| Report | Question ID | Question | Discussion | Answer | Year |
|---|---|---|---|---|---|
|
|
20071039 | Histology--Hematopoietic, NOS: If an initial bone marrow diagnosis is "...more compatible with CMML/MPD" and within three months the final diagnosis per the oncologist is "MPD/CMML with acute myeloid leukemia transformation," is histology coded to CMML or AML? See Discussion. | 09/06 BM Bx elsewhere was "compatible with MDS but more compatible with CMML/MPD" per MD notes. 10/06 BM Bx "...poor prognosis MDS, best classified as RAEB-2" 11/06 BM Bx "myeloproliferative CMML with leukemic transformation" (on evaluation for BMT) 12/12/06 Pt was admitted with rapidly progressive disease & was started on chemo to try to get into remission for BMT. Final dx by oncologist is "MPD/CMML with acute myeloid leukemia transformation". |
For cases diagnosed prior to 1/1/2010:Code CMML for this case. Code the histology at initial diagnosis. This patient had rapid progression, but the initial diagnosis was "more compatible with CMML/MPD." 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. |
2007 |
|
|
20071034 | Histology--Corpus uteri: Because coding a pathology final diagnosis of "serous carcinoma" for an endometrial primary to 8441/3 triggers the site/histology error in the SEER Edits, should histology be coded to 8010/3 [Carcinoma, NOS] instead? | Assign histology code 8441 [serous carcinoma] and override the edit. Endometrium with serous carcinoma is NOT one of the "impossible" site / histology combinations. | 2007 | |
|
|
20071049 | MP/H Rules/Histology--Colon: If a tubulovillous (TV) adenoma is in situ and other polyp(s) have an invasive component, does the in situ TV adenoma still have priority and should rule H18 be applied? | For cases diagnosed 2007 or later, always give precedence to coding the invasive. Rule H18 applies UNLESS the adenocarcinoma in the TV is in situ and the others are invasive. In this case, code the histology of the invasive adenocarcinoma. This clarification will be added when the MP/H manual is revised. |
2007 | |
|
|
20071035 | CS Extension--Prostate: Should CS Clinical Extension always be coded to 99 [Extension unknown] for prostatic adenocarcinoma found incidentally during surgery for another primary or at autopsy? See Discussion. | Patient had a cystoprostatectomy for bladder cancer. Pathology report states only 2 microscopic foci of prostate adenocarcinoma found on LEFT side of gland. Physician notes state patient has been followed for 4 years with a nodule in the RIGHT prostate and has refused biopsy despite rising PSA. There was no definite statement of suspected cancer.
Should CS Clinical Extension be coded 99 because prostate cancer wasn't clearly stated to have been suspected until cystoprostatectomy? Or could we code the right-sided "nodule" as clinically apparent (CS Extension 20), even though path found tumor only on the left (which is how we would code a standard prostate case)? |
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. Code CS extension 99 [Extension unknown]. This prostate cancer was not clinically evident; it cannot be clinically assessed based on the information provided. Note: This is an unusual case. A DRE was performed and a nodule was palpated on the right that was not cancer. The other lobe is presumed to have been negative because it was not mentioned. |
2007 |
|
|
20071088 | Type of Multiple Tumors--Lung: Is this field coded to 40 [Multiple invasive] or 80 [Unk in situ or invasive] when only one nodule is biopsied of multiple existing nodules for a reported single lung primary? See Discussion. | The right lung has 4 tumor nodules in the upper lobe. Biopsy of one tumor is positive for moderately differentiated adenocarcinoma. No other work up performed. Should code 40 be used because we dont know the behavior of the other nodules? |
The best code to use in this case is 40 [multiple invasive]. For lung only, it is assumed that all of the tumors are the same histology and that all are invasive. | 2007 |
|
|
20071053 | Grade, Differentiation: How is grade coded for cases using the FNCLCC (Federation Nationale des Centres de Lutte Contre Ie Cancer) system? See Discussion. | Is FNCLCC a recognized system in the United States? Tongue was the primary site for the case we saw that used FNCLCC. | Do not code the data item Grade based on the FNCLCC grade. You may record the FNCLCC grade in a text field. | 2007 |
|
|
20071003 | MP/H Rules/Histology--Prostate: If a patient is stated to have prostate "cancer" but a pathology report is not available nor is a specific histology stated in the medical record, can this histology be coded to 8140 [adenocarcinoma] instead of 8000/3 [cancer] because the vast majority of prostate cancers are adenocarcinomas? | For cases diagnosed 2007 and later, the correct histology code is 8000/3 [cancer]. The steps used to arrive at this decision are:
Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Other Sites Histology rules because no specific rules have been developed for prostate primaries.
To determine the histology, start at the SINGLE TUMOR: INVASIVE ONLY module, rule H8. The rules are intended to be reviewed in consecutive order within a module. Code the histology documented by the physician when there is no pathology/cytology specimen or the pathology/cytology report is not available. Code the histology as 8000/3 [cancer] because that is the only available information. In the absence of a pathology report or any other histologic confirmation, code the histology based on the information available. |
2007 | |
|
|
20071011 | Multiple Primaries (Pre-2007)--Breast: How many primaries are to be abstracted when each of multiple breast "re-excisions" performed more than two months apart in 2006 demonstrate intraductal carcinoma and there is no mention of "recurrence"? See Discussion. | Right Breast 06/27/2002 exc bx, DCIS. Margins involved. 09/24/2002 re-exc, several foci of intraductal ca. Margins involved. 10/15/2002 re-exc, microfocus of DCIS Radiation treatment started 11/18/2002. Is this 1, possibly 2, or maybe 3 breast primaries because of the 2 month rule and no statement of "recurrence"? Based on SINQ #20000478, this would be at least 2, but possible 3 primaries. Based on SINQ #20021143, this would be 1 primary if the case were diagnosed from 1998-2003. The excisions appear to represent wider excisions of the same tumor. |
For cases diagnosed prior to 2013:
For tumors diagnosed prior to 2007, this is one primary, assuming these are wider excisions of the same tumor.
For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules. |
2007 |
|
|
20071020 | Histology--CLL/SLL: What is the correct histology code for a lymph node described in the pathology report comment section as "phenotypically consistent with chronic lymphocytic leukemia"? See Discussion. | Current rules instruct us to select the lymphoma code for lymph node and/or tissue with the dual diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma. We have a cervical lymph node biopsy with that dual diagnosis, however, the pathology comment states that after immunohistochemistry testing, the lymph node is "phenotypically consistent with chronic lymphocytic leukemia." No bone marrow or blood work-up is performed. | For cases diagnosed prior to 1/1/2010:Code Small Lymphocytic Lymphoma. The current rules have not changed. Code to lymphoma because the diagnosis was made on a lymph node. "Phenotypically consistent" means the lymph node contains CLL/SLL, not some other hematopoietic or metastatic disease. 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. |
2007 |
|
|
20071047 | Ambiguous Terminology: Why do the instructions for this field use the term "accession" rather than "abstract"? | The purpose of the new data item "Ambiguous Terminology" is to identify cases that were put into the cancer registry database without a conclusive diagnosis. The decision to accession the case was influenced by ambigous terminology. The emphasis is on accessioning the case rather than abstracting it. | 2007 |
Home
