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20051138 | Histology/Reportability--Hematopoietic, NOS: Is "drug induced" myelodysplastic syndrome synonymous with "therapy related" myelodysplastic syndrome? If so, would "drug induced" myelodysplastic syndome be SEER reportable and coded with the histology 9987/3? | Page 44 of the "Abstracting & Coding Guide for the Hematopoiectic Diseases" lists this histology & behavior with the proper EOD code to use but yet on page 36 it states "Do not accession the following diagnoses coded to 285.0 and lists secondary SA as well as drug-induced SA. | For cases diagnosed prior to 1/1/2010:
There is considerable difference between therapy-related myelodysplastic syndrome (MDS) and drug-induced sideroblastic anemia (SA).
Therapy-related MDS is the result of irreversible damage to the bone marrow caused by certain kinds of myelotoxic drugs used to treat cancer. Examples are Cytoxan and Etoposide. There is usually a 10+ year delay between the first primary and its treatment and the therapy-related MDS. Therapy-related MDS is not reversible and is reportable as a malignancy. Because the drugs were almost always given to treat a malignancy, therapy-related MDS is almost always a second primary.
Drug-induced SA is not reportable as a malignancy. Drug-induced SA is the result of short term effects of certain drugs on the bone marrow. Drug-induced SA is reversible, as the marrow recovers once the drugs are out of the system.
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 |
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20051006 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Thyroid: How is histology coded for the tumor(s) that exist when the thyroidectomy addendum diagnosis is "Morphologic and IHC evaluations reveal two tumors: papillary thyroid carcinoma and squamous cell carcinoma." See Discussion. | The original final diagnosis after a thyroidectomy is "papillary carcinoma of the thyroid with an adjacent invasive squamous cell carcinoma, moderately differentiated." Per the additional addendum comment: "The findings can be interpreted in one of 2 different ways. Either there is a collision tumor of papillary thyroid and squamous cell carcinoma (with the squamous cell ca originating at a site other than the thyroid gland.) Or, less likely, there is a malignant squamous differentiation in the papillary thyroid carcinoma." A university hospital consultation report states the diagnosis as: "Spindle cell squamous cell carcinoma arising in association and from papillary carcinoma, predominantly tall cell variant..." Is this 2 thyroid primaries: 8344/3 [papillary carcinoma, tall cell] and 8074/3 [squamous cell carcinoma, spindle cell]? | For tumors diagnosed prior to 2007:
Our pathologist consultant agrees with the consultant's diagnosis. Therefore, abstract this as one primary of the thyroid. Code the histology as 8344 [Papillary tall cell]. This is the most appropriate histology code available for this complex case.
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 |
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20051118 | CS Tumor Size--Rectum: Should the tumor size be coded to 080 from the colonoscopy size or 075 from the CT scan size? See Discussion. | 6/29/04 Colonoscopy with biopsy: near obstructing circumferential friable mass extending from 8 to 16cm above anal verge. 6/30/04 CT Scan Abdomen/Pelvis: 7.5X7.2cm large rectal mass. The patient had radiation with concurrent 5-FU. Surgery is done after treatment. | 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. Code tumor size as 080 (8cm). Code the largest pretreatment size recorded when there is preoperative systemic treatment. |
2005 |
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20051049 | Reportability/Primary Site--Head & Neck: If a wedge resection/shield resection is performed on the lower lip for SCCA and the path report refers to "lip, NOS" with no mention of vermilion border, is this case reportable? | Review the operative and pathology reports, and the physical exam for mention of "mucosal surface" (reportable) or "skin" (not reportable). If neither are mentioned, lip, NOS is reportable per the ICD-O-3 code of C009. | 2005 | |
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20051003 | CS Tumor Size/CS Eval--Breast: How are these fields coded when there is a clinical size recorded but the tumor size is not specified on the pathology report associated with a subsequent resection? See Discussion. | 4/8/04 excisional biopsy of 1.5 cm palpable mass. Path: gives a specimen size only and states that there is a nodular firm area that correlates with the clustered microcalcification on radiograph. No pathologic tumor size is given. Would the size be coded to the clinical size of 1.5 cm? The patient did have surgery but the only size available is a clinical one. Because the size is clinical, is the CS Eval field coded to 0 [No surgical resection done. Evaluation based on PE...]? | 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. Clinical size can be coded when the patient has had surgery. For the case above, code the tumor size as 015 [1.5 cm] using the clinical information. The CS Tumor Size/Extent Eval field refers to both tumor size and extension. In this case, record the eval field as 0 or 1 (which ever is appropriate). The tumor size sets the T category unless the resection shows skin or chest wall or dermal lymphatic involvement. |
2005 |
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20051062 | Surgery of Primary Site--Prostate: How is the use of a Laserscope Niagara laser (modulated KTP-YAG laser beam (Niagara 122 prostate vaporization)) coded for prostate primaries? See Discussion. | The Laserscope Niagara laser performs an operation similar to the TURP, but there is virtually no bleeding and patients can sometimes go home the same day, most without a catheter. The laser is delivered through a fiber (the thickness of hair) into the cavity via an endoscope inserted through the urethra. | When performed as part of the first course of therapy, assign surgery code 15 [Laser ablation] to Niagara laser photovaporization of the prostate. | 2005 |
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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 |
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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 |
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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. |
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20051116 | Primary Site--Soft Tissue: How is the primary site coded for a PNET found in the groin when the Tumor Board states the primary is unknown but the SEER site/histology validation table does not allow a site of C809 or C76x to be coded in combination with the histology of 9473/3? | Code site to C495 [connective tissue of pelvis, groin]. This was not called metastatic PNET and no other site of disease is noted. PNET is a broad classification of a group of tumors that usually occur in the CNS and can also occur in soft tissue (neuroblastoma, extra-osseous Ewing sarcoma). |
2005 |
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