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Report Produced: 11/14/2025 10:04 AM

Report Question ID Question Discussion Answer Year
20081051 MP/H Rules/Histology--Prostate: Path said adenocarcinoma of the prostate with an endometroid adenocarcinoma component. What histology code is used?

For cases diagnosed 2007 or later:

Assign code 8500 [duct carcinoma].

According to The World Health Organization (WHO), the term endometrioid carcinoma of the prostate is now called Prostate Duct Carcinoma.

Using Rule H11 (one type), code 8500 (duct carcinoma) for this rare type of tumor. Do not stop at Rule H10 because this is not acinar.

 2008
20081060 CS Tumor Size--Lung: If a 5/11/07 CT showed a 6.5 cm LLL mass and a 7/24/07 CT showed 8.4 cm LLL mass, do we code the larger tumor size identified within four months of diagnosis or do we code the first size documented at the time of diagnosis?

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.Code the larger tumor size.

 2008
20081109

MP/H Rules--Breast: Patient has 2 existing primaries, both of left breast and both were pure lobular carcinoma, one was diagnosed in 1994 and the other in 2005. Now a biopsy in 2008 of a supraclavicular lymph node (laterality unknown) and subcutaneous scalp tissue show metastatic DUCTAL carcinoma. Per path report, breast is the primary site. Slides from prior tumors were not reviewed. Should this be made a new primary or assumed to be metastasis from the prior breast tumors? See Discussion.

A modified radical mastectomy was performed on 10/6/94.

The 2007 MP/H rules tell us that multiple ductal and lobular tumors of breast are a single primary; however, the rules do not apply to metastatic tumors.

For cases diagnosed 2007 or later:

Abstract the 2008 diagnosis as a new primary.

Since the primary site is unproven but stated to be breast, and since the laterality is unknown, we cannot determine that the 2008 diagnosis is the same as the 2005 or the 1994 diagnosis.

Revise this case accordingly if more information becomes available.

 2008
20081111

MP/H Rules/Histology--Breast: If an in situ carcinoma diagnosed in 2007 demonstrates comedo necrosis, should the histology be coded to comedocarcinoma in situ? See Discussion.

According to the new MP/H rules, we code descriptive features. There is no coding guidance or reference to "necrosis" within the breast MP/H rules. Based on SEER SINQ 20021002, the "comedo necrosis" would not be coded at all for pre-2007 cases. Does this still hold true for cases diagnosed after January 1, 2007?

For cases diagnosed 2007 or later, comedo necrosis is not synonymous with comedocarcinoma. If no further information is available for this case, code as carcinoma in situ.

 2008
20081082 Histology--Head & Neck: How do you code histology for a myofibroblastic sarcoma of the soft tissue of the head and neck? Assign code 8825/3 [Myofibroblastoma, malignant]. According to the WHO Classification of Soft Tissue Tumors, "Low grade myofibroblastic sarcoma represents a distinct atypical myofibroblastic tumor often with fibromatosis-like features and predilection for the head and neck." Also called myofibrosarcoma. 2008
20081107 Multiplicity Counter/Ambiguous terminology: How should these fields be coded for cases with an unknown date of diagnosis? If the date of diagnosis is unknown, it is likely that you have little information for this case. Both multiplicity counter and ambiguous terminology fields would probably be coded as unknown. However, if information on the number of tumors and the diagnostic confirmation are available, code these fields as specified in the manual. 2008
20081088 CS Lymph Nodes/CS Mets at Dx: How should these fields be coded for an in situ diagnosis when the patient was diagnosed by biopsy only and there is no information in the chart regarding an evaluation of lymph nodes or metastatic sites? See Discussion.

In reference to the case below, does it make a difference if the CS T stage is known based on the primary excision but there is no clinical information in the record regarding the nodes or metastasis evaluation.

This scenario is seen on outpatient records of breast biopsies and melanoma excisions; i.e., punch bx followed by gross excision of the lesion but the medical record contains no clinical information or statement of everything else normal.

I&R Question 17625 2/16/2006

A patient was diagnosed with ductal carcinoma in situ by needle core biopsy of the right breast. There was no further information in the chart stating if or where the patient went for staging work-up and treatment. What are the codes for CS Extension, CS Regional Lymph Nodes and CS Distant Mets at Dx?

I&R Answer: Sufficient tissue must be taken to determine the T category. If this is the case, CS Extension = 00.

Unless the physician makes the statement that the physical exam is negative, code the CS Regional Lymph Nodes = 99 CS Distant Mets at DX = 99.

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.

Code CS Lymph Nodes and CS Mets at Dx 00 [None] for an in situ diagnosis with no other information.

The CS instructions state that CS LN's should be coded 00 for in situ because in situ by definition is non-invasive. The same logic applies to CS mets in the case of in situ. The I&R answer will be revised.

 2008
20081121

Multiple primaries/Histology--Lymphoma: How many primaries should be abstracted and how should the histology field(s) be coded in this situation?

How would the bone marrow involvement by only NHL be handled? Composite lymphoma (9596) as defined by SEER and ICD-O is NHL and HD in one node which fits the final impression on the removed cervical node. See Discussion.

 Patient presented with cervical, supraclavicular & superior mediastinal lymphadenopathy. A cervical node was excised for pathological review. The final impression on that node was Composite lymphoma characterized by (1) Nodular Lymphocyte Predominant Hodgkin Lymphoma [HD] (2) CLL/SLL [NHL]. Then, a bone marrow aspirate/bx was performed revealing CLL/SLL [NHL].

For cases diagnosed prior to 1/1/2010:This is a single primary. The histology code is 9596/3 [composite Hodgkin and non-Hodgkin lymphoma].

According to the Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table, 9596/3 followed by 9670/3 is one primary.

For cases diagnosed 1/1/10 and later, 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.

 2008
20081046 MP/H Rules--Corpus uteri: How is histology coded for an endometrial tumor described as an "endometrioid adenocarcinoma with prominent squamous metaplasia"?

For cases diagnosed 2007 or later:

Endometrioid adenocarcinoma with squamous metaplasia is coded 8570 [Adenocarcinoma with squamous metaplasia]. This falls under the Histology Coding Rules for Other Sites, rule H17. The code for Endometroid adenocarcinoma is 8380. The code for Adenocarcinoma with squamous metaplasia is 8570. The histology with the numerically higher ICD-O-3 code is Adenocarcinoma with squamous metaplasia -- 8570.

 2008
20081126

MP/H Rules--Brain and CNS: Are stigmata of neurofibromatosis in the brain reportable neurofibromatosis lesions? See Discussion.

Reference: SINQ 20051108; SINQ 20061018 Three year old patient with history of neurofibromatosis 1. 3/05 MRI of the brain showed right optic nerve glioma. It also showed heterogeneous high t2 signal in the middle cerebellar peduncles and near the genu of the internal capsules bilaterally are stigmata of neurofibromatosis type I. 3/08 MRI showed new mass suspicious for glioma in the hypothalamus. Clinical diagnosis is benign glioma secondary to diagnosis of neurofibromatosis. How many primaries are to be accessioned for this patient? Should the matrix principle be invoked for the second glioma? Should the behavior code for the glioma be 0?

For cases diagnosed 2007 through 2017

Accession NF (9540/1) when there is CNS tumor -- a glioma or some other intracranial/intraspinal tumor. Stigmata of NF are reportable when the stigmata themselves are reportable tumors. For example, glioma, or another intracranial/intraspinal tumor. Do not report sitgmata that are only termed "stigmata seen on MRI," for example, without other reportable terminology.

Do NOT accession NF (9540/1) when there is only peripheral nerve/nervous system involvement.

Accession the neurofibromatosis itself only once per patient. Accession any initial neoplasm in the CNS separately. Abstract and code any subsequent CNS neoplasms according to the multiple primary brain rules.

Accession three primaries for the case described above.

  1. Neurofibromatosis (C729 9540/1)
  • Optic nerve glioma (C723 9421/3)--> see below.
  • Hypothalamus glioma (C710 9380/0)

--> Optic nerve gliomas associated with NF are pilocytic astrocytomas. Code pilocytic astrocytoma as 9421/3 in North America.

For cases diagnosed 2018 or later

See the 2018 Solid Tumor Rules for Non-Malignant CNS tumors.

 2008