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Report Produced: 02/25/2026 16:27 PM

Report Question ID Question Discussion Answer Year
20051126 Histology (Pre-2007)--Ovary: What codes are used to represent "mixed papillary serous and clear cell carcinoma" and "papillary serous carcinoma with focal clear cell features" of the ovary?

For tumors diagnosed prior to 2007:

Assign code 8323 [Mixed cell adenocarcinoma] to "mixed papillary serous and clear cell carcinoma." This is histology coding rule 3 in the 2004 SEER manual under single tumor (page 86). There is no other code for this mixture.

Example 1: 8323

Example 2: 8461 (clear cell is not coded according to Rule 6, page 87, because it is not the majority of the tumor).

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

 2005
20051094 Grade, Differentiation/Priorities: Which has priority, the differentiation or the nuclear grade for a liver biopsy histology described as "well differentiated hepatocellular carcinoma, nuclear grade 3/4"? For most sites, differentiation has priority over the nuclear grade when both are specified (excluding breast and kidney). Assign grade code 1 [well differentiated] to the example above. 2005
20051144 CS Lymph Nodes: Are lymphatic channels/vessels within an organ coded as regional lymph nodes?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Lymphatic channels/vessels carry lymph fluid throughout the organs and tissues of the body. Lymph channels/vessels within an organ are not nodes. Lymph channels/vessels outside an organ are not nodes.

 2005
20051020 CS Extension/CS Site Specific Factor--Breast: How is extension (localized or unknown) and SSF6 (entire tumor in situ or 888) coded for an in situ breast primary in which bone metastasis is diagnosed 4 months following the mastectomy? See Discussion. In situ breast primary with bone mets. No mets work up prior to mastectomy done 2/04. Path: 2.5 cm mass: ductal carcinoma in situ, solid type, with comedonecrosis (no invasive carcinoma found in mastectomy specimen). Bone scan done 4/04 showed compression fractures. MRI 6/04 showed diffuse metastatic disease of the bones.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

First, determine whether the bone mets in this case are progression of disease. If the patient was asymptomatic at the time of the mastectomy, the bone mets are disease progression, not initial stage.

If the initial stage includes the bone mets and they are not disease progression, extension must be coded to at least 10. Code site-Specific Factor 6 to 040 [Size of entire tumor coded, size of invasive component not stated].

 2005
20051046

Reportability/Diagnostic Confirmation--Leukemia: What is the diagnostic confirmation if a positive BCR/ABL result is diagnostic of a malignancy in a patient suspected to have chronic myelogenous leukemia? See Discussion.

Example 1: Peripheral smear states: "No morphologic evidence of chronic myelogenous leukemia."

Addendum: Molecular diagnostic studies showed a positive rearrangement for the BCR gene with the M-bcr (CML type) and of bcr-abl transcript expression".

Example 2: Hematopathology is negative.

Molecular diagnostic study: "fluorescent in situ hybridization (FISH) studies exceeded the limits established by the XXX Cytogenetics Laboratory for this probe set, and thus, demonstrated statistical evidence of BCR/ABL fusion."

For cases diagnosed prior to 1/1/2010:

Do not determine reportablility using cytogenetics or molecular studies alone.

Since these are not routine screening tests, we suggest that you query the physician and review the medical record to see what prompted the study and what is being done with the result, but the test alone is not in and of itself sufficient to report the case.

For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

 2005
20051083

Multiple Primaries--Lymphoma: How many primaries should be reported when there is a marginal zone B-Cell lymphoma [9699/3] diagnosed in 2000, and the clinician states that the diffuse large B-Cell type lymphoma [9680/3] diagnosed in 2004 was a transformation of the prior primary? See Discussion.

The Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table indicates they are most likely "D" different disease processes. As any low grade lymphoma can transform, we suspect this represents a transformation (the clinician is regarding this as transformed).

How many primary/ies should be coded?

And, how?

For cases diagnosed prior to 1/1/2010:

Report this case as one primary according to the physician's opinion. Code the histology as 9699/3 [marginal zone B-Cell lymphoma, NOS] and code the date of diagnosis as 2000.

Code the physicians opinion regardless of whether or not it agrees with the Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table. Use the table when the physician does not state whether or not there is a new primary.

For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

 2005
20051075 CS Extension--Breast: How is this field coded when path describes dermal lymphatic invasion of the nipple? See Discussion.

Example

Multicentric infiltrating lobular carcinoma of left breast treated with MRM. Microscopic summary: Blood/lymphatic Vessel Invasion: present. Path final diagnosis: Angiolymphatic invasion present, including dermal lymphatic invasion in nipple. Micro: There is angiolymphatic invasion, including dermal capillary invasion identified in sections of the nipple.

The path report describes multiple breast tumors, none of which is located adjacent to the nipple.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

Assign CS Extension code 20 [Invasion of subcutaneous tissue...] based on the final diagnosis on the path report. There is "dermal lymphatic invasion in nipple." In this case, the stage will be determined by the tumor size.

 2005
20051127 Reportability--Brain and CNS: Is an "intradural extramedullary schwannoma (neurilemoma)" of the spine reportable? See Discussion.

Example: Pt underwent laminectomy and excision of intradural extramedullary tumor.

Is there a default decision for tumors described as intradural extramedullary tumors, NOS?

For cases diagnosed 2011 and later:

A spinal "intradural extramedullary schwannoma (neurilemoma)" is reportable. This schwannoma originated in the spinal nerve root, C720.

See #2 under Reportability in the Data Collection Answers from the CoC, NPCR, SEER Technical Workgroup,

http://www.seer.cancer.gov/registrars/data-collection.html#reportability

2005
20051068 CS Extension--Retinoblastoma: When the degree of extension differs between the retinas, how is extension coded for simultaneous bilateral retinoblastoma?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign the CS extension code that corresponds to the greatest level of extension seen in either eye, excluding information from enucleation.

Record extension based on enucleation in Site Specific Factor 1.

Record bilateral disease under laterality. For retinoblastomas, bilaterality is not a component or consideration for staging.

 2005
20051133 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How are the number of primaries, histologies and CS extension fields coded for breast tissue that contains separate areas of invasive ductal carcinoma, intraductal carcinoma and Paget disease? See Discussion.

Excisional biopsy of a breast mass: 1.0 cm tumor that was infiltrating ductal carcinoma, high grade, with an associated intraductal component with comedonecrosis.

Pathology report for the mastectomy three weeks later: no residual tumor was found near the original biopsy site. In another portion of the same breast was found high-grade intraductal carcinoma involving the nipple ducts, with Paget Disease of the nipple. (No size was given for this.)

For tumors diagnosed prior to 2007:

This is a single primary. According to Exception 3 of Multiple Primary Rule 6 for multiple tumors, combinations of Paget disease and ductal carcinoma are a single primary. The histology code for this case is 8541 [Paget disease and infiltrating duct carcinoma]. Assign CS extension code 10 [confined to breast tissue] based on the information above.

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

 2005