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20120089 | MP/H Rules/Histology--Colon: The final diagnosis on a path report for a colon specimen says: Is a colon specimen final diagnosis of carcinoma in situ in a serrated adenoma coded to 8010/2, 8210/2 or 8213/2? | For cases diagnosed 2007 or later, code the histology as 8213/2 [carcinoma in situ in a serrated adenoma].
The steps used to arrive at this decision are:
: Apply ICD-O-3 rule F (Matrix principle) and assign the behavior code /2 when the behavior assigned by the pathologist differs from the usual behavior as given in the ICD-O-3.
: Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text) and go to the Colon Histology rules.
: Start at the SINGLE TUMOR module, Rule H1. The rules are intended to be reviewed in consecutive order within a module. Stop at rule H4. Code the histology as 8213/2.
Note: The histology 8213 (adenocarcinoma in serrated adenoma) will be added to rule H4 in the next revision. |
2012 | |
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20120048 | MP/H Rules/Primary site: Can you clarify how you interpreted the term "synchronous" to appropriately code the primary site to C68.9 [urinary tract] for SINQ 20110119 and did not use that code for SINQ 20100025 when both cases used MP/H Rule M8 to determine the number of primaries? See Discussion. | In SINQ 20100025 a patient was diagnosed with multiple urinary system tumors over a year apart. Rule M8 applies (single primary) and the primary site was left coded to the original primary site, C65.9 [renal pelvis]. In SINQ 20110119 a patient is diagnosed with multiple urinary system tumors within a month of each other, again rule M8 applies (single primary) and the primary site was coded to C68.9 [urinary system, NOS].
In both cases, rule M8 applies. However, the tumors were not diagnosed synchronously (e.g., one month apart in one case and greater than one year apart in the other). When the SINQ answer states, "same time" or "synchronous" does this mean during the same event? If not, what is the time range for "same time" or "synchronous"?
Please clarify when it is appropriate to code the primary site to C68.9 [urinary system, NOS] for Rule M8 and when it is not. |
For the purpose of applying the MP/H rules, the term "synchronous" means that the two diagnoses occurred at the same time or less than or equal to 60 days apart.
The case in SINQ 20100025 was not synchronous. The first lesion in the renal pelvis [C65.9] occurred in 1/08 and the subsequent tumors were diagnosed in 5/09, more than one year apart. In this case, you do not go back to change the primary site code on the original abstract.
The case in SINQ 20110119 was diagnosed synchronously, the first lesion in the bladder [C67.9] was diagnosed in 11/09 and the second lesion in the renal pelvis [C65.9] was diagnosed in 12/09, less than 60 days apart. Because the lesions were synchronous, the primary site is coded urinary system, NOS [C68.9]. |
2012 |
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20120063 | Reportability--Pancreas: Are neuroendocrine "tumors" reportable and are they synonymous with neuroendocrine "carcinoma"? See Discussion. | Example: Pancreatic mass that probably represents a neuroendocrine tumor is staged as cT2N0M0. | According to the World Health Organization (WHO) pancreatic neuroendocrine tumors (NET) are malignant. They are reportable.
For pancreas primaries, code NET, G1 (well differentiated) to 8240/3; NET G2 (moderately differentiated) to 8249/3; and nonfunctional NET, GI or G2 to 8150/3. The histology code for neuroendocrine carcinoma (NEC) is 8246/3, large cell NEC is 8013/3 and small cell NEC is 8041/3. |
2012 |
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20120067 | MP/H Rules/Histology--Thyroid: How is the histology coded for a poorly differentiated thyroid carcinoma with rhabdoid phenotype arising in a papillary carcinoma? | For cases diagnosed 2007 or later, code the histology as papillary carcinoma, poorly differentiated [8260/33].
The WHO classification lists grade III papillary carcinoma as one of the synonyms for poorly differentiated thyroid carcinoma.
The steps used to arrive at this decision are: Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Other Sites Histo rules because site specific rules have not been developed for this primary. Start with the SINGLE TUMOR: INVASIVE ONLY module, rule H8. The rules are intended to be reviewed in consecutive order within a module. Per rule H13 "phenotype" is not a term used to code a more specific histology. Moving to Rule H14 the histology is coded 8260/3 [papillary adenocarcinoma]. |
2012 | |
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20120092 | MP/H Rules/Multiple primaries/Recurrence -- Lung: How many primaries are accessioned if a diagnosis of squamous cell carcinoma of the lung is followed three years later by a diagnosis of adenocarcinoma of the lung if the pathologist reviews all the slides and states the subsequent diagnosis is a recurrence? See Discussion. | 7/12/2007 Left upper lobe lung lobectomy: Squamous cell carcinoma.
3/09/2010 Left lung completion pneumonectomy: Adenocarcinoma, predominantly acinar. The diagnosis comment on the pathology report indicates the previous lobectomy specimen from 2007 was reviewed and "there are areas that appear histologically similar to the current neoplasm. Thus, the findings are most compatible with recurrence."
Despite the difference in histology, is this a single primary per the MP/H Coding Rules, General Information instruction 7 because the pathologist did refer to the 3/9/2010 diagnosis as a "recurrence" of the 7/12/2007 diagnosis after reviewing the slides? |
For cases diagnosed 2007 or later, accession a single primary, left upper lobe squamous cell carcinoma diagnosed 7/27/2007.
The steps used to arrive at this decision are:
Go to the General Information notes for Determining Multiple Primaries for Solid Malignant Tumors in the Multiple Primary and Histology Coding Rules Manual.
General Information Rule 7 states "Use the multiple primary rules as written unless a pathologist compares the present tumor to the "original" tumor and states that this tumor is a recurrence of cancer from the previous primary."
Accession a single primary. Do not apply the Multiple Primary rules because the pathologist compared the 2007 and 2010 slides and determined this was a recurrence and not a new primary. |
2012 |
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20130037 | Histology--Heme & Lymphoid Neoplasms: How is the histology coded for a "cutaneous diffuse large B-cell lymphoma, leg type" that has been verified as a valid diagnosis with prognostic factors including age and number of lesions on the legs? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code this histology to 9680/3 [diffuse large B-cell lymphoma]. Primary cutaneous DLBCL, leg type, is listed as an Alternate Name for DLBCL per the Heme DB.
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. |
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20130101 | Reportability--Heme & Lymphoid Neoplasms: Is plasma cell dyscrasia, favor MGUS vs. smoldering myeloma reportable? See Discussion. | The pathology report states, "plasma cell dyscrasia, favor MGUS vs. smoldering myeloma." The patient then died of a heart attack and no further information is available. If this is reportable, what histology code applies? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case is not reportable. Neither plasma cell dyscrasia nor MGUS are reportable. Smoldering myeloma was given as a possible diagnosis, but never confirmed.
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. |
2013 |
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20130078 | Ambiguous terminology/Reportability--Heme & Lymphoid Neoplasms: Is a physician diagnosis of "appears to be a myeloproliferative disorder" reportable if the patient has no treatment and the physician elects to follow the patient with CBC's?. |
Yes. This is a reportable diagnosis and should be accessioned with the histology coded to 9975/3 [myelodysplastic/myeloproliferative neoplasm, unclassifiable]. The word is a reportable ambiguous term per the Hematopoietic Coding Manual (Case Reportability Instructions, Rule 4). Myeloproliferative disorder is synonymous with myeloproliferative disease. Myeloproliferative disease is listed as an alternate name for myelodysplastic/myeloproliferative neoplasm, unclassifiable. |
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20130029 | Reportability--Heme & Lymphoid Neoplasms: Is "post polycythemic myelofibrosis" reportable? See Discussion. | The bone marrow biopsy showed post polycythemic myelofibrosis. JAK2 mutations were present confirming the diagnosis of post polycythemic myelofibrosis. The patient does have a history of polycythemia vera (PV). | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Polycythemia Vera (PV) [9950/3] is reportable. The Abstractor Notes section in the Hematopoietic Database for PV indicates there are three phases of PV. The third phase is referred to as the "spent" or "post-polycythemic myelofibrosis phase". This patient appears to be in the third phase of PV. This would not be reported as a new primary if PV has already been reported.
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. |
2013 |
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20130190 | Reportability: Is a thymoma, type B3 malignant and, therefore, reportable? See Discussion. |
Recent information received from a registrar/pathologist states the WHO classifies well-differentiated thymic carcinoma [8585/3] as a synonym for type B3 thymoma. |
For cases diagnosed prior to 2021 Thymoma, type B3 [8585/1] is not reportable. Well-differentiated thymic carcinoma [8585/3] is reportable. WHO lists well-differentiated thymic carcinoma as a synonym for type B3 thymoma, but indicates the behavior code differs as indicated above. See the applicable SEER manual for cases diagnosed 2021 and later. |
2013 |
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