplicity Counter/Type of Multiple Tumors--Breast: How should these fields be coded when path shows a 1.2 cm infiltrating carcinoma with lobular features and several foci of infiltrating lobular carcinoma [7 foci described as multifocal], 1 large focus, and numerous foci of LCIS and CIS with lobular and ductal features? Should we count the foci or separate tumor nodules, ignore them, or code unknown values for these fields? See Discussion.

    Scenario: 10/17/07: Right axilla soft tissue bx - infiltrating mammary ca with lobular features arising within apparent breast tissue present within axilla. Tumor size 1.2 cm. 11/3/07: Right breast, reexcision lumpectomy - Several foci of infiltrating lobular CA. (2) foci & (5) foci within specimen (multifocal). (1) large focus also present. No lymphovascular invasion identified. Numerous foci LCIS. Pleomorphic LCIS & CIS with lobular and ductal features. Margins free of invasion however margins diffusely involved with LCIS.

    When do you count foci or separate tumor nodules, when do you ignore them, and when do you code unknown values for these fields? Coding instruction 3b states, "When the tumor is multifocal or multicentric and the foci of tumor are not measured, code as 99." Instruction 4b states, "Use code 01 when there is a single tumor with separate foci of tumor." Finally, instruction 6b states, "Use code 99 when the tumor is described as multifocal or multicentric and the number of tumors is not given," which seems to imply that if we know the number of tumors, we would code that number.

    Multiplicity Counter: Use instruction 4b. Since there is one measured tumor and the foci were not measured, code the multiplicity counter 01 [One tumor only].

    Type of Multiple Tumors: Code Type of multiple tumors 00 [Single tumor].

    		 2008
    		20081135

    MP/H Rules--Lung: Per rule M8, tumors of the same site (left lung), same histology (NSCC), greater than 3 yrs apart are separate primaries.

    However, there was a recurrence to mediastinal LNs after 2 years. Would that make a difference as to whether the 2008 left lung carcinoma is reportable as a new primary or not? See Discussion.

    		 Scenario: NSCC 2004 LLL with positive hilar/mediastinal LNs treated with LLL lobectomy, chemo and rad. 2006 per CT/PET recurrence in mediastinal LNs treated with chemoradiation. 2008 left lung nodule positive for NSCC stated by MD to be recurrence from 2004 (2008 path not compared to 2004 path).

    For cases diagnosed 2007 or later:

    The 2008 lung carcinoma is a separate primary according to rule M8. The 2006 diagnosis is metastases to the lymph nodes. Do not apply the MP/H rules to metastases.

    		 2008