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Report Produced: 12/30/2025 10:29 AM

Report Question ID Question Discussion Answer Year
20130204 MP/H Rules/Histology--Kidney, renal pelvis: How is histology coded for a tubulocystic renal cell carcinoma? See Discussion. Per the resected specimen final diagnosis COMMENT in the pathology report: Tubulocystic renal cell carcinoma is a relatively new renal epithelial neoplasm that has been added to an updated WHO classification of renal tumors. (Srigley et al. The International Society of Urologic Pathology Vancouver Classification of Renal Neoplasia Am J Surg Pathol. 2013;37:1469-1489). The majority of tubulocystic renal cell carcinomas reported in the literature (greater than 90%) have behaved in an indolent manner. Code the histology to 8312/3 [renal cell carcinoma, NOS] per Rule H3. The term "tubulocystic" is not a specific renal cell histology according to our kidney pathology expert. 2013
20130060 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned for a diagnosis of bilateral extranodal orbital lymphoma when the same histology is present in both orbits?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This case should be accessioned as a single primary lymphoma of bilateral orbits per Rule M2. Abstract a single primary when there is a single histology. Both orbits showed the same histology. Note 1 for Rule M2 states bilateral involvement of lymph nodes and/or organs is a single primary.

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.

2013
20130106 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2009 diagnosed Hodgkin lymphoma, nodular sclerosis type is treated and subsequently presents in 2010 with the same diagnosis? See Discussion.

2009 diagnosis of Hodgkin lymphoma, nodular sclerosis type involved the superior mediastinal nodes, AP window nodes, bilateral axillary nodes and pulmonary nodules. The patient received chemotherapy and went into remission.

Patient presents in 2010 with Hodgkin lymphoma, nodular sclerosing type in the superior mediastinum.

Does timing play any part in determining if this reported as one or two primaries? There is no timing rule in the Heme Manual.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Accession a single primary, Hodgkin lymphoma, nodular sclerosis type [9663/3] diagnosed in 2009 per Rule M2.

Accession a single primary when there is a single histology. Note 2 for Rule M2 indicates timing is not relevant. This is disease progression or recurrence and not a new primary.

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.

2013
20130008 Primary site--Kidney, renal pelvis: Should primary site be coded C809 [unknown] or C649 [kidney] when a patient is diagnosed with renal cell carcinoma in a transplanted kidney? Code the primary site to C649 [kidney]. Per the SEER Manual, code the site where the neoplasm originated. There are no separate instructions for coding primary site for transplanted organs. This patient's renal cell carcinoma originated in the kidney [C649]. 2013
20130128 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a patient has a history of chronic myelomonocytic leukemia and a 12/08/2011 subsequent biopsy of the left leg that confirms leukemia cutis? See Discussion. Patient with a history of chronic myelomonocytic leukemia has been undergoing treatment with Dacogen for three years. On 12/8/11 the patient had a biopsy of the left leg that confirmed a diagnosis of leukemia cutis. How is the leukemia cutis coded?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Accession a single primary, chronic myelomonocytic leukemia [9945/3], per Rule M2. Accession a single primary when there is a single histology.

This is not a new primary. Leukemia cutis is the infiltration of neoplastic leukocytes into the skin from the existing leukemia. This is an advanced phase of the leukemia and has a poor prognosis.

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.

2013
20130102

Histology--Heme & Lymph Neoplasms: Is follicular lymphoma, high grade synonymous with grade 3 lymphoma [9698/3] or is the "high grade" ignored and the histology coded to follicular lymphoma, NOS [9690]?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code histology to 9698/3 [follicular lymphoma, grade 3].

Follicular lymphoma, high grade is listed under the Alternate Names section of the Heme DB for Follicular lymphoma, grade 3.

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.

 2013
20130075

Reportability/Ambiguous terminology--Heme & Lymphoid Neoplasms: Is 'suspicious for an evolving acute leukemia' reportable?

For cases diagnosed 2010 and later

Please see the Hematopoietic database, https://seer.cancer.gov/seertools/hemelymph/

 2013
20130064 Primary site--Heme & Lymphoid Neoplasms: Are hematopoietic primaries coded to C421 [bone marrow] or C420 [blood]?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Refer to the Hematopoietic Database and Manual to determine the primary site.

Leukemias are coded to C421 [bone marrow]. The ONLY neoplasm that is coded to C420 [blood] is Waldenstrom's macroglobulinemia [9761/3].

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.

2013
20130005 Reportability--Brain and CNS: Are spinal schwannomas and neurofibromas reportable or non-reportable? The most accurate and most current instruction is to report these spinal tumors when they arise within the spinal dura or spinal nerve roots, or when they are stated to be "intradural" or "of the nerve root." Do not report these tumors when they arise in the peripheral nerves. The peripheral nerves are the portion of nerve extending beyond the spinal dura. 2013
20130084 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient is diagnosed on a 3/16/12 lymph node biopsy with diffuse large B-cell lymphoma which was followed on 4/18/12 with bone marrow biopsy diagnosis of follicular lymphoma? See Discussion. The patient has extensive right-sided cervical, supraclavicular, hilar, mediastinal and gastrohepatic adenopathy. A cervical node biopsy on 3/16/2012 showed DLBCL. On 04/18/2012 a bone marrow biopsy showed follicular lymphoma. The patient was started on CHOP/Rituxan after the bone marrow biopsy.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This case is accessioned as a single primary, diffuse large B-cell lymphoma [9680/3] per Rule M12. Abstract the acute neoplasm (DLBCL) when a patient is originally diagnosed with an acute neoplasm and the neoplasm reverts to the chronic neoplasm (follicular lymphoma) AND the patient has not been treated for the acute neoplasm.

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.

2013