Report | Question ID | Question | Discussion | Answer | Year |
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20020046 | Primary Site: How do we code site when endometrioid carcinoma arises in "endometriosis"? | Code the Primary Site to where the endometriosis implanted, which may or may not be the endometrium. Endometrioid carcinoma can arise in the ovary, endometrium and other internal genital sites. The site/histology edit for endometrioid and ovary has been removed from the SEER edit set. | 2002 | |
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20020014 | Grade, Differentiation--Bladder: Can the WHO grade be used to code differentiation for bladder primaries? | No, the WHO grade is not used to code differentiation for bladder primaries. | 2002 | |
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20021061 | Multiple Primaries/Histology--Mycosis Fungoides/Cutaneous T cell Lymphoma: Physicians often use the terms cutaneous T cell lymphoma (CTCL) and mycosis fungoides interchangeably and yet the SEER Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table indicates that these 2 diagnoses represent separate primaries. Do these cases represent one primary? If so, what histologic type should they be coded to? | For cases diagnosed prior to 1/1/2010:The patient does not have two different malignancies. Code the Histology field to 9700/3 [mycosis fungoides], the specific type of cutaneous T cell lymphoma. Mycosis fungoides is one of several types of cutaneous T cell lymphoma. Physicians often refer to mycosis fungoides by the "umbrella term" cutaneous T cell lymphoma.
The table indicates that the broad category of "T/NK-cell NHL" (which includes CTCL) and mycosis fungoides are presumably separate primaries because several entities are included in that broad category. In the specific case cited above, one entity (CTCL) within the broad category (T/NK-cell NHL) and mycosis fungoides are not separate primaries. 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 | |
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20021023 | EOD-Size of Primary Tumor/EOD-Extension--Breast: How do you code extension when the tumor in the breast is in situ and the regional axillary lymph nodes are positive? See discussion. |
For example, what extension code is used for a 4.5 cm DCIS (no invasive ca found in excisional biopsy or mastectomy specimen) with mets to 01/07 LNs? |
For cases diagnosed 1998-2003: Code the EOD-Size of Primary Tumor field to 045 [4.5 cm]. Document how the size was determined in the EOD-Extension field. Code the EOD-Extension field to 16 [Invasive and in situ components present, size of entire tumor coded in Tumor Size (size of invasive component not stated) AND proportions of in situ and invasive not known]. By virtue of the lymph node metastasis, this must be an invasive breast carcinoma. The size of the invasive component is unknown. |
2002 |
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20021056 | Histology (Pre-2007)/Terminology: Are "pattern", "architecture", and "architectural pattern" terms that indicate a majority of tumor? |
For tumors diagnosed 2004 to 2006: The terminology "Architectural pattern: ____________," when used in the final pathology diagnosis, indicates a subtype that can be coded. This type of format in a pathology report is based on a College of American Pathologists (CAP) protocol. Disregard "pattern" and "architecture" when not used in accordance with the CAP protocol. See www.cap.org for cancer protocols. 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 | |
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20020016 | Primary Site (Pre-2007)--Prostate/Prostatic Urethra: What code is used to represent primary site for an "adenocarcinoma with spindle cell differentiation" of the prostatic urethra? | For tumors diagnosed prior to 2007:
Code the Primary Site field to C61.9 [prostate] because the histology is adenocarcinoma.
When a malignancy is identified in the prostatic urethra, look at the histology to determine the primary site. If it is a transitional cell carcinoma, code the Primary Site field to C68.0 [urethra] and if it is an adenocarcinoma, code to C61.9 [prostate].
The EOD scheme is ultimately collapsed into the TNM scheme. The TNM system differentiates between adenocarcinoma of the prostate and transitional cell carcinoma of the urethra. Only adenocarcinoma of the prostate is staged by the prostate scheme. Transitional cell carcinoma of the prostatic urethra is coded to C68.0 [urethra] and staged with that scheme.
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 | |
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20021077 | Histology (Pre-2007)/Primary Site/EOD-Extension--All Sites: How do you code these fields for a resected thyroid that is negative for any diagnostic abnormality and a left ovary that demonstrates "papillary thyroid carcinoma arising in a cystic teratoma"? See discussion. | Teratomas occurring in the ovaries frequently contain various types of fully differentiated tissue that normally occur in other body parts. Should the primary be coded to the ovary or to the organ in which that type of tissue normally occurs? | For tumors diagnosed prior to 2007:
Code the Primary Site field to the organ in which the cancer arose. For this tumor, code the Primary Site field to C56.9 [ovary] and Histology to 8260/3 [papillary carcinoma of thyroid]. Use the ovary EOD for tumors diagnosed 1998-2003.
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 |
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20021025 | Histology: What code is used to represent the histology "endometrioid adenocarcinoma, villoglandular type"? | Assign code 8262/3 [Villous adenocarcinoma]. According to the WHO Classification of Tumours, Breast and Female Genital Organs (2003), villoglandular is one of four variants of endometroid adenocarcinoma. The corresponding ICD-O-3 code according to WHO is 8262/3. |
2002 | |
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20021124 | Multiple Primaries (Pre-2007)/Primary Site/EOD-Extension--Lung: Should lung cases be counted as more than one primary when nodules removed from separate lobes of the same lung have either the same histology or they are different immunophenotypes of the same main histologic classification (e.g., adenocarcinoma)? See discussion. |
1. Path report: "Two nodules (RLL, RUL) of primary pulmonary demonstrate adenocarcinoma with different histologic appearances and different immunophenotypes consistent with synchronous lung adenocarcinomas." Per ICC interpretation, two lung primaries are favored. 2. Path report: "Two peripheral nodules (LLL, LUL) demonstrate similar P.D. non-small cell carcinoma with features of large cell undifferentiated carcinoma." |
For tumors diagnosed prior to 2007: According to current SEER rules, both examples represent one primary because both tumors are in one lung and of a single histologic type. Code the Primary Site field to C34.9 [Lung, NOS] for both examples and the EOD-Extension field to 77 [Separate tumor nodules in different lobe]. This will capture the fact that there are multiple tumors within the lung for each of these examples. Differences in immunophenotypes confirm independent de novo cancers and rule out metastasis. Immunophenotype differences do not equate to different histologies. In the first example described, there are different histologic features; however, the main classification is adenocarcinoma. 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 |
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20021046 | Behavior Code/EOD-Extension--Bladder: If an in situ lesion of the urinary bladder involves the von Brunn nests, is it still in situ? See discussion. | Von Brunn nests: Compact, rounded aggregates of urothelial (transitional) cells in the lamina propria, with or without connection to the surface epithelium. Urothelial (transitional cell) carcinoma in situ...may involve von Brunn nests... Histologic Typing of Urinary Bladder Tumours, Second Edition, WHO, pp 12 & 21 |
For cases diagnosed 1998-2003:
Code the Behavior Code and the EOD-Extension field according to the pathology report.
If the pathology report states the tumor to be noninvasive or in situ, whether or not von Brunn nests are involved, code behavior as 2 [in situ] and extension as in situ.
If the tumor is described as invasive and involves the von Brunn nests, code the EOD-Extension field to 15 [invasive tumor confined to subepithelial connective tissue] because code 15 includes extension to the lamina propria and von Brunn nests are within the lamina propria. |
2002 |