CS Site Specific Factor--Lymphoma: Can the registrar calculate the International Prognostic Index (IPI) score from information found in the H&P or on the back of a TNM form for the SSF 3 field if the physician does not document it in the medical record?
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 the IPI score in SSF3 when the score is documented in the medical record. If the score is not stated, do not calculate it.
MP/H Rules/Histology--Thyroid: Regarding rule H15, is the mixed code 8340 [Papillary carcinoma, follicular variant] used when there are subtypes of these histologies described, such as a tumor diagnosed with follicular and papillary microcarcinoma or should 8341 [Papillary microcarcinoma] be used?
For cases diagnosed 2007 or later:
For coding purposes, this is a papillary and follicular combination that would be coded to the combination code 8340/3 [Papillary carcinoma, follicular variant].
For thyroid cancer only, the term micropapillary does not refer to a specific histologic type. It means that the papillary portion of the tumor is minimal or occult, usually less than 1 cm. in diameter.
Histology--Brain and CNS: How is histology to be coded for a pituicytoma WHO grade I, of the pituitary?
Assign code 9380/1 [glioma, borderline].
According to our pathologist consultant, the term pituicytoma is restricted to low-grade glial neoplasms of the neurohypophysis or infundibulum. The best category currently available for these is glioma.
EOD-Extension--Small Intestine: How do we interpret a pathology description of "extending through serosa and forming masses in the periserosal tissue" for a jejunum primary?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 55 [Invasion of/through serosa and adjacent connective tissue]. The description states the tumor extended through the serosa into periserosal tissue. The periserosal tissue in this case refers to adjacent connective tissue lying exterior to the intestinal wall and not the (sub)serosal tissue that lies exterior to the muscularis but inferior to the serosa. Analyze each case individually since pathologists are not consistent when using the above terminology.
EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank?
For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.
Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis.
Reportability/Histology--Colon: Is tubular adenoma with high grade dysplasia and focal invasion from a pathology report of a colon biopsy reportable?; if so, what is the histology code?
Tubular adenoma with high grade dysplasia and focal invasion is reportable. Assign the histology code and behavior as 8210/3 (Adenocarcinoma in tubular adenoma).
NAACCR Guidelines for ICD-O-3 Implementation discuss the term high grade dysplasia (without invasion). High grade dysplasia and related terms are under review and study for consideration as a reportable neoplasm. Registries should check with their state reporting legislation to see if included in the reporting requirements.
Reportability--Heme & Lymphoid Neoplasms: Is Rosai-Dorfman's syndrome (histiocytosis) a reportable malignant condition?
Rosai-Dorfman disease is not reportable. Rosai-Dorfman disease is a rare non-neoplastic disease. This disease can mimic lymphoma and extranodal involvement is frequent.
Systemic/Surgery Sequence--Breast: How is this field coded for a breast cancer patient treated with a lumpectomy followed by chemotherapy and then a mastectomy?
Assign code 2 [Systemic therapy before surgery]. The code in Systemic Treatment/Surgery Sequence is related to the surgery coded in Surgery of Primary Site. For SEER, the mastectomy will be coded in the surgery field. The chemotherapy occurred before the mastectomy.
MP/H Rules/Histology--Thyroid: How would the histology "micropapillary carcinoma" of the thyroid be coded for cases dx'd 2007 and after?
For cases diagnosed 2007 or later, assign code 8260/3 [Papillary adenocarcinoma] according to rule H14.
For thyroid cancer only, the term micropapillary does not refer to a specific histologic type. It means that the papillary portion of the tumor is minimal or occult, usually less than 1 cm. in diameter.
Primary site--Heme & Lymphoid Neoplasms: How do you code primary site for a case of "leukemia cutis" when the bone marrow exam is negative for involvement with leukemia?
Code the primary site to C421 [bone marrow] per Rule PH30 which states to use the to determine the primary site and histology when rules PH1-PH29 do apply. Leukemia cutis is the term for a leukemic infiltration of the epidermis, the dermis or the subcutis. This infiltration is easily identified as cutaneous lesions, but the primary site is still bone marrow. This is a type of "metastasis" or spread of the leukemia cells. The "conventional" definition for leukemia cutis is the infiltration of skin from a bone marrow primary. See the Hematopoietic & Lymphoid Neoplasm Coding Manual Glossary.
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.
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