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The behavior code for hemangioblastoma can be coded to /3 when a pathologist indicates that the behavior is malignant. The behavior code should be based on a pathologist's opinion. It is usually not possible for a radiologist or patient care physician to make this determination clinically.

The histologic appearance of hemangioblastoma may resemble metastatic renal cell carcinoma; therefore, one will often see renal cell carcinoma listed as a possible diagnosis. This does not indicate that the hemangioblastoma is malignant. Do not code the behavior as /3 based on a differential diagnosis of renal cell carcinoma.

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

Yes. The term "small B-cell non-Hodgkin lymphoproliferative disorder" is reportable. Code the histology to 9591/3 [non-Hodgkin lymphoma, NOS] per Rule PH28. When there is a diagnosis of lymphoproliferative disorder and any lymphoma, code the lymphoma histology.

The information in the discussion is reflective of the difficulty in diagnosing hematopoietic and lymphoid neoplasms. The differential diagnosis indicates that a number of possible specific lymphoma/leukemia diagnoses that have been ruled out, which explains why the final diagnosis is non-Hodgkin, NOS.

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.

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

Common variable immunodeficiency (acquired hypogammaglobulinemia) is not a reportable condition.

Common variable immunodeficiency represents a group of approximately 150 primary immunodeficiencies that have a common set of symptoms but different underlying causes, both benign and malignant.

The case is not reportable unless this immunodeficiency diagnosis is accompanied by a diagnosis of a cancer or a reportable hematopoietic or lymphoid neoplasm.

See Appendix F: Non-Reportable List for Hematopoietic Diseases.

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.

Do NOT use the Collaborative Stage Manual to determine the histology code. For CS STAGING purposes only, coding should be based on the squamous cell carcinoma component of this tumor.

The Multiple Primary and Histology Coding Rules Manual is the correct source for coding histology. For cases diagnosed 2007 or later, the following steps are used to determine the histology code:

Open the Multiple Primary and Histology Coding Rules manual. For an esophagus primary, use the Other Sites Histo rules to determine the histology code because esophagus does not have site specific rules.

Start at Rule H8 because this is an invasive histology (assuming this is a single tumor). which states that one should code the appropriate combination/mixed code from Table 2 when there are multiple specific histologies.

Find Other Sites for Table 2 under the Terms & Definitions section of manual.

Locate the appropriate mixed code for squamous cell carcinoma and adenocarcinoma in column 1. Per column 3, the correct histology is adenosquamous carcinoma. Per column 4, the correct histology is 8560/3.

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

This case is accessioned as two primaries per Rule M10 which states to abstract multiple primaries when a neoplasm is originally diagnosed as a chronic neoplasm and there is a second diagnosis of an acute neoplasm more than 21 days after the chronic diagnosis. The first primary is follicular lymphoma, grade 2 [9691/3] and it is a chronic neoplasm. The second primary is diffuse large B-cell lymphoma (DLBCL) [9680/3] and it is an acute neoplasm.

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.

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

Code the primary site to C770 [lymph nodes of the head and neck]. Per Rule PH19, code the primary site to the specific lymph node region when only one lymph node or one lymph node region is involved. No involvement other than the cervical lymph nodes is mentioned for the disease in 2010.

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.

Code as a single primary. The histology is carcinoid.

Our expert pathology consultant replied as follows: "This patient clearly has a condition driving the proliferation of neuroendocrine cells. Possibilities include hypergastrinemia from a gastrinoma or from response of antral gastrin cells due to achlorhydria from long standing chronic atrophic gastritis, or multiple endocrine neoplasia (MEN1) syndrome (genetically driven). How should these cases be coded given we do not have a way to code the inciting situation. (I suspect the gastroenterologist knows what it is, but we haven't obtained that information.) We do not have an ICD-O-3 code for the underlying condition, MEN1 or hypergastrinemia. Therefore, the only choice is to code the resulting tumor, carcinoid [8240/3]."

Multiplicity Counter field was initially coded 02. Change the code to 03 because the subsequent, additional tumor was determined to be the same primary. Update the Multiplicity Counter field only once. If additional tumors are determined to be the same primary for this case, it is not necessary to update this field again.

Date of Multiple Tumors field was initially coded November 2007. Multiple tumors were present at the time of the initial diagnosis. Do not change the date of this field when additional tumors are subsequently diagnosed. This data item reflects the earliest date that multiple tumors were present. See example 2 under #3 on page 81 of the 2010 SEER manual.

According to the MP/H rules, code histology to 8120/3 [urothelial carcinoma] for cases diagnosed 2007 or later. The term "glandular differentiation" is equivalent to adenocarcinoma differentiation. 8120/3 [urothelial carcinoma] would be the best way to code a "biphasic pattern with cautery-distorted urothelial carcinoma and adenocarcinoma" according to a pathologist consultant.

The steps used to arrive at this decision are as follows:

Go to the Urinary Histo rules found in the Multiple Primary and Histology Coding Rules Manual.

Start at the MULTIPLE TUMORS ABSTRACTED AS A SINGLE PRIMARY module, rule H9. Code the histology to 8120 [transitional cell/urothelial carcinoma] when there is transitional cell carcinoma with glandular differentiation.