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Report Produced: 01/11/2026 04:57 AM

Report Question ID Question Discussion Answer Year
20061057 CS Extension--Lung: Can extension be coded to 10 (Tumor confined to one lung) when either an autopsy or a CT scan describes the tumor as a mass of a specified size located in one lobe of the lung without any description of extension and no available TNM provided? See Discussion.

Example 1: Lung primary within the right lower lobe described clinically as greater than 3 cm on scan but was found to be 3 cm at autopsy.

Example 2: CT scan February shows 2 cm mass in RUL.

In both cases, the only tumor description was the size of tumor without any information regarding extension.

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.

Yes, assign code 10 [Tumor confined to one lung] for a mass in one lobe when none of the descriptions in codes 11 to 80 are documented.

 2006
20061012 CS Lymph Nodes--Lung: If the lymph nodes listed in codes 10 and 20 were contralateral or bilateral, and the only description was "mass", "adenopathy", or "enlargement" on mediastinoscopy or x-ray, is this field coded to 60? See Discussion. (CS Manual page 407) Note 2: If at mediastinoscopy/x-ray, the description is "mass", "adenopathy", or "enlargement" of any lymph nodes named as regional in codes 10 and 20, assume that at least regional lymph nodes were involved.

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.

Yes. The named nodes listed in codes 10 or 20 should be coded 60 if the "mass", "adenopathy", or "enlargement" on mediastinscopy or x-ray is described as bilateral or contralateral.

 2006
20061024 Histology (Pre-2007)--Kidney: How is a "mucinous tubular and spindle cell carcinoma" coded? See Discussion. Literature search results: "The new WHO-classification of renal tumors includes new subtypes, one of which is the mucinous, tubular, and spindle cell carcinoma. Many of these tumors had been previously diagnosed as sarcomatoid carcinoma. There are areas of cord-like growth and spindle cell configuration, sometimes with a clear cell appearance."

For tumors diagnosed prior to 2007:

Code histology to 8255 [Adenocarcinoma with mixed subtypes]. ICD-O-3 does not have a code specific to this combination histology. 8255 is the best code available.

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
20061002 Multiple Primaries (Pre-2007): How many primaries? See Discussion. 5/05 perianal skin bx, 6/05 mapping bx perianal skin, 9/05 punch bx perianal skin: all positive for extramammary Paget Disease. 9/05 Perianal Excision of Paget w/V-Y flap repair. Path: Perianal and anal skin: Extramammary Paget disease associated with: Invasive adenoca of anal canal. Anal margins positive for invasive adenoca. Comment: invasive adenoca with local mucinous features involving the anal margin/end of specimen. This adenoca is in continuity with (associated with) extensively diffuse extramammary Paget disease. Unclear whether the adenoca represents a rectal primary with spread to perianal area, anal gland adenoca or mets. 12/05 AP resection-no residual Paget or invasive neoplasm.

For tumors diagnosed prior to 2007:

There is one primary.

Code the histology to 8542 [Paget disease, extramammary]. Code the primary site C210 [anus]. Histology rule 7 on page 87 of the 2004 SPCM applies in this 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.

 2006
20061009 CS Site Specific Factor--Breast: If there are two ER/PR tests, one positive and one negative, which result should be coded in the SSF fields 1 and 2? See Discussion.

SINQ #20021074 states that for cases up to 2003, if there are differences in ER/PR results, to code the positive findings over the negative findings. Does this hold true for coding SSF1 & SSF2 for breast?

Scenario: 10/19 Breast bx: ER + PR -; No date/specimen: ER/PR -; 12/3 Partial Mast: ER/PR +

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.

For cases diagnosed prior to January 1, 2007, according to the CS Steering Committee, record the pathologist's interpretation of the assay value for the most representative tumor specimen. This may require conversation with the pathologist when specimen size is not specified.

 2006
20061081 Collaborative Staging--Lung: Given that the AJCC lung TNM is not applicable for a high grade sarcoma of this site, how do we code Collaborative Stage for this site/histo combination when the pathologist indicates a TNM stage of T2bN0M0=stage III, using AJCC Soft Tissue Sarcoma schema?

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.

Use the lung schema to code CS for sarcoma of the lung. Complete the CS information as best you can from the medical record WITHOUT using the TNM Soft Tissue Sarcoma staging form. Visceral sarcomas are specifically excluded from soft tissue sarcoma TNM staging and sarcomas are excluded from the TNM staging for lung.

Sarcoma is listed on the Histology Exclusion Table for lung. When a case is coded in Collaborative Staging and the histology is on the exclusion list, SEER Summary Stage 1977 and 2000 can be assigned. For these cases, TNM will not be calculated and displayed results will be "T NA N NA M NA and Stage Group NA".

 2006
20061107 Histology (Pre-2007)/Flag--Pancreas: How is histology coded given that 8046 [non-small cell carcinoma] of the pancreas is not on the SEER Site/Type validation listing?

For tumors diagnosed prior to 2007:

Assign 8046 [non-small cell carcinoma] for "non-small cell carcinoma" of the pancreas. If necessary, override any site/type edits.

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
20061093 Ambiguous Terminology--Breast: Is a stereotactic biopsy that is "focally suspicious for DCIS" reportable if it is followed by a negative excisional biopsy? See Discussion.

Per the 2004 SEER manual page 4, 1.a, the case is reportable based on the ambiguous term "suspicious" for DCIS.

Per the 2004 SEER manual page 4, 1.c, use these terms when screening diagnoses on pathology reports, operative reports, scans, mammograms, and other diagnostic testing other than tumor markers.

Note: If the ambiguous diagnosis is proven to be not reportable by biopsy, cytology, or physician's statement, do not accession the case.

 Do not accession this case. The needle localization excisional biopsy was performed to further evaluate the suspicious finding found on stereotactic biopsy. The suspicious diagnosis was proven to be false. 2006
20061061 CS Lymph Nodes--Breast: Clarify the use of code 25 [Movable axillary lymph node(s), ipsilateral, positive with more than micrometastasis (i.e., at least one metastasis greater than 2 mm)] vs code 60 [Axillary/regional lymph node(s), NOS; Lymph nodes NOS] when surgically removed lymph nodes are positive but the size of the metastasis is not stated. See Discussion.

Note 2 in CS manual states: "If the pathology report indicates that nodes are positive but size of the metastases is not stated, assume the metastases are greater than 0.2mm and code LNs as positive in this field. Use code 60 in the absence of other information about regional nodes."

1. If the LNs are known to be axillary LNs, note 2 seems to imply the size can be assumed to be greater than 0.2mm. Would you code 25 or 60?

2. Both codes 25 and 60 map to N1, node involvement. Do they each mean something else in the evaluation process?

3. What would constitute "absence of other information"?

4. Is the use of 60 over 25 specific to SEER registries or all users?

5. Abstractors are trained to assume LNs are mobile if there is no contrary information. Is this appropriate?

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 Lymph Nodes code 25 for breast when there are positive axillary nodes without internal mammary nodes. Code 25 is used in a couple of situations: a. when you know the lymph nodes are clinically movable and only the axillary nodes are involved; b. when you know the size of the metastasis in an axillary lymph node is more than a micrometastasis (i.e., > 2 mm). Code 60 can be used for any regional lymph node (internal mammary, infra- or supraclavicular, as well as axillary. So you can code to 25 if you have "regular" metastases in axillary lymph nodes only. If you don't know whether the mets are micro or regular, use code 60. Assign code 60 when there are positive regional nodes not further described.

1. Assign code 25 for positive axillary lymph nodes.

2. Codes 25 and 60 may map to N1, N1a, N2a or N3a depending on the coding of SSF3.

3. Assign code 60 when there is not enough information to assign a code from 13 to 50.

4. CS instructions are the same for all users. There are no CS instructions specific to SEER registries.

5. Yes, assume lymph nodes are moveable (not matted, not fixed) when there is no information to the contrary.

 2006
20061104 Reportability/Behavior--Hematopoietic, NOS: Is a "myelodysplastic/myeloproliferative disease, unclassifiable" coded to 9975 with a behavior code of 3 as indicated in the WHO blue book on "Tumours of Haematopoietic and Lymphoid Tissues" or is it not abstracted because it has a behavior code of 1 which means the case is not reportable?

For cases diagnosed prior to 1/1/2010:Code MDS/MPD U to 9975/3 [Myelodysplastic/myeloproliferative disease, unclassifiable]. Change the behavior code to /3 according to ICD-O-3 Rule F. The case is reportable.

The WHO book is more recent and gives a specific code for this new hybrid category of the WHO/REAL classification.

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