Reportability--Brain and CNS: Is Langerhans cell histiocytosis [9751/1] of the meninges [C709] reportable?
For cases diagnosed prior to 1/1/2010:Yes. The criteria for reportable benign/borderline CNS tumors is based on location (site) and behavior (benign/borderline). There is no caveat for histologic type. Therefore, this would be reportable as these tumors have been reported arising from the meninges or choroid plexus.
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.
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.
Recurrence (Pre-2007)--Colon: When there is no statement of recurrence on the abstract, is a colon tumor at the anastomosis site a recurrence of the previous colon cancer or a new primary?
For tumors diagnosed prior to 2007:
If the cancer at the anastamosis site is more than two months after the previous colon cancer, abstract as a separate primary.
If the cancer at the anastamosis site is within two months of the original diagnosis and the histologies are the same, do not abstract as a separate primary.
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.
2004 SEER Manual Errata/CS Lymph Nodes--Head & Neck: On page C-353, in the supraglottic larynx schema, there is no mention of Level IV nodes in the CS Lymph Node codes.
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.The CS Steering Committee is aware of this issue and is working to resolve it.
Reportability--Colon: Is a pathologically confirmed "tubulovillous adenoma with high grade dysplasia" reportable if clinical diagnosis at the time of the subsequent re-biopsy states "follow-up for colon polyps with ca in situ"? See Discussion.
SINQ 20000245 states that high grade dysplasia is not synonymous with behavior code 2 (in situ). However, the 2004 SEER manual states that "cases clinically diagnosed are reportable. If the physician treats a patient for cancer in spite of the negative biopsy, accession the case."
A pathologic diagnosis has priority over a clinical diagnosis. According to the pathologist, this case is not reportable. A re-biopsy is not treatment.
Histology (Pre-2007)--Melanoma: How is a "plaque-like nodular spitzoid malignant melanoma" coded?
For tumors diagnosed prior to 2007:
Code histology to 8721 [nodular melanoma]. Essentially, "plaque-like nodular spitzoid malignant melanoma" is nodular melanoma. Code 8721 is the most specific ICD-O-3 histology code available for this diagnosis.
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.
Multiple Primaries/Histology--Lymphoma: If an oral mucosa, right hard palate biopsy contains a composite lymphoma [low-grade follicular + chronic lymphocytic leukemia], how many tumors should be abstracted and how should the histology field(s) be coded?
For cases diagnosed prior to 1/1/2010:This is one primary. Assign code 9590 [Malignant lymphoma, NOS]. This is a composite lymphoma. Code to lymphoma when there is any solid tumor (in lymph nodes, tissue, etc.) Code to lymphoma, NOS since this is not purely follicular and there is no code for composite lymphoma.
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.
Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: For cases diagnosed in 2005, if a specimen contains an invasive 4.5 cm lobular carcinoma of the right breast and also has a tiny focus of intraepidermal tumors cells [Paget disease of nipple], how many cases should be abstracted and how should the histology field(s) be coded?
For tumors diagnosed prior to 2007:
There are two primaries in this example:
1. Invasive lobular carcinoma [8520/3]
2. In situ Paget disease of nipple [8540/2].
There is no combination code for lobular carcinoma and Paget disease.
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.
Reportability--Breast: Is a biopsy proven squamous cell carcinoma of the breast nipple reportable if a subsequent areolar resection shows foreign body granulomatous reaction to suture material and no evidence of residual malignancy in the nipple epidermis?
Yes, this case is reportable. The primary site is C500 [nipple]. There was a diagnosis of malignancy on 2/15/06: "Positive for malignancy." Even though no residual malignancy was found in the later specimen, that does not disprove the malignancy diagnosed on 2/15/06.
Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Testis: If an orchiectomy specimen contains non-seminomatous mixed germ cell tumor and a separate satellite of seminoma, how many tumors should be abstracted and how should the histology field(s) be coded?
Pathology: R Orchiectomy: 2.1 cm non-seminomatous mixed germ cell tumor (50% teratoma primarily mature, 50% embryonal CA and yolk sac tumor). Located 3cm from the main tumor is a 2mm satellite pure seminoma.
For tumors diagnosed prior to 2007:
This is a single primary because the first three digits of the ICD-O-3 histology codes are the same, according to Rule 3a on page 11 of the 2004 SEER manual. Code the histology 9065 [Germ cell tumor, nonseminomatous]. Code 9065 is preferred over the less-specific code of 9061 [Seminoma, NOS].
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.
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