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Report Produced: 12/21/2025 23:27 PM

Report Question ID Question Discussion Answer Year
20091008 Surgery of Primary Site--Breast: How is this field coded when a mastectomy and a sentinel lymph node excision, that yields only one lymph node, are performed? See Discussion. Is there a minimum number of lymph nodes that must be removed in order to code a modified radical mastectomy? Assign code 41 [Total (simple) mastectomy...] for a simple mastectomy with removal of one or more sentinel lymph nodes. As long as the nodes removed are designated sentinel, use code 41 for a simple mastectomy. 2009
20021125 Histology (Pre-2007)--Testis: What code is used to represent the histology of "mixed germ cell tumor, embryonal carcinoma and mature teratoma" of the testis? See discussion. Is the teratoma required to be described as "immature" or "malignant" in order to use the histology code of 9081/3 [mixed embryonal carcinoma and teratoma]?

For tumors diagnosed prior to 2007:

Code the Histology field to 9081/3 [Teratocarcinoma, mixed embryonal carcinoma and teratoma], in both ICD-O-2 and ICD-O-3.

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.

 2002
20110014 MP/H Rules/Histology--Corpus Uteri: Which MP/H rule applies in coding histology for a "high grade endometrioid adenocarcinoma with squamous differentiation (adenosquamous carcinoma)"? See Discussion. Is the pathology describing a specific histology, adenosquamous carcinoma [8560/3]? Or is this a combination/mixed histology code per rule H16? The Rule H16 instruction is to code a mixed histology code, 8323/3 [mixed cell adenocarcinoma] from Table 2 when two or more of the histologies are present (i.e., endometrioid and squamous in this case).

For cases diagnosed 2007 or later:

Endometrioid adenocarcinoma with squamous differentiation is coded to 8570 [Adenocarcinoma with squamous metaplasia].

The following row needs to be added to Table 2 in order to be able to correctly use the MP/H rules to reach this conclusion.

Column 1:   Endometrioid adenocarcinoma

Column 2:   Squamous metaplasia

                    Squamous differentiation

Column 3:   Adenocarcinoma with squamous metaplasia

Column 4:   8570

The change will be made in the next revision of the rules.

2011
20020012 MP/H Rules/Histology--Breast: What code is used to represent the histology "ductal carcinoma in situ and invasive lobular carcinoma"? See discussion. Is the histology coded to the combination code of 8522/3 (ductal and lobular) or to the invasive component 8520/3 (lobular)?

For cases diagnosed 2007 or later:

Assuming ductal carcinoma in situ and invasive lobular carcinoma are present in a single tumor, code 8520/3 [Infiltrating lobular carcinoma, NOS].

Using the 2007 MP/H rules for breast, the single tumor invasive and in situ carcinoma module, start and stop at rule H9 and code the invasive histology.

 2002
20110096 Behavior--Lung: How is behavior to be coded for a diagnosis of adenocarcinoma of a lung tumor that is further classified per the CAP protocol as, "non-mucinous bronchiolo-alveolar carcinoma (adenocarcinoma in situ)" while the pathologist also classifies the tumor as pT1b, pN0? See Discussion. Is the following case coded with an invasive or in situ behavior when a RUL lobectomy specimen reveals adenocarcinoma and the Histologic Type per the CAP protocol layout is non-mucinous bronchiolo-alveolar carcinoma (adenocarcinoma in situ)? The stage per the pathologist is pT1b, pN0. Per the COMMENT section in the pathology report, "The terminology adenocarcinoma in situ is based on a recent publication in the Journal of Thoracic Oncology (Volume 6, #2, February 2011). Based on this criterion, the behavior represents adenocarcinoma in situ with no evident invasive component." Code the behavior as in situ. The pathologist has the final say on the behavior of the tumor. This pathologist is indicating that in his opinion based on a recent publication, this tumor is in situ. 2011
20081023 Histology: Must every word in the ICD-O-3 code definition appear in the diagnosis in order to assign that ICD-O-3 code? See Discussion. Is the diagnosis "Acute myeloid leukemia, M2" coded to Acute myeloid leukemia with maturation, FAB M2, NOS, (9874/3) or to Acute myeloid leukemia, NOS, (9861/3)?

For cases diagnosed prior to 1/1/2010:The general instructions for assigning histology codes are to code as precisely as possible. Acute myeloid leukemia with maturation is the definition of the FAB M2 category. A pathologist does not need to provide every word in the term associated with an ICD-O code; pathologists don't always talk that way. AML M2 is a very specific diagnosis and should be coded to 9874/3.

For cases diagnosed 1/1/10 and later, 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.

2008
20010168

Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma, undifferentiated, with sarcomatoid features"? See discussion.

Is the case more accurately coded with histology of adenosarcoma [8933/34] or adenocarcinoma, undifferentiated [8140/34]? Should "sarcomatoid" be interpreted as sarcoma?

For tumors diagnosed prior to 2007:

Code the Histology field to 8140/34 [adenocarcinoma, undifferentiated]. Sarcomatoid means sarcoma-like and should not be used in coding histology.

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.

 2001
20071053 Grade, Differentiation: How is grade coded for cases using the FNCLCC (Federation Nationale des Centres de Lutte Contre Ie Cancer) system? See Discussion. Is FNCLCC a recognized system in the United States? Tongue was the primary site for the case we saw that used FNCLCC. Do not code the data item Grade based on the FNCLCC grade. You may record the FNCLCC grade in a text field. 2007
20071045 Ambiguous Terminology: How is this field to be coded when there is a "conclusive term" exactly 60 days following the initial diagnosis? See Discussion. Is code 1 [Ambiguous terminology diagnosis only within 60 days of initial diagnosis] or code 2 [Ambiguous term followed by a conclusive term more than 60 days after the initial diagnosis] to be used for a case that had a conclusive diagnosis at 60 days from initial diagnosis? The instructions on page 97 do not match the code definitions on page 95.

The definition for code 2 should be "More than 60 days" after the date of diagnosis.

Code 1 is 60 days or less, code 2 is more than 60 days.

This will be clarified in the first revision to the MP/H manual.

 2007
20130062 Date of diagnosis--Heme & Lymphoid Neoplasms: Should the diagnosis date be coded to the date of the flow cytometry on the peripheral blood or the date of the bone marrow biopsy for a diagnosis of chronic lymphocytic leukemia/low grade B-cell lymphoma? See Discussion. Is a flow cytometry on peripheral blood alone diagnostic of a hematopoietic malignancy (CLL)? If not, when the diagnosis is verified by a subsequent histologic diagnosis (bone marrow biopsy) would the diagnosis date be the date of the peripheral blood flow cytometry or the date of the bone marrow biopsy? The Class of Case depends on this diagnosis date.

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

Code the diagnosis date to the date of the peripheral blood flow cytometry because this is a procedure used to diagnose CLL. Per both the Abstractor Notes and the Definitive Diagnostic Methods sections in the Heme DB, CLL is diagnosed by flow cytometry (immunophenotyping).

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