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Report Produced: 02/25/2026 15:13 PM

Report Question ID Question Discussion Answer Year
20081133 MP/H Rules--Breast: What histology code is used for lobular carcinoma, pleomorphic type? For cases diagnosed 2007 or later, use rule H14 and code the histology 8520 [lobular carcinoma]. 8520 is the only ICD-O-3 code for lobular carcinoma. There are no codes for specific lobular types. 2008
20081039 Diagnostic Confirmation/Histology--Hematopoietic: How are these fields coded when the final pathologic diagnosis for a bone marrow biopsy differs from the final clinical diagnosis of a hematopoietic disease? See Discussion.

Frequently, pathology reports describe hematopoietic diseases using ambiguous terms. Flow cytology and cytogenetics may be obtained. It appears that the clinician is the person who pulls all the information together for a diagnosis.

Example: Bone marrow biopsy is most compatible with chronic phase myeloproliferative disease. Path comment: Differential would include CML. Outside hematology report indicates an elevated peripheral WBC, primarily neutrophils. Flow cytometry showed 1.0 % of the white cells are myeloid blasts of abnormal phenotype, additionally finding 7.3 % basophils. Flow reported peripheral blasts at 1.2 % and peripheral basophilia. Cytogenetics report showed abnormality with trisomy of chromosomes 13 and 21. This finding is consistent with a clonal abnormality suggestive of acquired disease. Results were consistent with the absence of the t(9,22)(q34;q11) translocation or fusion product associated with CML. Subsequent clinical impression: Bone marrow evaluation most consistent with CML. Overall features most consistent with CML.

For cases diagnosed prior to 1/1/2010:Code the Diagnostic Confirmation field as 1 [positive histology]. Code the ICD-O-3 morphology based on the clinician's statement.

The code in Diagnostic Confirmation pertains to the best method used to confirm the presence of cancer over the entire course of the disease. Therefore, if a bone marrow report confirms cancer, code 1 [positive histology] in Diagnostic Confirmation.

Code the histology using all of the information available. The clinician has access to all of the information relating to this case. The pathologist had only the bone marrow. Code the histology recorded by the clinician.

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
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
20081064

MP/H Rules--Bladder: Is a TURBT in 4/07 that demonstrates papillary carcinoma (8130/3) followed two weeks later with biopsies that demonstrate high grade flat dysplasia/carcinoma in situ (8010/2) two primaries?

For cases diagnosed 2007 or later, rule M6 applies and this is a single primary.

Flat transitional cell carcinoma and carcinoma in situ of the bladder are synonymous. See the definition of "Flat Tumor (bladder)/Noninvasive flat TCC" in the Urinary Terms and Definitions section of the 2007 MP/H manual.

 2008
20081065 Surgery of Primary Site--Melanoma: Which surgery codes should be used for cases that have a 1 cm margin? See Discussion. For a melanoma case the surgery codes in the 30's are to be used when margins are stated to be less than 1 cm. The codes in the 40's are to be used for cases where the margins are greater than 1 cm. If the margin is exactly 1 cm, assign a surgery code from the 20-36 range. Use a code in the 40's only when the margin is greater than 1 cm. 2008
20081136 CS Extension--Corpus uteri: Can a suspicious cytology be used to code extension? See Discussion.

Endometrial primary confirmed by biopsy on 10/26/06. Pelvic washing on 11/14/06 was 'suspicious for malignancy.' Resection path the same day stated the primary tumor invades the inner 1/3 of the myometrium.

Can we use the pelvic washing cytology & code CS extension 61 or should CS extension be coded 12?

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 extension code 61 [cancer cells in peritoneal washings] for the case described above.

"Suspicious" is listed as a term indicating involvement. There is no exception noted for cytology reports. See page 122 of the 2007 SEER manual.

 2008
20081025 MP/H Rules/Histology--Anus: What is the correct histology code and MP/H histology rule to use for AIN-3 arising in a polyp? See Discussion.

Patient has colonoscopy with excision of small 5mm polyp in rectum (no mention of anus or anal canal); path reads out: AIN-3 (anal intraepithelial neoplasm grade 3).

In coding the histology using the "Other Sites" rules, H2 would be the first rule that applies for this case. However, we lose the fact that the AIN-3 arose in a polyp (H3). Is this how SEER wants these cases coded?

 For cases diagnosed 2007 or later, apply rule H2 and assign histology code 8077/2 (squamous intraepithelial neoplasia, grade III). Apply the rules in order, H2 precedes H3. 2008
20081081 Reportability: If a dermatopathologist refers to an atypical fibroxanthoma as a malignant process, but the ICD-O-3 indicates it is a borderline process, is this a reportable case? See Discussion. "Final Diagnosis: Surface of ulcerated histologically malignant spindle cell neoplasm, consistent with atypical fibroxanthoma. Note: An exhaustive immunohistochemical work-up shows no melanocytic, epithelial or vascular differentiation. Atypical fibroxanthoma is a superficial form of a malignant fibrous histiocytoma." The pathologist has the final say on behavior. In this case, the pathologist states that this tumor is malignant in the final diagnosis. Therefore, this case is reportable. 2008
20081101

MP/H Rules/Multiple primaries--Lung: If a 1.7 cm LUL lung tumor is not treated surgically, would a 2.1 cm tumor in the same lobe three years later be a new primary? See Discussion.

In 2004 the patient has a 1.7cm squamous cell carcinoma diagnosed in the LUL of the lung treated with radiation and chemotherapy. In 2007, the patient was diagnosed with a 2.1cm squamous cell carcinoma in the LUL treated with radiation. According to the lung MP/H rules, the 2007 tumor would be a new primary. Given that there was no surgery, would the second tumor be progression of disease or would it be a new primary?

For cases diagnosed 2007 or later:

If the tumor diagnosed in 2004 was successfully treated and disappeared, apply the MP/H rules for lung. According to rule M8, the 2004 tumor and the 2007 tumor are multiple primaries. If there was no disease-free interval between tumor occurrences, that is, if the 2007 tumor is still the same tumor that was diagnosed in 2004, the MP/H rules do not apply.

 2008
20091119

MP/H Rules/Multiple primaries--Lung: How many primaries are to be reported for an adenocarcinoma of the lung in the right middle lobe of the lung and bronchioalveolar carcinoma, non-mucinous type in the right upper lobe? See Discussion.

Bilobectomy revealed two tumors, adenocarcinoma in the right middle lobe and bronchioalveoar carcinoma non-mucinous type in the right upper lobe. MP/H rule M10 states that tumors with non-small cell carcinoma (8046) and a more specific non-small cell type (chart 1) are a single primary. Does rule M10 apply to only those cases for which one tumor is stated to be non-small cell, NOS? Or do we use chart 1 to identify specific subtypes? For this case, using chart 1, would we note that bronchioalveolar is a subtype of adenocarcinoma and count this case as a single primary? Most of the MP/H rules schemas have a rule making an adenocarcinoma and a more specific type of adenocarcinoma a single primary. Would we apply rule M10 to this case and count it as a single primary? Or would we move on to rule M11 and count the case as two primaries?

For cases diagnosed 2007 or later, Rule M11 applies. Accession two primaries.

Rule M10 applies only to cases for which one tumor is stated to be "non-small cell carcinoma."

 2009