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Report Produced: 04/25/2026 04:26 AM

Report Question ID Question Discussion Answer Year
20081114

Reportability--Brain and CNS: Is hygroma reportable? See Discussion.

Benign brain guidelines indicate that named tumors that have been assigned an ICD-O-3 code are reportable. However, per I&R: "Most cystic hygromas (9173/0) are fetal malformations and occur in patients less than two years old. If this patient was an adult, they are primarily treated with surgery. Hygroma (used in a general sense) is a response to trauma (i.e., subdural hematoma) and as such, is not a "new growth" and would not be reportable either as a cyst or as a neoplasm. Unless the patient had some sort of operation, I'd hesitate to include the case as a reportable benign tumor."

How is the cancer registrar to distinguish between reportable and non-reportable hygromas? Example: Brain MRI showed diffuse cerebral volume loss and incidental bilateral frontal subdural hygromas (histology code 9173/0).

Reference: I&R 14825

Hygromas are not reportable. This instruction will be added to the next revision of the benign brain rules.

According to an expert in the field, hygromas are not neoplastic. Hygromas are cystic dilations of a localized subarachnoid or subdural accumulation of clear fluid related to an excess accumulation of CSF, typically related to an old hemorrhage that somehow prevents reabsorption of CSF.

 2008
20081108 CS Extension--Pancreas: How is this field coded for a head of pancreas primary with involvement of the inferior vena cava?

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 extension code 54 [Blood vessel(s) major]. The inferior vena cava is one of the major blood vessels.

The inferior vena cava is located just behind the head of the pancreas. The hepatic artery, the superior mesenteric vessels and the portal vein are nearby.

 2008
20081019 Multiple Primaries--Lymphoma: How many primaries are abstracted for a patient with a 1995 periaortic lymph node biopsy showing lymphocytic lymphoma, diffuse small cleaved probable intermediate grade B cell positive, followed by stomach biopsies on 6/18/05 showing diffuse large B cell lymphoma and on 6/24/05 showing malignant lymphoma, tumor cells positive for [CD20] B cell respectively?

For cases diagnosed prior to 1/1/2010:There are two primaries:

  • Lymphocytic lymphoma, diffuse, intermediate in 1995

  • Diffuse large B-cell lymphoma in June, 2005

    • According to the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table, 9673 [Malignant lymphoma, lymphocytic, diffuse, intermediate] and 9680 [Malignant lymphoma, large B-Cell, diffuse] are separate primaries. Again, according to the table, 9680 [Malignant lymphoma, large B-Cell, diffuse] and 9591 [Malignant lymphoma, non-Hodgkin, NOS] are the same primary.

    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.

    		 2008
    		20081111

    MP/H Rules/Histology--Breast: If an in situ carcinoma diagnosed in 2007 demonstrates comedo necrosis, should the histology be coded to comedocarcinoma in situ? See Discussion.

    According to the new MP/H rules, we code descriptive features. There is no coding guidance or reference to "necrosis" within the breast MP/H rules. Based on SEER SINQ 20021002, the "comedo necrosis" would not be coded at all for pre-2007 cases. Does this still hold true for cases diagnosed after January 1, 2007?

    For cases diagnosed 2007 or later, comedo necrosis is not synonymous with comedocarcinoma. If no further information is available for this case, code as carcinoma in situ.

    		 2008
    		20081107 Multiplicity Counter/Ambiguous terminology: How should these fields be coded for cases with an unknown date of diagnosis? If the date of diagnosis is unknown, it is likely that you have little information for this case. Both multiplicity counter and ambiguous terminology fields would probably be coded as unknown. However, if information on the number of tumors and the diagnostic confirmation are available, code these fields as specified in the manual. 2008
    		20081118 Surgery of Primary Site--Brain and CNS: How is this field to be coded when a patient undergoes stereotactic biopsy of a brain tumor? Path specimen consists of four fragments of tissue measuring .7, .6 and .3 cm. Assign code 20 [Local excision (biopsy) of lesion or mass. Specimen sent to pathology from surgical event 20]. 2008
    		20081053

    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.

    		 2008
    		20081120 MP/H Rules--Sarcoma: How many primaries should be abstracted for chondrosarcoma of right toe in 2002, of right lower leg in 2006 and right tibia in 2007? See Discussion. A patient had a myxoid chondrosarcoma of the right toe in 2002. This was amputated and staged as T2 - high grade. Patient had a recurrence in the lower right leg in 2006. At this time he had a below knee amputation. The tumor in 2006 was stated to be similar histologically to the 2002 tumor with pathologic comparison done. Then in 2007 the patient presents with pain in right knee and stump. CT says compatible with recurrent disease, but no copies of path sent. Patient then had an above knee amputation, with diagnosis of clinically recurrent chondrosarcoma of tibia. How many primaries should be abstracted? Is 2007 diagnosis a new primary?

    For cases diagnosed 2007 or later:

    Abstract two primaries in this case, 2002 and 2007.

    The first primary was diagnosed in 2002. The 2006 diagnosis would not be a new primary according to the rules in effect at that time (2004 SEER manual, page 11, rule 5, exception 1).

    Use the current MP/H rules to compare the 2007 diagnosis to the 2002 diagnosis. Start with rule M3 and stop at rule M10. The 2007 diagnosis is a separate primary.

    		 2008
    		20081132 MP/H Rules--Breast: What is the histology code for a breast tumor that is ductal ca with focal squamous differentiation? See Discussion. SINQ 20021062 states for cases Dx'd prior to 2007, use 8570. Is 8570 also used when the squamous differentiation is focal? For cases diagnosed 2007 or later, use rule H14 and code the histology 8500 [duct carcinoma]. Ignore histologies described as "focal," "focus," or "foci." This instruction will be added to the histology rules in the upcoming revision of the MP/H manual. 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