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Report Produced: 09/17/2025 17:02 PM

Report Question ID Question Discussion Answer Year
20140015 Primary site--Heme & Lymphoid Neoplasms: Is there an instruction missing under Rule PH22 of the 2014 Heme Manual that addresses when it might be appropriate to code primary site to C779 for a Stage II lymphoma? See discussion. It appears there is no instruction under PH22 that covers Example 5 (The patient has a history of Stage II lymphoma, no other information is available). All the bulleted instructions are for organ and lymph node combination involvement. Was the 2010 Heme Rule PH31 (Code the primary site to lymph nodes, NOS (C779) when lymph node(s) are involved but no primary site/particular lymph node region is identified) supposed to be listed under PH22? There does appear to be an empty bullet on the current web version.

The 5th bullet under Rule PH 22 was inadvertently omitted. A corrected version of the Heme manual will be posted soon. Thank you for identifying this omission.

In the meantime, please add the following to PH22:

Code the primary site to lymph nodes, NOS (C779) when lymph node(s) are involved but no primary site/particular lymph node region is identified.

 2014
20140062

MP/H Rules/Multiple Primaries--Lung: Does lung MP/H Rule M6 apply to synchronous tumors only, metachronous tumors only, or both? See discussion.

How many primaries should be reported when a patient has a history of RLL adenocarcinoma diagnosed on 10/8/2009 followed by diagnoses of LUL adenocarcinoma on 10/5/2012 and a RUL adenocarcinoma on 3/26/2014?

We applied Rule M6 to the 10/5/2012 diagnosis of LUL adenocarcinoma and reported an additional primary. However, we are unsure how to apply the MP/H rules for the 3/26/2014 RUL adenocarcinoma.

Should we apply Rule M8 because the RUL adenocarcinoma was diagnosed more than 3 years after the original RLL adenocarcinoma and then apply M6 because the RUL and LUL indicate a single tumor in each lung (resulting in a third primary); or does Rule M12 apply because there has been more than a single tumor in each lung (no new primary)?

Assuming each of the three diagnoses is a single tumor and there are no other tumors in either lung, abstract two primaries: 1 in the RLL diagnosed on 10/8/2009 and 1 in the LUL diagnosed on 10/5/2012. Do not abstract the 3/26/2014 diagnosis as a new primary.

Rule M6 applies to the 2009 and 2012 diagnoses. Rule M12 applies to the 2012 and 2014 diagnoses. Do not compare the 2014 diagnosis to the 2009 diagnosis. Always compare the latest diagnosis to the most recent previous diagnosis in cases like this.

2014
20140014 First course treatment/Surgery of Primary Site--Anus: Would infrared coagulation be coded as treatment for AIN III of the anus/anal canal? See discussion. SINQ 20051064 indicates infrared coagulation is not treatment for cancer. Internet search explains that infrared coagulation delivers heat to destroy the tissue so it can be removed. In our region it is currently used to treat internal and external anal low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL). While it is understandable that this wouldn't be coded as treatment for an invasive anal primary, could it be treatment for an in situ tumor? If it is treatment, should it be coded under Surgery code 15 The answer to SINQ 20050164 still applies. Do not code infrared coagulation as cancer treatment. It is used to coagulate blood vessels and not to destroy cancer tissue. 2014
20140001 Grade--Brain and CNS: How should grade be coded for a pineal parenchymal tumor of "intermediate differentiation"? See discussion.

Per a web search, the term "pineal parenchymal tumor of intermediate differentiation" refers to a pineal tumor with the histology/behavior that falls somewhere between the category of pineocytoma (9361/1) and pineoblastoma (9362/3). In other words, it is a malignant tumor that is a WHO grade II/III neoplasm because it's histologic features and behavior are not quite equivalent to a pineoblastoma (WHO grade IV). Thus, it appears the expression "intermediate differentiation" is actually referring to a type of WHO classification system rather than the grade field.

Should the type of documentation provided in pathology report be used to imply the grade field is being referenced and thus be coded to 2 for "intermediate differentiation" or should grade be coded to 9 based on the information found during the web search?

Code the grade as 2 based on instruction #8 in the revised grade instructions for 2014.

Do not use WHO grade to code the grade field for CNS tumors.

 2014
20140038

MP/H Rules/Multiple Primaries--Urinary: How many primaries are there and which MP rules apply in this scenario? See discussion.

Patient has 2 tumors in the left ureter; one is transitional cell (8120) and one is papillary transitional cell (8130). Rule M6 says BLADDER tumors with any combination of the following histologies ... are a single primary. But this is not a bladder case. Rule M8 says urothelial tumors in 2 or more of the following sites are a single primary... but this is not in 2 or more sites. Rule M9 then says histologies different at the 1st, 2nd, or 3rd digit are separate primaries. That makes this 2 primaries, but I do not think this should be 2 primaries.

Rule M9 applies. Abstract 2 primaries.

We will evaluate this scenario for the next version of the multiple primary rules.

2014
20140016 MP/H Rules/Histology--Bladder: What is the correct histology code for this situation? See discussion. Patient has 2 bladder tumors, both invasive -- one is transitional cell carcinoma (8120/3) and the other is papillary TCC (8130/3). They have the same extent of disease, both involve the lamina propria. Is this 8120, because of the Note under rule H11 or is this 8130 because under rule H12, it says 'papillary carcinoma and transitional cell carcinoma'? If so, what is the meaning of the note under rule H11?

Rule H12 applies, code to 8130.

The note under H11 is intended to explain the order of the rules; that is, why the rule to code papillary transitional/urothelial cell carcinoma (H12) follows the rule to code transitional/urothelial cell carcinoma (H11).

 2014
20140046

MP/H/Multiple Primaries--Urinary: Is this one primary with a C689 primary code and morphology 8130/3? Or is this 2 primaries: 1. C679 8130/3 and 2.C680 8120/2. See discussion.

Urinary: Transitional Cell Carcinoma and open prostatectomy: Path from Bladder: Papillary and solid transitional cell carcinoma of bladder - grade II and III Stage A.

Path from prostatectomy: The prostatic tissue samples shows areas of urothelia carcinoma in situ - related to the tumor present in the bladder.

Conclusion: Prostatectomy showing foci of transitional cell carcinoma in situ of prostatic urethra.

Abstract a single primary, C679 8130/3. Rules M2 and H4 apply. Transitional cell/urothelial carcinoma in the prostatic urethra is likely an extension from the known bladder TCC in this case, not a separate primary. See prostatic urethra on page 63 in the Urinary Terms and Definitions, http://www.seer.cancer.gov/tools/mphrules/mphrules_definitions.pdf

2014
20140064

Reportability--Testis: Is a mature teratoma of the testis reportable? See discussion.

Mature teratoma is listed as a benign neoplasm (9080/0) in the ICD-O-3. SINQ 20120085 references a NAACCR Webinar that indicated pure mature teratomas of the testis in adults are reportable. We are not aware of any further documentation of this change in reportability. When did mature teratomas of the testis for adults become reportable? What is the defined age range for "adult"? The original SINQ question above lists the 2012 SEER Manual as a Reference, however, no clarification or mention of this change in reportability was found in that manual.

For testis, mature teratoma in an adult (post-puberty) is reportable because it is malignant (9080/3); however, mature teratoma in a child is benign (9080/0). The 2011 NAACCR webinar introduced this concept and it was documented in the 2012 SINQ question. You may use 2011 or 2012 as the date of this change. The next edition of the SEER manual will include reportability examples.

2014
20140057

MP/H Rules/Histology--Bladder: What is the correct histology code for a diagnosis of urothelial plasmacytoma carcinoma of the bladder per pathology report?

Assign code 8120/3, urothelial carcinoma, NOS, to urothelial plasmacytoma carcinoma of the bladder.  The WHO classification describes plasmacytoid variants of urothelial carcinoma. There is no specific ICD-O-3 code for these variants; however, and 8120/3 must be used.

2014
20140019

Reportability--Breast: Is this reportable as 8520/2?

Final Diagnosis: Atypical Lobular Hyperplasia (ALH/LCIS). We are seeing this diagnosis quite often.

 ALH/LCIS is reportable. LCIS (lobular carcinoma in situ) is a reportable neoplasm. When LCIS is stated as the final diagnosis, report the case. 2014