| Report | Question ID | Question | Discussion | Answer | Year |
|---|---|---|---|---|---|
|
|
20061141 | Reportability--Leukemia: Is the diagnosis "a minority abnormal T-cell population (2-3%) with phenotypic features of large granular lymphocyte leukemia cells" reportable if it is from a flow cytometry procedure performed on a non-diagnostic bone marrow biopsy specimen? See Discussion. | Pt had only a bone marrow Bx done at the hospital. Bone marrow biopsy and aspirate: Peripheral blood showing mild relative lymphocytosis and mild relative neutropenia. Normocellular bone marrow (50%) with mild eosinophilia. No conclusive morphologic evidence of a neoplastic process. Flow cytometry of the marrow shows a minority abnormal T-cell population (2-3%) with phenotypic features of large granular lymphocyte leukemia cells. PCR is positive for a clonal T-cell population. The significance of these findings is unclear. COMMENT: Flow cytometry, PCR and morphologic correlation were performed at [names removed]. The significance of a minimal, clonal, large granulocyte leukemia population absent absolute lymphocytosis is unclear. Positive results for a T-cell receptor PCR study in the setting of mild leukopenia alone is reportedly relatively common and usually regarded as nonspecific. In essence, this could be characterized as a small, monoclonal T-cell proliferation of uncertain significance associated with mild leukopenia. Appropriate follow up is suggested. |
For cases diagnosed prior to 1/1/2010:Do not report this type of case until there is a definitive reportable diagnosis. Based on the information provided, this case is not yet reportable. It could develop into a reportable case in the future. 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. |
2006 |
|
|
20061040 | Reportability--Anus: Is a final diagnosis on a pathology report of "squamous cell carcinoma of the anus, NOS" assumed to be a skin of anus primary or a primary of the anus? | Squamous cell carcinoma of the anus is reportable unless known or stated to be skin of anus. | 2006 | |
|
|
20061090 | CS Extension--Prostate: Does the term "activity" in a Prostascint report indicate a clinically apparent tumor, tumor extension or tumor involvement for this primary site? (http://www.rtrurology.com/prostascint.htm) | 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. No, the term "activity" alone does not indicate clinically apparent tumor or involvement. |
2006 | |
|
|
20061142 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Skin: How many cases are to be abstracted and how is the histology field(s) coded for cases in which a fibrosarcoma arises in or transforms from a dermatofibrosarcoma protuberans? See Discussion. | 1. If the fibrosarcoma occurs after DFP, and is called metastatic, is it a recurrence or is it a new primary? Example: Pt diagnosed in 7/05 with a high grade fibrosarcoma arising in a dermatofibrosarcoma protuberans. The path indicated "The presence of high grade fibrosarcoma, the extent of the tumor necrosis and the mitotic rate are all adverse prognostic findings that indicate a significant risk for mets." The patient had a recurrence in 8/06 called a low grade fibrosarcoma mets from prev." The DFP code is 8832/3 and a fibrosarcoma code is 8810/3. Our pathologist feels that the fibrosarcoma is a more aggressive tumor so should the case be coded to the 8810/3.
2. If DFSP has areas of fibrosarcoma, should it be coded to the latter because it is more aggressive? Example: Skin and subcutaneous tissue reads: Low grade sarcoma - tumor extends to margin. Comment: "Although the predominant pattern of this tumor is consistent with dermatofibrosarcoma protuberans, focal presence of hypercellularity and increased mitotic figures suggest transformation to Grade I fibrosarcoma. This progression, although focal, carries an increased risk of mets over classic DFSP. Code to 8810/31? |
For tumors diagnosed prior to 2007:
Code histology to 8832/3 [Dermatofibrosarcoma protuberans] for both cases. DFSP with transformation to fibrosarcoma and DFSP with areas of fibrosarcoma are coded to 8832/3.
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. |
2006 |
|
|
20061023 | Reportability--Skin: Is a pilomatrix carcinoma of the skin reportable if it is described as being a malignant diagnosis based on poor circumscription, infiltrative growth pattern, and focal abundant mitoses? | No. Pilomatrix carcinoma is not reportable to SEER. Please see page 1 of the 2004 SEER manual. Skin primaries with histology codes from 8090 to 8110 are not reportable. Pilomatrix carcinoma is coded 8110/3. | 2006 | |
|
|
20061071 | CS Extension--Lymphoma: In the absence of physician staging, is an "enlarged" spleen seen on CT coded as involvement of the spleen for lymphoma cases? | 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. Do not code spleen involvement when the only evidence is an enlarged spleen. When imaging is the only diagnostic tool (no biopsy or splenectomy), spleen involvement is based on the presence of nodules and not on enlargement. Splenic enlargement alone (by physical exam or imaging) is insufficient to support involvement of spleen. |
2006 | |
|
|
20061131 | CS Lymph Node Examined--Lung: How is this field coded when a mediastinoscopy and lobectomy are performed and the pathology report indicates multiple lymph node fragments were removed as biopsy specimens and the lobectomy specimen revealed 3 interlobar 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. Code the CS Lymph Node Examined field to 98 [number unknown] because the biopsy information is not clear and as a result you do not know how many lymph nodes were examined. |
2006 | |
|
|
20061048 | CS Extension--Pancreas, Head: When a tumor is described as having "vascular encasement of the celiac artery", is extension coded to 68 [tumor is inseparable from the celiac axis]? | 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 vascular encasement of the celiac artery to CS extension code 68 [tumor is inseparable from the celiac axis].
This celiac axis is a small (1cm) area of branching arteries. The celiac artery branches into hepatic, gastric, and splenic at the axis. Dissecting tumor out from around the celiac axis is very tricky and usually encasement by tumor is a sign of inoperability. |
2006 | |
|
|
20061139 | CS Lymph Nodes--Lung: Do modifying terms such as "borderline" affect whether lymph nodes are coded as involved when they are used in conjunction with the descriptors listed in Note 2 (i.e., mass, adenopathy or enlargement) for lung primaries? See Discussion. | Lung primary: CT states "borderline" enlarged hilar lymph nodes. Note 2 in the Lung schema under CS Lymph Nodes does not address qualifiers. | 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. Do not code the hilar lymph nodes as involved in this case. "Borderline" enlarged hilar lymph nodes do not meet the clinical criteria for enlargement. |
2006 |
|
|
20061113 | Histology (Pre-2007)--Melanoma: How is histology coded for a final pathology diagnosis of "malignant melanoma, NOS" that is clinically described as a nevus? | For tumors diagnosed prior to 2007:
Code 8720 [malignant melanoma]. Assign the histology code based on the histology stated in the final diagnosis on the pathology report. The pathology report must say melanoma arising in junctional nevus to use the code 8740/3 [Malignant melanoma in junctional nevus].
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. |
2006 |
Home
