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Report Produced: 01/15/2026 14:29 PM

Report Question ID Question Discussion Answer Year
20031060

Histology--Hematopoietic, NOS: Because histology 9895/3 [Acute myeloid leukemia with multilineage dysplasia] was recognized as a distinct entity by WHO with too few cases of the subtypes [with or without prior MDS] to warrant separate histology codes for each, should the wording for the non-bold definitions in ICD-O-3 be changed to the following in both the alpha and numeric sections? See Description.

AML with multilineage dysplasia and prior MDS

AML with multilineage dysplasia and without prior MDS

How do we code histology for the following case of AML?

Patient was admitted for profound anemia and thrombocytopenia with

no immediate explanation. Path final diagnosis on bone marrow biopsy: acute myelogenous leukemia (AML). Per micro description: findings are

characteristic of AML that appears to be arising within the context of a myelodysplastic syndrome. The discharge diagnosis (2 days after bone marrow biopsy) read: myelodysplastic syndrome with profound anemia and

thrombocytopenia.

Do we code the histology per the final path diagnosis (code 9861/3)?

Using the current version of ICD-O-3, we could arrive at a histology code of 9895/3 based on the micro findings of AML with prior myelodysplastic syndrome. However, per the above-mentioned SEER e-mail, we would not because there was no mention of multilineage dysplasia.

For cases diagnosed prior to 1/1/2010:To assign code 9895, it is important that the diagnosis includes "multilineage dysplasia." Use code 9895 when the diagnosis is with or without prior (not concurrent) myelodysplastic syndrome AND multilineage dysplasia. Acute myeloid leukemia without prior myelodysplastic syndrome and without multilineage dysplasia is coded 9861 [Acute myeloid leukemia, NOS].

Although the wording of 9895 cannot be changed, coders can make a note that the synonyms are intended to include:

-Acute myeloid leukemia WITH multilineage dysplasia with prior myelodysplastic syndrome

and

-Acute myeloid leukemia WITH multilineage dysplasia without prior myelodysplastic syndrome.

The histology code for the case example is 9861/3 [Acute myeloid leukemia, NOS].

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.

 2003
20031024 Surgical Fields--Head & Neck: How does one code the removal of benign submandibular and sublingual glands performed during a neck dissection for a head and neck cancer? See discussion. Should the removal be coded as incidental in the surgical Procedure if the Other Site field? Does it make a difference if the submandibular gland is removed en toto with lymph nodes or if the gland is submitted as a separate specimen? Does it make a difference if the glands are involved?

Removal of the lower salivary glands is part of a radical neck dissection and is not recorded in Surgery of Primary Site or Surgery of Other Site. Radical neck dissection is coded under "Scope of Regional Lymph Node Surgery."

It does not matter whether or not the gland is submitted as a separate specimen. It does not matter whether or not the gland is involved.

 2003
20031053 Reportability/History (Pre-2007)/Behavior Code--Ovary: Should the matrix principal in Rule F be applied to code a 2002 right ovary case to 8462/3 [Papillary serous borderline ovarian tumor] when peritoneal washings reveal the same histology?

For tumors diagnosed prior to 2007:

Do not apply the matrix principle in this case. This ovarian tumor is not reportable (behavior /1 per ICD-O-3). The peritoneal washings reveal the same histology (/1), rather than malignant cells. Based on the information provided, there is no evidence to support changing the behavior code.

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.

 2003
20031132 EOD-Lymph Nodes--Breast: Are micrometastases in the lymph nodes, found only on immunohistochemical staining, coded as positive lymph nodes?

For cases diagnosed 1998-2003: Do not code as positive lymph nodes that have micrometastases diagnosed ONLY on immunohistochemistry. By traditional diagnostic methods, these are still negative lymph nodes.

Summary Stage and EOD ignore the IHC positive micrometastases for cases diagnosed through 2003. The collaborative staging system that begins with 2004 cases and is based on the sixth edition of TNM addresses this issue.

 2003
20031039

EOD-Clinical Extension--Liver: How do the segments of the liver described by AJCC Manual correspond to the lobes of the liver described by the SEER EOD Manual? See Description.

CT described hepatocellular ca involvement of the liver with nodules identified in segments 5 and 7. Would EOD-extension be coded to 30 [multiple tumors (one lobe)]?

Segments 2, 3, and 4 correspond to the left lobe of the liver. Segments 5, 6, 7 and 8 correspond to the right lobe of the liver. Segment 1 is the caudate lobe, which has completely different drainage and vascularization, is separate from the larger right and left lobes.

For cases diagnosed 1998-2003: Since segments 5 and 7 are both in the right lobe, assign EOD-extension code 30 for the case above, unless there is mention of vascular invasion. Be sure to record the size of the largest primary tumor.

Tumor size and vascular invasion are the most important factors for AJCC 6th edition staging.

 2003
20031205 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: How are these fields coded when an autopsy report reveals pathologically involved regional lymph nodes but does not state how many nodes were positive nor how many were examined? See Description. A final autopsy report described widely disseminated adenocarcinoma, probably lung primary. Metastatic tumor in brain, lungs, and in lymph nodes. The Gross description of the autopsy report stated that there were numerous metastases to hilar and mediastinal lymph nodes. The Micro description of the autopsy report did not add any clarification. In the absence of a stated number of lymph nodes, the options for coding number of regional lymph nodes examined are codes 96-98. These codes include descriptions of surgical procedures such as sampling and dissection. How do we code number of regional lymph nodes examined when the pathological examination of lymph nodes was done only at autopsy and not during a surgical procedure?

For cases diagnosed 1998-2003: The rules that apply to the use of pathology reports for EOD coding also apply to autopsy reports.

When a cancer diagnosis is made and positive lymph nodes are discovered on autopsy, in the absence of a stated number of lymph nodes, code the number of lymph nodes positive to 97 [Positive nodes but number of positive nodes not specified]. Code the number of lymph nodes examined to 97 [Regional lymph node removal documented as dissection and number of lymph nodes unknown/not stated]. An autopsy is a dissection.

 2003
20031013 EOD-Extension--Pleura: How do you code this field for a pleural mesothelioma with negative pleural effusion? For cases diagnosed 1998-2003: Pleural effusion is disregarded if it is unknown, NOS or benign. Use other information on the case to stage. 2003
20031199 CS Extension/Polyp--Colon: How is CS extension coded for tumor invasion described as "Haggitt level 4"? See Description. Polypectomy specimen revealed adenocarcinoma of the rectum in a tubulovillous adenoma. Per path extent of invasion was Haggitt level 4. The micro description of the tumor stated that there was malignant epithelial neoplasm in colonic mucosa.

In a 1985 Gastroenterology journal article, Haggitt described five levels of polyp invasion:

Level 0-confined to mucosa

Level 1-head

Level 2-Neck

Level 3-Stalk

Level 4-Submucosa of underlying colonic wall.

For cases diagnosed 2004 and forward:

Use the best information available to code CS extension. The following conversion may be used when the only information available is the Haggitt level.

Level 0 - Extension 10

Level 1 - Extension 13

Level 2 - Extension 15

Level 3 - Extension 14

Level 4 - Extension 16

 2003
20031140 Primary site--Unknown & ill-defined site/Kidney: How should this field be coded when humeral metastases are compatible with renal cell carcinoma pathologically, no kidney lesion is found clinically and the physician's signout diagnosis is "no primary found, as of now unknown"? See Description. Path states "biopsy of humerus, mets sarcomatoid carcinoma consistent with renal cell carcinoma." Material was sent to Mayo Clinic for consult & they state "with focus of clear cells, agree that a likely primary is renal cell carcinoma." Abdominal CT showed no abnormality in kidneys. When the registrar abstracted the case she spoke to the managing physician who told her that "no specific site was found and it was, as of now, unknown." This was stated about three months after dx. Can we code as a renal primary based on pathologic information or should we code unknown based on CT and physician's statement?

Code this case to C64.9 [Kidney, NOS].

ICD-O-3 rule H states that the topography code attached to a morphology term may be used when the topographic site is not given in the diagnosis. Topography code C64.9 is attached to morphology code 8312/3 [Renal cell carcinoma] in ICD-O-3.

 2003
20031127 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: Would the simultaneously occurring histologies of "high grade ductal carcinoma in situ with micro invasion" and "keratinizing squamous cell carcinoma" be coded as two primaries or as a single primary when the pathologist is not clear whether two separate tumor masses exist?

For tumors diagnosed prior to 2007:

Code as two primaries, assuming the tumors are separate and the margins are clear/negative. Code 8071/3 [Invasive squamous cell ca, keratinizing] and 8500/3 [Ductal carcinoma, "microinvasive"].

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.

 2003