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Report Produced: 02/25/2026 15:19 PM

Report Question ID Question Discussion Answer Year
20021046 Behavior Code/EOD-Extension--Bladder: If an in situ lesion of the urinary bladder involves the von Brunn nests, is it still in situ? See discussion.

Von Brunn nests: Compact, rounded aggregates of urothelial (transitional) cells in the lamina propria, with or without connection to the surface epithelium.

Urothelial (transitional cell) carcinoma in situ...may involve von Brunn nests...

Histologic Typing of Urinary Bladder Tumours, Second Edition, WHO, pp 12 & 21

For cases diagnosed 1998-2003:

Code the Behavior Code and the EOD-Extension field according to the pathology report.

If the pathology report states the tumor to be noninvasive or in situ, whether or not von Brunn nests are involved, code behavior as 2 [in situ] and extension as in situ.

If the tumor is described as invasive and involves the von Brunn nests, code the EOD-Extension field to 15 [invasive tumor confined to subepithelial connective tissue] because code 15 includes extension to the lamina propria and von Brunn nests are within the lamina propria.

 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
20021056

Histology (Pre-2007)/Terminology: Are "pattern", "architecture", and "architectural pattern" terms that indicate a majority of tumor?

For tumors diagnosed 2004 to 2006:

The terminology "Architectural pattern: ____________," when used in the final pathology diagnosis, indicates a subtype that can be coded. This type of format in a pathology report is based on a College of American Pathologists (CAP) protocol. Disregard "pattern" and "architecture" when not used in accordance with the CAP protocol. See www.cap.org for cancer protocols.

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
20021200 Date of Diagnosis: How do you code this field when the pathologic confirmation is delayed for 2 months because the clinician decides to "watch and see what happens" to a CT identified mass thought to be either a "metastasis from a previously diagnosed malignancy or a new primary"? Code the Date of Diagnosis field to the date of the scan. This is the earliest date that a recognized medical practitioner said the patient had cancer. The diagnosis on the CT scan was a malignancy. The only question was whether the mass on the scan was metastatic or a primary. 2002
20021087 Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are represented when a1998 invasive squamous cell carcinoma of the true vocal cord is followed by a 1999 diagnosis of in situ squamous cell carcinoma of the true vocal cord (called "recurrent" by the clinician), and in 2001 there is another invasive squamous cell carcinoma of the true vocal cord (no statement of recurrence)? Would your answer be any different if no statement of "recurrent" had been made in 1999?

For tumors diagnosed prior to 2007:

Code this case as two primaries, an invasive true vocal cord primary in 1998 and another invasive true vocal cord primary in 2001.

If there had been no statement of recurrence for the 1999 in situ diagnosis and the 1999 diagnosis was more than two months following the 1998 diagnosis, this case would be coded as three primaries.

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
20021005 EOD-Extension--Lymphoma: What code is used to represent this field for an extranodal lymphoma that has more than one tumor in the primary site OR has intraluminal extension from the primary site to an adjacent organ? See discussion.

1. Small lymphocytic lymphoma with 2 tumors in the stomach.

2. Lymphoma involving the cecum and ileum.

3. Lymphoma of the fundus of stomach with extension into the esophagus.

For cases diagnosed 1998-2003:

Using the EOD scheme for lymphoma, code the Extension field to 11 [Localized involvement of a single extralymphatic organ or site; Stage IE] for all 3 of these cases.

For the stomach lymphoma: There are 2 areas of lymphoma, but it is still confined to one site.

For the other 2 lymphomas: Intraluminal (mucosal) spread of the lymphoma never equals extension. The same phrase that was added to code 21, "Direct extension to adjacent organs or tissues", will be added to code 11 in the Collaborative Stage System. Neither "mucosal spread to a contiguous organ" or "direct extension into a nearby organ" affect staging. Both are still coded to 11 as long as there are no other sites of lymphoma involvement.

EOD code 80 is poorly written. It does not mean diffuse invovement or multiple tumors in a single organ but rather "diffuse disease in two or more organs."

 2002
20021002 Histology (Pre-2007)--Breast: What code is used to represent the histology "ductal carcinoma in situ with comedo necrosis"? See discussion.

SEER distributed breast questions to the Advisory Group made up of pathologists from different SEER regions. One question dealt with the terms comedo type, comedo necrosis and comedocarcinoma. Per the Advisory Group, "Do not code comedo necrosis. These three phrases each represent a different level of diagnosis and can't be compared. "Comedocarcinoma" is an established diagnosis of in situ carcinoma and should be coded as such. "Comedo type" refers to a type of intraductal cancer; whether it is considered to be a true diagnosis is probably still equivocal. "Comedo necrosis" refers to a description of cellular pathological events that occasionally occur within an intraductal tumor of comedo type, which should not be coded at all."

Per the SEER preferred answer: Comedo type = comedocarcinoma. Ignore comedo necrosis.

For tumors diagnosed prior to 2007:

Code the Histology field to 8500/2 [ductal carcinoma in situ].

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
20021007 Scope of Regional Lymph Node Surgery: If a named regional lymph node is aspirated should this field be coded to 1 [Regional lymph node removed, NOS], as is stated on page 127 of the SEER Program Code Manual, or should this field be coded to a more specific code when that is available (e.g. Lung primary code 3 [Ipsilateral mediastinal and/or subcarinal nodes])? For cases diagnosed 1/1/2003 and after: A generic scheme was created for the Scope of Regional Lymph Node Surgery field. As a result, there no longer are codes available that represent specific named lymph node chains. Code aspiration of a lymph node to 1 [Biopsy or aspiration of regional lymph node, NOS]. 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