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Report Produced: 05/02/2026 19:24 PM

Report Question ID Question Discussion Answer Year
20081128

MP/H Rules/Histology--Breast: What is the histology code for the following?

4/21/03 Left breast: infiltrating ductal carcinoma, grade 3 micropapillary type. Tumor size: 3.5 cms; deep margin negative. Skin, nipple & areola positive for invasive ductal carcinoma. Dermal lymphatic invasion by carcinoma breast. Extensive intraductal component absent. 6+/6. See Discussion.

 How should histology be coded for a 2003 diagnosis and also for the same diagnosis in 2007 or later?

For a case diagnosed in 2003, code 8507/3 [Duct micropapillary carcinoma]. See Coding Complex Morphologic Diagnoses, revised August 2002, 3rd example on page 5 and page 3, #4.

For cases diagnosed 2007 or later, code 8507/3 [Duct micropapillary carcinoma]. Use rule H12.

 2008
20081114

Reportability--Brain and CNS: Is hygroma reportable? See Discussion.

Benign brain guidelines indicate that named tumors that have been assigned an ICD-O-3 code are reportable. However, per I&R: "Most cystic hygromas (9173/0) are fetal malformations and occur in patients less than two years old. If this patient was an adult, they are primarily treated with surgery. Hygroma (used in a general sense) is a response to trauma (i.e., subdural hematoma) and as such, is not a "new growth" and would not be reportable either as a cyst or as a neoplasm. Unless the patient had some sort of operation, I'd hesitate to include the case as a reportable benign tumor."

How is the cancer registrar to distinguish between reportable and non-reportable hygromas? Example: Brain MRI showed diffuse cerebral volume loss and incidental bilateral frontal subdural hygromas (histology code 9173/0).

Reference: I&R 14825

Hygromas are not reportable. This instruction will be added to the next revision of the benign brain rules.

According to an expert in the field, hygromas are not neoplastic. Hygromas are cystic dilations of a localized subarachnoid or subdural accumulation of clear fluid related to an excess accumulation of CSF, typically related to an old hemorrhage that somehow prevents reabsorption of CSF.

 2008
20081084

Reportability: Is a tubular adenoma reportable if the final diagnosis is "high grade atypia" and the diagnosis comment is "atypia limited to muscularis mucosa areas of pseudostratification [formerly qualifying for carcinoma in situ]"?

This case is not reportable.

The pathologist would need to include "carcinoma in situ" as part of the final diagnosis in order for this case to be reportable.

 2008
20081108 CS Extension--Pancreas: How is this field coded for a head of pancreas primary with involvement of the inferior vena cava?

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.Assign CS extension code 54 [Blood vessel(s) major]. The inferior vena cava is one of the major blood vessels.

The inferior vena cava is located just behind the head of the pancreas. The hepatic artery, the superior mesenteric vessels and the portal vein are nearby.

 2008
20081061 Histology--Breast: What is the histology code for a 2007 diagnosis of basal-type breast carcinoma?

Code basal-type breast carcinoma to 8500/3 [Infiltrating duct carcinoma, NOS].

Basal-type breast carcinoma is a subtype of infiltrating duct carcinoma thought to have a poorer prognosis. There is no specific ICD-O-3 code for basal-type breast carcinoma.

 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
20081105 Primary site/Surgery of Primary Site--Lymphoma: What is the primary site for lymphoma involving lymph nodes and tonsil? Is a tonsillectomy coded as surgery for lymphoma? See Discussion.

6/1/2008 cervical lymph node biopsy showed lymphoma. A 6/3/2008 CT Chest/abdomen showed mediastinal and mesenteric lymphadenopathy. A 6/15/2008 tonsillectomy is performed for markedly enlarged right tonsil. Tonsil pathology reveals extensive lymphoma involvement.

Nothing in the chart specifies the primary site.

Should this be a C778 primary because of 3 lymph node areas plus tonsil (a lymphatic organ)? Or should it be coded to C099 Tonsil?

Is this tonsillectomy coded as surgical therapy? If so, is it surgery of primary site or surgery of other site?

For cases diagnosed prior to 1/1/2010:Code the primary site to tonsil (C099). This advanced stage lymphoma involves an extranodal site (tonsil) and that site's regional lymph nodes (cervical). The lymphoma has also spread to non-regional lymph nodes (mediastinal and mesenteric). Code the tonsillectomy as surgery of primary site.

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
20081080 CS Lymph Nodes/CS Site Specific Factor--Head and Neck: How should these fields be coded when the information is from an out of state data exchange and the record provides no supporting text, all the required fields are not coded and the codes that are provided are in conflict? See Discussion. A parotid case with CS LN coded to 10 [single positive ipsilateral regional node]; Regional LNs Positive coded to 68 and Regional LNs Examined coded to 74. No SSFs were coded. Based on the number of nodes coded as positive, the CS LN code was incorrect. Because the only information available to the central registry was that multiple regional LNs NOS were positive, we coded CS LN to 80 [lymph nodes NOS] and coded all SSFs to 999. Upon running the SEER edits, this case popped up on edits yielding a CS Site-Specific Factor codes, CS Lymph Nodes and Head/Neck Schemas conflict. Provide some guidance as how to properly code CS LNs & SSFs 1-6 for this case given the very limited information provided to us?

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.This is an unusual situation with conflicting information. If possible, request the pathology report and/or audit the case.

If you cannot obtain any further information or clarification, there are two choices:

  • Code CS LN's 80; code SSF 1 & 2 999, code SSF 3-6 000.

  • Code CS LN's 99; code SSF 1-6 999.

    		•  2008
    		20081079 Ambiguous terminology/Reportability--Kidney: Is a case reportable if a biopsy diagnosis of "suggestive of oncocytoma, malignant neoplasm cannot be excluded" follows a CT scan that was read as "suspicious for carcinoma"? See Discussion. Pt is nursing home resident. CT abdomen/pelvis shows a "mass in the right kidney, highly suspicious for renal cell carcinoma". CT-guided needle biopsy performed with final diagnosis: "Neoplasm suggestive of oncocytoma. A malignant neoplasm cannot be excluded." No other information is available. This case is not reportable based on the information provided. The suspicious CT finding was biopsied and not proven to be malignant. "Suggestive of" is not a reportable ambiguous term. 2008
    		20081074 Primary site/Histology: Does SEER accept the site/type combination of lymph nodes (C77.0-C77.9) with the histology of either 9823 (B-cell chronic lymphocytic leukemia/small cell lymphocytic lymphoma) or 9827 (Adult T-cell leukemia/lymphoma)? See Discussion. There is a discrepancy between the SEER Site/Type table and the CS histology codes under Lymph Nodes.

    For cases diagnosed prior to 1/1/2010:These are not "impossible" site/histology edits. You can override them. However, if the lymph nodes are involved and a lymphoma histology is available, the lymphoma histology should be coded rather than leukemia histology. For example, assign histology code 9670 (Malignant lymphoma, small B lymphocytic, NOS) instead of 9823 (B-cell chronic lymphocytic leukemia/small cell lymphocytic lymphoma) if the disease is identified in the lymph nodes.

    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