SEER Inquiry System - Search

It appears an argument could be made for both NLPHL (9659/3) and THRLBCL (9688/3). We favor coding NLPHL (9659/3) because the pathologist did specifically call this a Hodgkin lymphoma, and also specified that it only has a T-cell/histiocyte-rich large B-cell lymphoma-like pattern.

Cytology is not listed in the Priority Order for Using Documentation to Identify Histology (Histology Coding Rules) in the Head and Neck schema. Other schemas do include cytology in the hierarchy below tissue from a biopsy or resection. Cytology is often less specific than histology, so one would expect cytology to be listed below tissue in this hierarchy. Was this an oversight? Or would cytology be equivalent to histology if it provided the most specific histology for the case?

According to this article, PRRT treatment lutetium Lu 177 dotatate was approved earlier this year by the United States Food and Drug Administration for adult use. PRRT is a nuclear medicine therapy that travels throughout the body looking for a certain receptor within neuroendocrine tumors. These include pancreatic and small neuroendocrine tumors in the gastrointestinal tract. Once absorbed into the tumor, the radioactive material starts to break down tumor cells, killing them. It is the first radioactive drug approved for the targeted treatment of gastroenteropancreatic neuroendocrine tumors.

(http://cinj.org/rutgers-cancer-institute-new-jersey-and-robert-wood-johnson-university-hospital-are-first-state ).

The Solid Tumor Rules indicate bladder tumors that are urothelial carcinoma (8120) and small cell carcinoma (8041) are separate primaries per Rule M13 (Abstract multiple primaries when separate/non-contiguous tumors are on different rows in Table 2). These are distinctly different histologies and, presumably, one would want to capture the small cell carcinoma (or small cell carcinoma component) as this has a worse prognosis.

However, if a subsequent bladder tumor is composed of invasive urothelial carcinoma and small cell neuroendocrine carcinoma, the histology is coded as 8045/3 per Rule H4, but this is not abstracted as a multiple primary. The only M Rule that applies is Rule M18 (Abstract a single primary when tumors do not meet any of the above criteria). The mixed histology code 8045 is not included in Table 2, so none of the histology-based M Rules apply. Is the subsequent mixed invasive urothelial and small cell carcinoma tumor (8045/3) the same primary as a previously diagnosed invasive urothelial carcinoma (8120/3) when these tumors are diagnosed within three years?

The previous SEER Program Coding and Staging Manual included Appendix C that has Coding Guidelines for some sites. The breast guidelines specifically instructed one to code the subsite with the invasive tumor when the pathology report identifies invasive tumor in one subsite and in situ tumor in a different subsite or subsites. The current Breast Solid Tumor Rules Table 1: Primary Site Codes refers one back to the SEER Manual and COC Manual for a source document priority list but does not make mention of invasive vs. in situ on that final version of the source document.

In addition, the Colon Solid Tumor Rules currently contains no Site Coding Section/Table. However, the Lung Solid Tumor Rules do and also refer one to the SEER/COC Manuals for document priority lists. The Urinary Solid Tumor Rules has both the Primary Site Codes Table and an additional section called Priority for Coding Primary Site, which does not reference a document priority list or other manuals. Unfortunately, there is additional information in Appendix C Bladder Coding Guidelines that may have been used in the past regarding site source priority.

Could the remaining applicable Appendix C information be consolidated into the Solid Tumor Rules consistently among all the sites to lessen the need for additional manual referencing? Also, is there a reason one site includes the Priority Site Coding instructions and others do not?

SINQ 20170043 is a similar question about an ovarian mucinous borderline tumor with microinvasion, but the answer seems to be specifically referencing mucinous tumors only. It is unclear if that SINQ could be applied to this case. In addition, we were not sure how to interpret the nodal involvement. The physician assessment after surgery was low grade serous carcinoma, chemo not recommended and letrozole started.

I have searched ICD-O-3 for a histology listing but could not locate. I also searched the SEER Inquiry database for possible answers, but none were found. The patient underwent a pediatric MRI of the brain of which final impression was: 1) Subependymoma nodules, cortical tubers, and SEGAs are seen bilaterally consistent with tuberous sclerosis.

2015 Rt kidney nephrectomy pathology states: congenital cellular mesoblastic nephroma, tumor sz 5.9cm, tumor limited to kidney, extension into pelvicalyceal system, margin not applicable, LVI negative. Per PubMed.gov: (In newborns) among the low-grade malignant tumors, congenital mesoblastic nephromas can be successfully treated with simple nephrectomy. Per ScienceDirect: ...currently thought that cellular mesoblastic nephroma is actually a renal variant of infantile fibrosarcoma.