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Report Produced: 12/29/2025 00:12 AM

Report Question ID Question Discussion Answer Year
20081019 Multiple Primaries--Lymphoma: How many primaries are abstracted for a patient with a 1995 periaortic lymph node biopsy showing lymphocytic lymphoma, diffuse small cleaved probable intermediate grade B cell positive, followed by stomach biopsies on 6/18/05 showing diffuse large B cell lymphoma and on 6/24/05 showing malignant lymphoma, tumor cells positive for [CD20] B cell respectively?

For cases diagnosed prior to 1/1/2010:There are two primaries:

  • Lymphocytic lymphoma, diffuse, intermediate in 1995

  • Diffuse large B-cell lymphoma in June, 2005

    • According to the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table, 9673 [Malignant lymphoma, lymphocytic, diffuse, intermediate] and 9680 [Malignant lymphoma, large B-Cell, diffuse] are separate primaries. Again, according to the table, 9680 [Malignant lymphoma, large B-Cell, diffuse] and 9591 [Malignant lymphoma, non-Hodgkin, NOS] are the same primary.

    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.

    		 2008
    		20081073

    CS Extension/Ambiguous terminology--Pancreas: Should an exception be made for "abuts" or "encased/encasing" regarding CS pancreas extension? See Discussion.

    According to the CS Manual regarding ambiguous terminology, we do not accept "abuts" or "encased/encasing" as involvement. According to the March/April 2008 issue of "CA, A Cancer Journal for Clinicians", vol 58, number 2, an article concerning Pancreas staging by M.D. Anderson researchers/clinicians recommends defining unresectable involvement of the celiac axis/mesenteric artery with the terms "abutment" as involvement of 180 degrees or less of the circumference of the vessel, and "encasement" as more than 180 degree involvement. A large comprehensive cancer center in our area has already adopted these guidelines.

    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.Follow the current CS instructions regarding ambiguous terminology. "Abuts" and "encased/encasing" are not involvement.

    The American College of Surgeons Commission on Cancer provided the following in response to this question: This concept can be considered for CS version 2, but it would need to be made in conjunction with acceptance of that same theory in AJCC 7th Edition so that the stage can be derived. Many times what can be defined and accepted in a closed environment of a single institution research project cannot be duplicated and accepted across the nation and in every community facility. Would pathologists specify the > or < 180 degree involvement in every pathology report? It would also have to be reviewed to see if this idea has been accepted by the larger oncology community, or just the idea of a single institution.

    		 2008
    		20081086 Reportability: Is a case reportable if a benign diagnosis is obtained on a resection that follows a positive needle aspiration? See Discussion. Fine needle aspiration of the thyroid diagnosis was "positive for malignant cells, favor medullary carcinoma." Subsequent thyroidectomy was reported as benign. This case is reportable. The cytology is positive. Report as medulary carcinoma of the thyroid. 2008
    		20081098 MP/H Rules/Histology--Colon: How do you use Rule H5 or H6 to code "moderately diff adenoca with mucinous component"?

    For cases diagnosed 2007 or later, code the histology 8140 [Adenocarcinoma]. Rule H6 applies because the final diagnosis is not "mucinous adenocarcinoma" and the percentage of mucinous adenocarcinoma is not stated.

    Rule H13 does not apply because "component" is not a term that indicates a specific histology.

    		2008
    		20081018 CS Tumor Size: Is a 5.5 mm tumor coded as 005 or 006? See Discussion. We interpret the CS Manual general instructions to indicate to ONLY round up to 001 when the tumor size is stated to be 0.1 to 0.9mm.

    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 CS tumor size 006. Because only whole numbers in mm can be collected, basic mathematical principles are used for rounding; 1-4 round down, 5-9 round up.

    		 2008
    		20081095 Race, ethnicity/Spanish surname or origin: If birthplace is Brazil or Portugal, patient's last name is on the Spanish Surname list, and there is no text to further clarify ethnicity, what is the correct Spanish Ethnicity code: 0 or 7? See Discussion. See also SINQ 20081075.

    Assign code 7 [Spanish surname only] when the last name is on the Spanish Surname list. This includes cases for which the birthplace is Brazil, Portugal or the Philippines and there is no text to further clarify ethnicity.

    The instruction to use code 0 [Non-Spanish/Non-Hispanic] in the SEER manual on page 51 (#2) applies when the only information available is the birthplace or a statement of "Portuguese," "Brazilian" or "Filipino."

    		 2008
    		20081068 Scope Regional LN Surgery--Melanoma: How is this field coded when there is no primary skin lesion and the only disease present is one axillary lymph node that reveals melanoma? See Discussion. According to SINQ 20061045, the CS Lymph Node field is coded to 80. Code scope of regional LN surgery 4 [1 to 3 regional lymph nodes removed] for this case. One lymph node was removed. For this case, the axillary lymph node is coded as regional for the CS Lymph Node field. Therefore, include this lymph node is also coded in the Scope of Regional LN Surgery field. 2008
    		20081029 Multiple Primaries--Brain and CNS: Multiple cavernous hemangiomas diagnosed in 1995 are treated with radiation and steroids in 1996. A 1999 MRI states there is no interval change with the lesions in selected location since 1995. How many new primaries should be reported if a 2006 MRI states there are additional cavernous hemangiomas in other parts of the brain? See Discussion.

    7-03-97 PE: Past history significant for cavernous hemangiomas. Has had radiation and was on high-dose steroids in early 1996. Patient reports subsequent MRI done and neurologist gave "clean bill of health."

    1-26-99 MRI BRAIN. Clinical information: history of intracranial cavernous hemangiomas. Comparison with prior brain MRI in 12/15/95. IMP: Upper medullary, right parieto-occipital, left frontal cavernous hemangiomas without interval change in size as compared to 12/15/95.

    1-25-06 MRI BRAIN. Clinical info: history of prior radiation for cavernous angiomas. Comparison made with prior exam on 1/26/99. Impression: Multiple, variable sized cavernous angiomas within medulla, pontomedullary junction, midbrain, & cerebral hemispheres. Dominant lesion centered within posterior pontomedullary junction. FINDINGS: 8mm lesion in posterior pontomedullary junction. 2mm lesion within right paracentral portion of medulla. Several less than 5mm lesions noted within brain stem bilateral. Two, less than 1-2mm, areas within right inferior aspect of right and left cerebellar hemispheres. 1cm lesion centered within white matter within right posterior parietal/occipital region. Several small, less than 1-2mm, lesion within surrounding white matter. 3rd dominant lesion within left frontal lobe equal 6mm. Several 1-2mm foci of susceptibility artifact within subcortical white matter of high right and left cerebral hemispheres consistent with small cavernous angiomas.

    Benign and borderline brain and CNS tumors diagnosed January 1, 2004 and later are reportable. Multiple tumors in different brain and CNS sites are separate primaries. Different sites are those with ICD-O-3 topography codes that differ at the first, second, third or fourth character.

    There are four reportable primaries in the scenario described above.

  • Brain stem, C717 (medulla, pontomedullary junction, midbrain)

  • Cerebrum, C710 (right cerebral hemisphere)

  • Cerebrum, C710 (left cerebral hemisphere)

  • Parietal/Occipital region, C718

    		• 2008
    		20081015

    MP/H Rules/Multiple primaries--Lung: Should a subsequent primary be abstracted using rule M8 for a patient diagnosed in January 2000 with adenocarcinoma of the right upper lung if the patient initially sought alternative therapies and presented in September 2007 for a right upper lobe lung mass with extension into the mediastinum, mediastinal lymph node mets and a pericardial effusion? See Discussion.

    After more than seven years, the patient in this case decided to proceed with the originally suggested standard therapy. Is this a multiple primary case because the tumors are "diagnosed" more than 3 years apart? Or should we assume this is further progression of the 2000 case because it was originally only treated with alternative therapies? The clinician in this case indicates the patient is being referred for treatment to the right upper lung originally diagnosed in 2000.

    For cases diagnosed 2007 or later:

    Do not abstract a 2007 primary for this case. From the information provided, there is disease progression/extension and lymph node metastasis in 2007; but there are no new lung tumors in 2007. Therefore, the 2007 MP/H rules do not apply.

    		 2008
    		20081036 MP/H Rules--Breast: Is inflammatory breast cancer always one primary per lifetime? Or is a subsequent inflammatory breast cancer a second primary if diagnosed more than five years later? For cases diagnosed 2007 or later, a diagnosis of inflammatory breast cancer more than five years after a previous diagnosis of inflammatory breast cancer is a separate (new) primary. See rule M5 in the Breast Multiple Primary Rules. 2008