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Report Produced: 12/16/2025 00:54 AM

Report Question ID Question Discussion Answer Year
20021105 Grade, Differentiation: Do we code to the highest grade even when no grade is given at the time of initial diagnosis, but a grade is obtained on tissue removed after non-surgical treatment has occurred? See discussion.

1. In 2000 a pleural fluid aspirate had no grade. Pt treated with chemo. In 2000 a BSO diagnosed high grade papillary serous adenocarcinoma of the ovary.

2. In 1993 a prostate bx had no grade. Pt treated. In 2001 prostate bx revealed a Gleason's 4+3.

Code the grade at the time of initial diagnosis (if the specimen is from the primary site) or to the grade identified as part of a first course of cancer-directed surgery to the primary site. When different grades are specified for tissue pathologically reviewed from the primary site before and after treatment, code the higher grade. This is true even if the higher grade is obtained while the pt is still undergoing first course of cancer-directed therapy.

1. Code the Grade to 4 [high grade], if the grade information from the BSO specimen represents the grade associated with primary site surgical specimen. Even though the grade was obtained after first course of cancer-directed therapy started, it was obtained during first course of cancer-directed therapy.

2. Code the Grade to 9 [Cell type not determined, not stated or not applicable]. Grade was obtained well after the first course of cancer-directed therapy ended.

 2002
20021007 Scope of Regional Lymph Node Surgery: If a named regional lymph node is aspirated should this field be coded to 1 [Regional lymph node removed, NOS], as is stated on page 127 of the SEER Program Code Manual, or should this field be coded to a more specific code when that is available (e.g. Lung primary code 3 [Ipsilateral mediastinal and/or subcarinal nodes])? For cases diagnosed 1/1/2003 and after: A generic scheme was created for the Scope of Regional Lymph Node Surgery field. As a result, there no longer are codes available that represent specific named lymph node chains. Code aspiration of a lymph node to 1 [Biopsy or aspiration of regional lymph node, NOS]. 2002
20021044 Histology (Pre-2007)/Grade, Differentiation: Can histology and/or grade be coded from a metastatic site? See discussion.

Example 1: No pathology specimen is available from the primary site for a lung primary. Rib biopsy demonstrated "anaplastic adenocarcinoma."

Example 2: Lung tissue biopsy revealed "poorly differentiated non-small cell carcinoma" for a lung primary. Pleural effusion cytology was consistent with "adenocarcinoma".

For tumors diagnosed prior to 2007:

Example 1: Code the Histology and Grade, Differentiation fields to 8140/39 [adenocarcinoma, NOS, grade not stated]. Because there was no microscopic examination of tissue from the primary site, the histology may be coded from the microscopic examination of the tissue from a metastatic site. Do not code grade from a metastatic site regardless of whether the involvement of the metastatic site is by direct extension or by discontinuous metastases.

Example 2: Code the Histology and Grade, Differentiation fields to 8046/33 [non-small cell carcinoma, poorly differentiated]. Because there is a microscopic examination of tissue from the primary site, that information should be used to code histology rather than a cytology of a metastatic site.

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.

 2002
20021087 Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are represented when a1998 invasive squamous cell carcinoma of the true vocal cord is followed by a 1999 diagnosis of in situ squamous cell carcinoma of the true vocal cord (called "recurrent" by the clinician), and in 2001 there is another invasive squamous cell carcinoma of the true vocal cord (no statement of recurrence)? Would your answer be any different if no statement of "recurrent" had been made in 1999?

For tumors diagnosed prior to 2007:

Code this case as two primaries, an invasive true vocal cord primary in 1998 and another invasive true vocal cord primary in 2001.

If there had been no statement of recurrence for the 1999 in situ diagnosis and the 1999 diagnosis was more than two months following the 1998 diagnosis, this case would be coded as three primaries.

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.

 2002
20020031 Multiple Primaries--Hematopoietic, NOS: When the SEER Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table indicates that a disease is not a new primary, but a pathologist or clinician states that it is a new primary, do we use the physician information or the table?

For cases diagnosed prior to 1/1/2010:If the physician clearly states that this is a new primary, submit it as a new primary. Otherwise, use the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table.

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.

 2002
20021006 EOD-Extension--Hematopoietic, NOS: If a solitary plasmacytoma originates in the right tonsil and extends to the left tonsil, vallecula and hypopharynx, is extension still coded to 10 [localized disease, solitary plasmacytoma only]?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 10 [localized disease, solitary plasmacytoma only] for all cases of solitary plasmacytoma.

 2002
20020002 Date Therapy Initiated: What date should be entered in Date Therapy Initiated when treatment follows a surgical procedure that is not coded under Surgery of Primary Site? See discussion. If a patient has a surgical procedure that is not coded in the Surgery of Primary Site field and then the patient undergoes additional first course of treatment, such as radiation therapy, how should the Date Therapy Initiated field be coded? In this example, code the Date Therapy Initiated field to the date of the first surgical procedure. If a SEER edit is triggered, please notify us. 2002
20021193 Grade, Differentiation--Breast: Does SEER agree with our pathologist who contends that "by convention lobular carcinoma is considered to be grade 2"? No. SEER does not have a default grade code for lobular carcinoma. Code the grade as stated in the pathology report. If no grade is stated, code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable]. 2002
20021072 EOD-Size of Primary Tumor--Breast: The path report provides a size for both the Paget disease and the underlying intraductal component in the breast. Should we assume the Paget disease to be invasive and code the size of the primary tumor to that invasive component? See discussion. For example, path diagnosis for resection gave the size of the Paget disease as 1 mm and the size of the underlying intraductal tumor as 4 cm. Should size for this breast case be coded to 040 or 003, less than 3 mm.

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 040 [4 cm], the size of the larger underlying intraductal tumor. Paget disease is classified according to the size of the underlying in situ or invasive tumor. Paget with an underlying in situ tumor is staged as in situ to match the AJCC classification of this disease process.

 2002
20021063 EOD-Pathologic Review of Number of Regional Lymph Nodes Examined: What code is used to represent this field when a path report from a lymph node biopsy or dissection describes lymph node "portions" or "fragments"? See discussion.

1) Lymph nodes, right pelvic dissection: No evidence of malignancy in 4 portions of lymph node examined. (Should we code the number examined as 01, 04, or 97?)

2) Lymph nodes, left pelvic dissection: 5 fragments of lymph nodes show no evidence of malignancy. (Should we code the number examined as 05 or 97?)

3) Biopsy of right neck mass: Malignancy in fragments of lymph nodes. The following month, pt had a right modified lymph node dissection: 16/32 lymph nodes are positive for malignancy. (Should we code the number examined as 32, 33, 97, 98?)

For cases diagnosed 1998-2003:

The total number of lymph nodes examined is recorded in EOD-Num of Reg LN Examined. If the number of actual lymph nodes represented by the "fragments" or "portions" cannot be determined, assign code 96, 97, or 98 as appropriate.

1) Based on the terminology "four portions of lymph node (singular)" code to 01 despite "dissection" terminology.

2) Code to 97 based on "fragments of lymph nodes (pleural)" terminology and procedure identified as dissection.

3) Code to 97 based on statement of "fragments of lymph nodes (pleural)" for biopsy plus dissection.

 2002