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Report Produced: 02/27/2026 06:29 AM

Report Question ID Question Discussion Answer Year
20020049 EOD-Extension--Breast: Should clinically mentioned "thickening" of the breast be ignored if the pathology report does not mention thickening or skin involvement? See discussion. For cases diagnosed 1998-2003: Can clinical "thickening" of the breast be coded to 20-28 extension code when there is no mention of the thickening or skin involvement in the pathology report? How do we code cases when pathology reports don't support the clinical finding of skin involvement. For cases diagnosed 1998-2003: Do not use code 20-28 when there is no preoperative treatment and the pathology report does not confirm skin invasion. The clinical diagnosis of skin involvement was not supported by the pathology report. 2002
20020011 Histology (Pre-2007): What code should be assigned to acinar adenocarcinoma and ductal adenocarcinoma?

For tumors diagnosed prior to 2007:

Assign code 8255 [Adenocarcinoma with mixed subtypes]. According to histology rule #4 for a single tumor on page 86 of the 2004 SEER manual, use a combination code if one exists.

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.

 2002
20021153 Grade, Differentiation--Breast: Is "histological grade" another way of saying "tubule formation" which would result in the following case having a Bloom-Richardson (BR) score of 7 which would be coded to grade 2? See discussion. Final path diagnosis stated: Invasive ductal ca, histological grade 3/3, nuclear grade 2/3, mitotic index-moderate. Yes. Code the Grade, Differentiation field to 2 [Grade 2] for this case. This case has a BR score of 7 which converts to a grade of 2. This pathologist seems to be describing the three parts of the BR system: tubule formation, mitotic activity and nuclear grade. 2002
20021189

Multiple Primaries--Lymphoma: How many primaries should be reported when a 5/99 diagnosis of stage III follicular large cell lymphoma [9698/3] of the conjunctiva [C69.0] is followed with a 6/01 diagnosis of small cleaved lymphoma [9591/3] of the breast [C50.9]? See discussion.

The Lymphatic and Hematopoietic Diseases folding table states that this should be one primary, but is this true when they are both extralymphatic in origin?

For cases diagnosed prior to 1/1/2010:Report as two primaries if that reflects the medical opinion for this case. The table is a guide, but does not overrule the clinician's opinion. These extranodal lymphomas are diagnosed in two different sites more than 2 months apart. They are listed as the same primary in the folding table because 9591/3 is generally a non-specific term and 9698/3 is a more specific cell type. If both histologies were diagnosed in the same organ or tissue, this is the same primary. However, the primary sites in this example are distinctly different.

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.

 2002
20021025 Histology: What code is used to represent the histology "endometrioid adenocarcinoma, villoglandular type"?

Assign code 8262/3 [Villous adenocarcinoma].

According to the WHO Classification of Tumours, Breast and Female Genital Organs (2003), villoglandular is one of four variants of endometroid adenocarcinoma. The corresponding ICD-O-3 code according to WHO is 8262/3.

 2002
20021168 Histology (Pre-2007)--Corpus Uteri: What code is used to represent the histology "endometrioid carcinoma with squamous differentiation" for an endometrium primary?

For cases diagnosed 2004-2006:

Endometrioid adenocarcinoma with squamous differentiation is coded 8570 [Adenocarcinoma with squamous metaplasia].

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.

 2002
20021199

Primary Site/Surgery of Primary Site--Lymphoma: What codes are used in these fields when both regional lymph nodes and an extra-nodal site are involved with lymphoma and there is not a clear statement from the clinician as to the primary site? See discussion.

In our registry, we code the primary site for such cases to the extra-lymphatic site if there is one extra-nodal site involved with disease and the patient does not have disseminated involvement of multiple extra-nodal sites. Is this correct? Example: A patient with a submandibular lymphoma and involved nodes undergoes a salivary gland excision and a modified radical neck dissection yielding 100 nodes.

For cases diagnosed prior to 1/1/2010:Code the Primary Site to C08.0 [submandibular gland] and use the surgery code schemes that apply to that site (Parotid and Other Unspecified Glands). Physiologically, lymphoma cells in regional lymph nodes do not "back-flow" into the extralymphatic organ to involve it secondarily. As a result, the primary site is usually the extralymphatic organ with regional lymph node involvement. Do not be afraid to code an extralymphatic site as primary when that site and its regional nodes are involved.

If the lymph nodes are not regional to the extra-nodal involved site and the primary site cannot be determined, code the primary site to C77.9 [Lymph node, NOS].

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.

 2002
20021099 Reportability/Histology (Pre-2007)--Pancreas: Are the following pancreatic tumors with mention of "low grade malignant potential/borderline" reportable to SEER? If so, what histology and behavior codes should be used? See discussion.

1. AFIP diagnosis: Pancreas, tail, resection: Mucinous cystadenocarcinoma (mucinous cystic neoplasm) of low grade malignant potential. Comment: There are no reliable histomorphologic features which can separate these neoplasms into benign and malignant tumors, and so we consider them all to be low grade malignant tumors.

2. Whipple resection: Intraductal papillary mucinous tumor of the pancreas with extensive low grade and multifocal high grade ductal dysplasia (so-called borderline tumor and carcinoma in-situ).

For tumors diagnosed prior to 2007:

Both tumors are reportable to SEER.

1. Code the Histology and Behavior Code fields to 8470/3 [Mucinous cystadenocarcinoma, NOS].

2. Code the Histology and Behavior Code fields to 8453/2 [Intraductal papillary-mucinous carcinoma, non-invasive].

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.

 2002
20021142 Date of Diagnosis: If an originally diagnosed "benign" tumor is later discovered to have "metastasized", should the date of diagnosis be back-dated to the date the original tumor was discovered or to the date the metastatic disease was identified? Code the Date of Diagnosis field to the date the malignancy is diagnosed. If there was a medical or pathologic review of the original benign diagnosis that indicates that the patient had cancer at the earlier time, then the earlier date is coded as the date of diagnosis. If no medical or pathologic review of the original benign diagnosis is done, then code the date of diagnosis to the date the metastasis is discovered. 2002
20021185 Surgery of Primary Site--Major salivary gland: How do you code Surgery of Primary Site for a submandibular gland primary when the operative report refers only to an excision of the submandibular "tumor" while the pathology report states the submandibular "gland" was removed? See discussion. The gross description on the pathology report indicates that the specimen consists of a "submandibular gland." A further description on the pathology report included, "the specimen was sectioned exposing a focally cystic mass that nearly replaces the entire specimen." For cases diagnosed on 1/1/2003 or after: Code the Surgery of Primary Site field to 40 [Total parotidectomy, NOS; total removal of major salivary gland, NOS], per the pathology report's gross description of the specimen unless the operative report description of procedure indicates that the removal was less than total. 2002