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Report Produced: 07/01/2025 05:28 AM

Report Question ID Question Discussion Answer Year
20010092 Scope of Regional Lymph Node Surgery/EOD-Number of Regional Nodes Examined: What codes is used to represent these fields when the surgeon states that a "lymph node dissection" was done, but no nodes are identified in the pathology report?

For cases diagnosed 1/1/2003 and after: Code the Scope of Regional Lymph Node Surgery field to 3 [Number of regional lymph nodes removed unknown or not stated; regional lymph nodes removed, NOS] and code the EOD-Number of Regional Nodes Examined field to 00 [No nodes examined].

The surgery fields reflect the procedures the physician performed. The EOD fields reflect the results of those procedures.

 2001
20010002 EOD-Size of Primary Tumor: How do you code tumor size for lesions described as "at least 2 cm"? See discussion. The expression "at least 2 cm" seems to be different from "greater than 2 cm." Stating "at least" seems to indicate that if the tumor is larger than 2 cm, it is difficult to ascertain the exact tumor size. Should we accept 2 cm as the best info we have, or default to 999 because of the lack of specificity?

For cases diagnosed between 1998-2003:

Code the EOD-Size of Primary Tumor field to 020 [2 cm], using the rule "code what you know."

 2001
20010096

Multiple Primaries (Pre-2007)--Bladder: Should an invasive malignancy following an in situ malignancy by more than two months be a new primary? Why? See discussion.

Example: An in situ bladder case was diagnosed and treated. Three months later another TURB diagnosed an invasive bladder carcinoma. Is the invasive case reportable to SEER as a new primary?

For tumors diagnosed prior to 2007:

Yes. These are two primaries.

In situ cancers are not included in SEER incidence rates. Incidence rates must correlate with mortality rates.

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.

 2001
20010100 Grade, Differentiation--Lymphoma/Leukemia: What code is used to represent this field when the phenotype is combined B cell and T cell?

For cases diagnosed prior to 1/1/2010:Code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable]. There is no combination code for B cell and T cell. There is also no hierarchy established for choosing one code over the other. Therefore coding such a case as a pure B cell or a pure T cell would misrepresent the phenotype.

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.

 2001
20010036 Histology (Pre-2007)--Breast: What code is used to represent the histology for a single lesion with "metaplastic carcinoma" and the majority of tumor has sarcomatoid appearance? Squamous cell carcinoma and high grade intraductal carcinoma are also present. Is the term "sarcomatoid" equivalent to sarcoma?

For tumors diagnosed prior to 2007:

For cases diagnosed on or after 1/1/2001: Code the Histology field to 8575/3 [metaplastic carcinoma]. Sarcomatoid is not coded as sarcoma.

The terms metaplastic carcinoma, squamous cell carcinoma and intraductal carcinoma are used, but only the metaplastic and squamous cell carcinomas are invasive. Metaplastic, loosely defined, means tissue that is not normal.

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.

 2001
20010134 Diagnostic Confirmation--Testis: How do you code this field when a testicular mass is confirmed to be cancer on physical exam and testicular antigen, but the orchiectomy specimen was negative and yet the final signout diagnosis on the medical record was "testicular cancer"? Code the Diagnostic Confirmation field to 5 [Positive laboratory test/marker study] because the disease was confirmed both clinically and by a positive marker. Code 8 [Clinical diagnosis only] is used when the diagnosis is based on information other than that coded in 5, 6, or 7 [positive lab test/marker study, visualization, and radiography or other imaging techniques]. Code 8 is rarely used. 2001
20010006 Terminology/EOD-Clinical Extension--Prostate: Is "firm" a term that implies clinically apparent prostate disease? See discussion.

PE: Prostate firm on DRE

IMP: Rule out prostate cancer

For cases diagnosed between 1998-2003:

Code the EOD-Clinical Extension field to clinically inapparent. The clinically apparent term list classifies "firm" as "maybe" being involved. If a maybe term such as "firm" is the only description available, code as clinically inapparent.

 2001
20010128 Multiple Primaries (Pre-2007)--Bladder/Prostatic Urethra: When invasive TCC of the bladder and TCC in-situ of the prostatic urethra are diagnosed at the same time, are they reportable as two primaries? See discussion. There is no direct extension of tumor from the bladder to the urethra. According to the SEER rules for determining separate primaries, bladder (C67) and urethra (C68) are separate sites. However, it seems that TCC in the bladder and urethra should be reported as a single primary.

For tumors diagnosed prior to 2007:

This is one primary. Mucosal spread of in situ cancer from a hollow organ (bladder) into another hollow organ (prostatic urethra) is coded as a single primary.

This type of mucosal spread of tumor is sometimes referred to as "intramucosal extension" or " in situ component extending to." Mucosal spread can also be expressed as a statement of an invasive component in one organ with adjacent or associated in situ carcinoma in a contiguous organ with the same type of epithelium.

This case represents an invasive bladder tumor with in situ extension to the prostatic urethra. A tumor that is breaking down can be invasive in the center with in situ cancer at its margins. Occasionally, the in situ margin can move into a contiguous organ with the same type of epithelium.

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.

 2001
20010099 EOD-Extension--Pancreas: How do you code extension when CT scan shows a mass in the head of the pancreas "encompassing" the hepatic branch of the celiac artery? See discussion. We do not code the term "encompasses" as involvement. However, should we code this case as extension to the peripancreatic tissue, NOS or as unknown?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 40 [Extension to peripancreatic tissue, NOS]. There has to be extension to peripancreatic tissue if the mass encompasses the celiac artery.

 2001
20010122

Primary Site/EOD-Extension/EOD-Lymph Nodes--All Sites: What codes are used to represent these fields for an "extramedullary myeloid tumor (granulocytic sarcoma)" of the colon with positive or negative lymph nodes?

For cases diagnosed 1998-2003:

If only the extramedullary site is involved, such as colon, code the Primary Site field to the site of origin. Granulocytic or myeloid sarcoma is an exception to the rule that all leukemias should be coded to bone marrow as the primary site. Granulocytic sarcoma is a deposit of malignant myeloid cells in a site other than bone marrow (extramedullary). For EOD staging, granulocytic sarcoma [9930/3] is included in the Hematopoietic, Reticuloendothelial, Immunoproliferative and Myeloproliferative Neoplasms scheme and the Extension field is coded to 10 when the lymph nodes are negative, since it (like solitary plasmacytoma) is a localized deposit of tumor.

However, if the regional lymph nodes associated with the extramedullary primary site are involved, code the EOD-Extension field to 80 [Systemic disease] because the disease is no longer an isolated deposit of malignant granulocytes (in other words, it is not localized).

The EOD-Lymph Nodes field is coded to 9 regardless of whether or not the lymph nodes are involved because that is the only allowable code for that field.

 2001