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Report Produced: 10/27/2025 21:56 PM

Report Question ID Question Discussion Answer Year
20081129 MP/H Rules--Breast: What histology code should be used with invasive papillary carcinoma with cribriform carcinoma component? There is also DCIS adjacent to the invasive tumor, predominant cribriform and focal papillary patterns. This is a single breast tumor. See Discussion. Registry staff is divided between 8523 and 8255.

For cases diagnosed 2007 or later:

First apply rule H9, code the invasive. To determine the code for the invasive histology, start with rule H10 and stop at rule H15. Code the histology 8503 [papillary]. Papillary (8503) and cribriform (8201) are listed in Table 1 as specific duct types, but in this case they are invasive.

Table 1 and Table 2 will be clarified in the next version of the MP/H rules.

 2008
20091088 MP/H Rules/Histology--Breast: How is histology coded for a diagnosis of "metaplastic carcinoma with the sarcomatous component of high grade sarcoma with focal areas of osteoid formation"? See Discussion. Right breast simple mastectomy, path: 2.5 x 1.5 x 1.5 cm metaplastic carcinoma with; the sarcomatous component is high grade sarcoma with focal areas of osteoid formation. The epithelial component is predominantly grade 2 DCIS. For cases diagnosed 2007 or later, assign code 8575 [Metaplastic carcinoma, NOS]. Metaplastic carcinomas often include mixtures of epithelial carcinoma with sarcoma, for example. 2009
20091110 MP/H Rules--Bladder: Should an invasive urothelial carcinoma of the bladder diagnosed in 2004 followed by an in situ urothelial carcinoma of the ureter diagnosed in 2008 be reported as multiple primaries per the three-year guideline in Rule M7 or a single primary per the subsite guideline in Rule M8? See Discussion. Rule M7 states, "Tumors diagnosed more than three (3) years apart are multiple primaries." Should this rule be modified to say, "Bladder tumors diagnosed more than three (3) years apart are multiple primaries"? Does Rule M7 apply to only bladder tumors or does this rule apply to tumors in any of the urinary sites similarly to Rule M8 which states, "Urothelial tumors in two or more of the following sites are a single primary: Renal pelvis (C659) Ureter (C669) Bladder (C670-C679) Urethra/prostatic urethra (C680)"?

For cases diagnosed 2007 or later, Rule M7 pertains to renal pelvis, ureter, bladder and other urinary sites as defined by the topography codes listed in the header of these rules.

An invasive urothelial bladder tumor followed more than three years later by an in situ TCC of the ureter are reported separate primaries. Rule M8 applies when the tumors in these sites are diagnosed within three years of each other.

2009
20130214 Primary site--Heme & Lymphoid Neoplasms: Does Rule PH20 apply if a patient with lymphoma has bilateral axillary and bilateral inguinal lymph node involvement? Rule PH20 states to code the primary site to the specific lymph node region when multiple lymph node chains within the same region as defined by ICD-O-3 are involved. Note 1 further states that one is to use this rule when there is bilateral involvement of lymph nodes.

Rule PH21 applies to this situation which states to code the primary site to multiple lymph node regions, NOS (C778) when multiple lymph node regions, as defined by ICD-O-3, are involved and it is not possible to identify the lymph node region where the lymphoma originated. Axillary nodes are coded to C773 and inguinal nodes are coded to C774. There are two lymph node regions involved. Code the primary site to C778 [multiple lymph nodes].

If this patient had only bilateral axillary OR only bilateral inguinal nodes are involved, then PH20 would have applied and you would code to the specific lymph node region mentioned.

2013
20130051 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when biopsies of the left and right tonsils show diffuse large B-cell lymphoma and there is no other evidence of involvement? See Discussion. Scans are negative for lymphadenopathy and the bone marrow biopsy was benign. Radiation Oncology staged this as localized bilateral tonsil primary lymphoma.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This case should be accessioned as a single primary, diffuse large B-cell lymphoma [9680/3] of bilateral tonsils. Per Rule M2, a single histology is a single primary. Note 1 for Rule M2 states bilateral involvement of lymph nodes and/or organs is still a single primary.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

2013
20071072 Ambiguous Terminology/Date of Conclusive Terminology: If there is an unknown date of diagnosis, should the Ambiguous Terminology field always be coded to 9 and the Date of Conclusive Terminology be coded to 99999999? See Discussion. Scenario: Mammogram is suspicious for carcinoma, unknown date in 2007. A biopsy prior to admission to reporting facility is positive for carcinoma. Patient seen at reporting facility in June 2007 for treatment. The purpose of the data item "Ambiguous Terminology" is to flag cases entered into the registry based on a diagnosis with ambiguous terminology. Because the case above was entered into the registry based on conclusive terminology, code Ambiguous Terminology to 0 [Conclusive term] and code Date of Conclusive Terminology to 88888888 [not applicable]. 2007
20081135

MP/H Rules--Lung: Per rule M8, tumors of the same site (left lung), same histology (NSCC), greater than 3 yrs apart are separate primaries.

However, there was a recurrence to mediastinal LNs after 2 years. Would that make a difference as to whether the 2008 left lung carcinoma is reportable as a new primary or not? See Discussion.

 Scenario: NSCC 2004 LLL with positive hilar/mediastinal LNs treated with LLL lobectomy, chemo and rad. 2006 per CT/PET recurrence in mediastinal LNs treated with chemoradiation. 2008 left lung nodule positive for NSCC stated by MD to be recurrence from 2004 (2008 path not compared to 2004 path).

For cases diagnosed 2007 or later:

The 2008 lung carcinoma is a separate primary according to rule M8. The 2006 diagnosis is metastases to the lymph nodes. Do not apply the MP/H rules to metastases.

 2008
20061005 CS Reg LN Pos/Exam: Are lymph nodes coded as positive or negative when the pathology report for a lymph node dissection performed after radiation and chemo reveals that the nodes are negative but they demonstrated previous involvement by cancer? See Discussion. Scenario: The patient was treated with radiation and chemotherapy prior to resection for esophageal cancer. The pathology report stated, "1/3 nodes c/w treated previous ca."

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.Record lymph nodes that are pathologically confirmed as positive in Regional Nodes Positive. Evidence of previous involvement by cancer is not recorded in this data item.

In the above scenario, the lymph nodes are negative according to pathology.

Clinically positive lymph nodes are coded in CS Lymph Nodes.

 2006
20081095 Race, ethnicity/Spanish surname or origin: If birthplace is Brazil or Portugal, patient's last name is on the Spanish Surname list, and there is no text to further clarify ethnicity, what is the correct Spanish Ethnicity code: 0 or 7? See Discussion. See also SINQ 20081075.

Assign code 7 [Spanish surname only] when the last name is on the Spanish Surname list. This includes cases for which the birthplace is Brazil, Portugal or the Philippines and there is no text to further clarify ethnicity.

The instruction to use code 0 [Non-Spanish/Non-Hispanic] in the SEER manual on page 51 (#2) applies when the only information available is the birthplace or a statement of "Portuguese," "Brazilian" or "Filipino."

 2008
20130180 Histology--Pancreas: What is the difference between pancreatic endocrine neoplasm (PanNETs) [8240/3] and the new ICD-O-3 terms pancreatic endocrine tumor, benign [8150/0] and pancreatic endocrine tumor, malignant [8150/3]? See Discussion. SEER Inquiry 20120035 discusses the reportability of pancreatic endocrine neoplasm (PanNETs) tumors.

The difference is that 8150 is for islet cell tumors. The preferred name was changed by WHO/IARC to reflect the current language used by pathologists to describe islet cell tumors [8150].

The 8240 histology code added the neuroendocrine tumor, grade 1, low or well differentiated terms to the carcinoid ICD-O name.

Islet cell tumors are more aggressive than the pancreatic NET tumors. Treatment and prognosis are determined by the histologic type. While the histology code 8150 is not new, the histology name has been updated.

2013