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Report Produced: 04/26/2026 12:29 PM

Report Question ID Question Discussion Answer Year
20061122 CS Lymph Nodes--Head & Neck (Parotid): What code is used to represent a positive intraparotid or a periparotid lymph node for a parotid primary? See Discussion.

The CS scheme for parotid places intraparotid lymph nodes under code 10 as well as code 12. Periparotid lymph nodes are included under code 12. Should both intraparotid and periparotid lymph nodes be included under code 10 only?

For head and neck sites, several lymph node groups fall into the "Other groups" category. They are not included in the level I-VII groups. In the coding schemes for most (but not all) of the head and neck sites, the "other groups" category includes intraparotid and periparotid lymph nodes and is coded 12 (or 52).

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 code 10 for a single positive intraparotid or periparotid lymph node. If multiple nodes are involved, assign the appropriate code from the 20 series.

A recent revision to the CS lymph nodes scheme for parotid places both intraparotid and periparotid lymph nodes under code 10. Please see the August 21, 2006 update to the CS staging manual.

http://www.cancerstaging.org/cstage/cshtml.

 2006
20061062 Reportability: Is a "pleomorphic hyalinizing angiectatic tumor of soft parts (PHAT)" reportable if the case has a TNM stage assigned and is stated by the pathologist to be a rare intermediate grade sarcoma?

Pleomorphic hyalinizing angiectatic tumors of the soft parts are not reportable.

According to our pathologist consultant, PHAT is a borderline malignancy (/1). While the true nature of these tumors is under debate (reactive vs. neoplastic), so far none have metastasized.

 2006
20061125 CS Lymph Nodes: Are positive right superficial inguinal lymph nodes coded to 30 (which is the case for anal canal primaries) or 31 (which is the case for anus primaries) if the primary is stated to be in the "cloacogenic zone" or is an anorectal primary?

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 code 30 for positive unilateral superficial inguinal lymph nodes for cloacogenic primaries. The cloacogenic zone is part of the anal canal.

 2006
20061057 CS Extension--Lung: Can extension be coded to 10 (Tumor confined to one lung) when either an autopsy or a CT scan describes the tumor as a mass of a specified size located in one lobe of the lung without any description of extension and no available TNM provided? See Discussion.

Example 1: Lung primary within the right lower lobe described clinically as greater than 3 cm on scan but was found to be 3 cm at autopsy.

Example 2: CT scan February shows 2 cm mass in RUL.

In both cases, the only tumor description was the size of tumor without any information regarding extension.

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.

Yes, assign code 10 [Tumor confined to one lung] for a mass in one lobe when none of the descriptions in codes 11 to 80 are documented.

 2006
20061136

Primary Site: What site code best reflects the final diagnosis of a metastatic "pancreatobiliary" adenocarcinoma to the liver? See Discussion.

CT showed multiple masses in the liver and lymphadenopathy in areas of gastrohepatic ligament, celiac axis, superior mesenteric and left periaortic regions. No mention of a mass in pancreas or common duct. When the term "pancreatobiliary" primary is stated in the final diagnosis, what site code should be used?

Contact the physician for clarification of the term "pancreatobiliary." If no further information can be obtained for this case, assign code C249 [Biliary tract, NOS] based on the CT findings for the specific case in this question.

When the primary is described as "pancreatobiliary" with NO FURTHER INFORMATION, assign C269.

 2006
20061126 Histology--Leukemia: How is a "plasmacytoid dendritic cell leukemia/lymphoma" coded when it is discovered on a bone marrow biopsy for a patient who presented with multiple enlarged lymph nodes and the discharge diagnosis was Type 2 plasmacytoid dendritic cell leukemia?

For cases diagnosed prior to 1/1/2010:

The best code currently available for this entity is 9727/3 [precursor cell lymphoblastic leukemia].

The WHO classification refers to this as "Blastic NK-cell lymphoma." The 2005 WHO-EORTC classification for cutaneous lymphomas states that blastic NK-cell lymphoma may be derived from a plasmacytoid dendritic cell precursor. They suggest more appropriate terms for this condition may be "CD4+/CD56+ hematodermic neoplasm," and "early plasmacytoid dendritic cell leukemia/lymphoma." According to WHO, this is a rare form of lymphoma.

Willemze, et al. WHO-EORTC classification for cutaneous lymphomas. Blood, 15 May 2005. Volume 105, Number 10.

For cases diagnosed 2010 forward, 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.

 2006
20061139 CS Lymph Nodes--Lung: Do modifying terms such as "borderline" affect whether lymph nodes are coded as involved when they are used in conjunction with the descriptors listed in Note 2 (i.e., mass, adenopathy or enlargement) for lung primaries? See Discussion. Lung primary: CT states "borderline" enlarged hilar lymph nodes. Note 2 in the Lung schema under CS Lymph Nodes does not address qualifiers.

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.

Do not code the hilar lymph nodes as involved in this case. "Borderline" enlarged hilar lymph nodes do not meet the clinical criteria for enlargement.

 2006
20061144 Date of Diagnosis/Histology--Hematopoietic, NOS: How are these fields coded if a 3/17/03 bone marrow biopsy diagnosis of "malignant proliferative disorder" is subsequently confirmed to be a "low grade lymphoma" per a bone marrow biopsy in early 2006? See Discussion.

3-17-03: Bone marrow biopsy from rt iliac crest: Hypercellular marrow (90%) with extensive involvement by lymphoproliferative disorder (see description). Micro: The bone marrow is diffusely (>90%) involved by a malignant lymphoproliferative disorder. This consists of small lymphocytes,histiocytes, and large atypical cells with prominent nucleoli.

12-22-05 Extensive bone marrow involvement by lymphoproliferative disorder, bone biopsy from femur.

1-27-06 Hem/Onc Physician Note:

following pt for a lymphoproliferative disorder. ...bone marrow biopsy 2003, suggestive of, but not truly diagnostic, a lymphoproliferative disorder. Therefore, I elected not to do anything, but just follow her.

3-23-06 Hem/Onc Note:

pt with a history of an apparently low-grade lymphoma involving the marrow, as well as, I believe, the liver and recently pathologically diagnosed as a T-cell-rich B-cell lymphoma. ...followed in the past by Dr. ___ and has never actually had any treatment for this lymphoma, although it is documented even three years ago by bone marrow biopsy.

For cases diagnosed prior to 1/1/2010:

Code the diagnosis date to 3/17/03. The histology code is 9970/3 [Malignant myeloproliferative disorder]. The bone marrow biopsy confirms a "Malignant" lymphoproliferative disorder. Apply ICD-O-3 rule F and assign /3 to histology code 9970.

For cases diagnosed 2010 forward, 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.

 2006
20061141 Reportability--Leukemia: Is the diagnosis "a minority abnormal T-cell population (2-3%) with phenotypic features of large granular lymphocyte leukemia cells" reportable if it is from a flow cytometry procedure performed on a non-diagnostic bone marrow biopsy specimen? See Discussion.

Pt had only a bone marrow Bx done at the hospital.

Bone marrow biopsy and aspirate:

Peripheral blood showing mild relative lymphocytosis and mild relative neutropenia.

Normocellular bone marrow (50%) with mild eosinophilia. No conclusive morphologic evidence of a neoplastic process.

Flow cytometry of the marrow shows a minority abnormal T-cell population (2-3%) with phenotypic features of large granular lymphocyte leukemia cells. PCR is positive for a clonal T-cell population. The significance of these findings is unclear.

COMMENT: Flow cytometry, PCR and morphologic correlation were performed at [names removed]. The significance of a minimal, clonal, large granulocyte leukemia population absent absolute lymphocytosis is unclear. Positive results for a T-cell receptor PCR study in the setting of mild leukopenia alone is reportedly relatively common and usually regarded as nonspecific. In essence, this could be characterized as a small, monoclonal T-cell proliferation of uncertain significance associated with mild leukopenia. Appropriate follow up is suggested.

For cases diagnosed prior to 1/1/2010:Do not report this type of case until there is a definitive reportable diagnosis. Based on the information provided, this case is not yet reportable. It could develop into a reportable case in the future.

For cases diagnosed 2010 forward, 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.

 2006
20061021 Histology (Pre-2007)--Bladder: How is a "carcinoma with squamous, mucinous, and signet ring cell features" coded?

For tumors diagnosed prior to 2007:

Code histology to 8490 [Signet ring cell carcinoma]. Rule 7 on page 87 of the 2004 SEER Manual applies to this case.

Rule 7: Code the numerically higher ICD-O-3 code. This is the rule with the lowest priority and should be used infrequently.

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.

 2006