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Report Produced: 02/25/2026 18:15 PM

Report Question ID Question Discussion Answer Year
20100079 Reportability--Heme & Lymphoid Neoplasms: Does the fact that the Hematopoietic Database states the ICD-O-3 code 9970/1 [Lymphoproliferative disorder/disease, NOS] mean that the ICD-O-3 books should be updated to indicate that as of 2010 the code 9970/1 [Lymphoproliferative disorder/disease, NOS] is no longer applicable?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Lymphoproliferative disorder/disease, NOS [9970/1] is not a reportable neoplasm. There are also new codes that define lymphoproliferative disorder/disease more specifically. If you do a "smart search" and enter only the word "lymphoproliferative" into the Heme DB, you will get a listing of all of the reportable and non-reportable terms. That enables you to look at your record and compare the words in the Heme DB to those in the record you are reviewing.

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.

2010
20100032 First course treatment--Prostate: Is Degarelix coded as hormonal treatment for prostate cancer? Code the administration of Degarelix in the "Hormone Therapy" field. Assign code 01 [Hormone therapy administered as first course therapy]. This drug will be added to the next update of SEER*Rx. 2010
20100026 Multiplicity Counter--Kidney, Renal Pelvis: How many times is this field updated after an invasive primary is originally diagnosed? Should subsequently diagnosed in situ tumors to be included in this field? See Discussion. How should the Multiplicity Counter be coded when a patient has a renal pelvis primary [C659] diagnosed 1/23/08. The patient had one tumor, invasive grade 3 of 3 papillary urothelial carcinoma arising in the depth of a calyx in mid portion of kidney. In 6/1/09, a TURBT showed three separate high grade urothelial carcinoma in-situ lesions on the right side of the bladder, the largest tumor being 7mm. In 2/8/10, another TURBT showed one lesion on the left side of bladder, high grade urothelial carcinoma in-situ, tumor was 4mm. These are all a single primary per rule M8.

Code multiplicity counter 04. Count both invasive and in situ tumors.

Multiplicity counter would have been coded 01 in 2008. Add the three in situ tumors diagnosed in 2009 to the first tumor and update multiplicity counter to 04. Make only one update to multiplicity counter. Because the multiplicity counter was updated once, the fifth tumor diagnosed in 2010 does not need to be added.

2010
20100053 Primary site--Heme & Lymphoid Neoplasms: How is primary site coded for a myeloid sarcoma (granulocytic sarcoma) arising in the chest wall in a patient that has a negative bone marrow biopsy? See Discussion.

Patient was diagnosed with Myeloid Sarcoma (granulocytic sarcoma) by chest wall biopsy. This is an extramedullary manifestation of acute leukemia and is not in the bone marrow (bone marrow is negative).

How should primary site be coded? The Heme DB states that almost any part of the body can be involved. It also states to not code primary site to C421. In this case the only involvement is the chest wall [C493]. However, use of the primary site code C493 triggers an edit error questioning this site/histology combination. If the primary site is coded to C421 [bone marrow], there is no edit error. Please explain the site code and rationale.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Unless there are scans showing involvement of a lymph node or tissue other than the chest wall, the histology should be coded myeloid sarcoma [9930/3] and the primary site to C493 [soft tissue of chest wall]. Per Rule PH 30, use the Heme DB to determine primary site and histology when rules PH1-PH29 to not apply. Override the edit.

Per the Abstractor Notes section in Heme DB, for myeloid sarcoma [9930/3] the most frequently affected sites are skin, lymph nodes, gastrointestinal tract, soft tissue, and testis.

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.

2010
20100067 MP/H Rules/Reportability--Ovary: Should an ovarian tumor with the histology of mixed epithelial borderline tumor with multiple foci of intraepithelial carcinoma be accessioned based on the presence of a foci of intraepithelial carcinoma? See Discussion.

The final diagnosis on the pathology report, "Omentum: mixed epithelial borderline tumor with multiple foci of intraepithelial carcinoma. Peritoneal fluid for cytology: neoplastic cells present; low grade serous neoplasm. Lymph nodes, right pelvic: one lymph node harboring implants of serous borderline tumor and endosalpingiosis within the subcapsular sinus. Bilateral fallopian tubes and ovaries: mixed epithelial borderline tumor with multiple foci of intraepithelial carcinoma involving ovarian surface and serosal surface of the tube. Detached fragment of borderline tumor within the tubal lumen. Uterus, cervix, and segment of colon: mixed epithelial borderline tumor with multiple foci of intraepithelial carcinoma involving parametrial and paracervical tissue, cul de sac, uterine and colonic serosa. Nine pericolonic lymph nodes negative for tumor. Stage III.

I&R # 45622 asked if a mucinous borderline tumor with intraepithelial carcinoma and focal microinvasion is reportable. The answer given on that site was that the case is not reportable. According to MPH, FORDS, and Collaborative Stage, intraepithelial carcinoma is in situ, behavior code 2, and is reportable. Has this changed?

This case is reportable because there is a diagnosis of carcinoma (intraepithelial carcinoma). 2010
20100072 Histology/Reportability--Heme & Lymphoid Neoplasms: Is a diagnosis of follicular lymphoma in situ of the gallbladder reportable for 2010? See Discussion. Coding the histology to 9690 [Follicular lymphoma] with a behavior of 2 [in situ] causes many edits including SEER and CS edits to fail. According to the chief of pathology, this is a recently identified pathologic entity.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Currently, lymphoma in situ is not reportable. It is true that this is a recently identified pathologic entity. Our experts say that there is still some controversy to be ironed out regarding the criteria for identifying an in situ lymphoma. Their recommendation was to wait until clear guidelines had been established for the pathologists before we start collection of in situ lymphomas. We anticipate collecting these entities in the future.

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.

2010
20100103 Reportability--Corpus uteri: Is gestational trophoblastic neoplasia reportable if there is no mention of metastasis but the patient has been treated with chemotherapy? See Discussion.

Per SINQ 20021106, for tumors diagnosed prior to 2007, a clinical diagnosis of metastatic gestational trophoblastic disease was to be coded to histology 9100/3 [Choriocarcinoma]. "Gestational trophoblastic neoplasia includes the diagnosis of choriocarcinoma."

Do not report gestational trophoblastic neoplasia unless stated to be malignant. 2010
20100015

Type of Multiple Tumors/Multiplicity Counter--Breast. Are the data items "Type of Multiple Tumors Reported as One Primary" and "Multiplicity Counter" related? How should they be coded for breast cases in which there are multiple measured invasive tumors, plus DCIS which is not measured nor stated whether it is separate from the invasive tumors? See Discussion.

For example, path report states only "multifocal invasive ductal carcinoma, 1.5 cm and 0.8 cm, and low-grade DCIS." The Multiplicity Counter instructions tell us to ignore/do not count foci that are not measured. Should we interpret this to mean, count only the two invasive foci and ignore the DCIS? Should Type of Multiple Tumors then be coded 30 or 40, because only the invasive tumors are coded in Multiplicity Counter? Code Type of Multiple Tumors 30 [in situ and invasive]. The code in Type of Multiple Tumors may or may not reflect the tumors that were counted in Multiplicity Counter. For this case, it is correct to code 02 in multiplicity counter. 2010
20100056

Primary site/Histology--Heme & Lymphoid Neoplasms: How are these fields coded for a case with pathologic diagnosis of "anaplastic large cell lymphoma, ALK-negative" involving the brain and a clinical statement of involvement in the right inguinal lymph nodes and the right lower extremity by a cutaneous lymphoma? See Discussion.

The final diagnosis on the pathology report for a brain biopsy is "Anaplastic large cell lymphoma, ALK-negative." Per a progress note: right inguinal lymphadenopathy. CT scan is consistent with multiple lymph node groups enlarged. Right lower extremity cutaneous nodular lesion; cutaneous lesions likely cutaneous lymphoma.

Should the histology be coded 9702/3 [anaplastic large cell lymphoma, ALK-negative], and the primary site C447 [skin of leg]? Or is the physician using "cutaneous lymphoma" as a general term indicating infiltration and the primary site is really C779 [lymph nodes, NOS]?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code to primary site to C447 [skin of leg]) per Rule PH25 and histology to 9702/3 [anaplastic large cell lymphoma, ALK-negative]. Per the Abstractor Notes section in Heme DB, these are the usual presentations for this disease. It also states this disease presents with peripheral node involvement and is often generalized with infiltrates in the bone marrow, liver, spleen, and extranodal tissue. Less frequently involved sites are lung, salivary gland and CNS.

Per PH25, code the primary site to the organ when the lymphoma is present in an organ (skin, right leg) and that organ's regional lymph nodes (inguinal). Distant lymph nodes or other organs may also be involved, but should be disregarded for coding primary site.

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.

2010
20100096 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a 9/30/10 biopsy diagnoses follicular lymphoma, grade 1 and the patient is subsequently diagnosed on a 10/11/10 biopsy with large B-cell lymphoma which is stated to be a transformation of the prior lymphoma?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Per Rule M11, this case is to be accessioned as two primaries; follicular lymphoma, grade 1 [9695/3] and diffuse large B-cell lymphoma (DLBCL) [9680/3]. The case represents a chronic neoplasm (follicular lymphoma, grade) and an acute neoplasm (diffuse large B-cell lymphoma) diagnosed within 21 days of one another and there is documentation of two biopsies, one confirming the chronic disease and the other confirming the acute disease.

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.

2010