Histology--Hematopoietic: How is histology coded for a "chronic lymphocytic leukemia with plasmacytic differentiation"?
For cases diagnosed prior to 1/1/2010:Assign histology code 9823/3 [Chronic lymphocytic leukemia]. Plasmacytic differentiation does not indicate a plasma cell or plasmacytic leukemia.
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.
Surgery of Primary Site--Breast: Does the presence of axillary lymph node(s) in a "simple mastectomy" specimen impact the coding of the Surgery of Primary Site field for breast primaries?
Yes. Determine whether there is, in fact, at least a portion of axillary tissue present. If axillary lymph nodes (not internal mammary nodes) are present in the specimen, code the Surgery of Primary Site field to 51 [Modified Radical Mastectomy WITHOUT removal of uninvolved contralateral breast]. If there are no axillary lymph nodes present in the specimen, code the Surgery to Primary Site field to 41 [Total (simple) mastectomy WITHOUT removal of uninvolved contralateral breast].
Code histology to 9732/3 [multiple myeloma]. The plasmablastic subtype/variant does have a prognostic indication, but the disease is still coded as multiple myeloma.
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.
Histology (Pre-2007)--Breast: What code is used to represent the histology "ductal adenocarcinoma with medullary features?"
For tumors diagnosed prior to 2007:
Medullary is a subtype of duct and "with features of" is a term that indicates a majority of tumor. If this is an invasive adenocarcinoma with no in situ component, code to 8510/3 [Medullary adenocarcinoma]. If only one of the components is invasive, code that component.
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.
Histology/Behavior--Brain and CNS: How should Histology and Behavior be coded for a polymorphous low-grade neuroepithelial tumor of the young (PLNTY) arising in the brain?
CS Site Specific Factor--Lymphoma: Can the International Prognostic Index (IPI) score be taken from a TNM form in the record? If so, what score would we code for "low" (0-1 points) and "high" (4-5 points)?
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 IPI score from the TNM form can be used to code SSF 3. Without further information, code "low" as 000 [0 points]. Code "high" as 004 [4 points].
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).
Histology (Pre-2007)--Melanoma: How is histology coded if the final diagnosis is "melanoma" and only in the comment section of the pathology report is there an indication of "Type: Lentigo Maligna. Cell Type: Small Cell"?
For tumors diagnosed prior to 2007:
Code the histology as 8742 [lentigo maligna melanoma]. Code the specific histologic type, even if stated only in the comment section.
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.