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20041067 | Histology (Pre-2007)--Lung: Does 8070 [squamous cell carcinoma], 8560 [adenosquamous carcinoma] or 8255 [adenocarcinoma with mixed subtypes] best represent this field for a lung biopsy described as a "poorly differentiated non-small cell carcinoma with squamous and glandular features with focal mucin positivity per mucin stain"? | For tumors diagnosed prior to 2007:
Assign code 8560/33 [Adenosquamous carcinoma, poorly differentiated]. "Glandular" carcinoma is a synonym for adenocarcinoma. Mixed adenocarcinoma and squamous carcinoma is coded to 8560. Do not use code 8255 [Adenocarcinoma with mixed subtypes] when a more specific complex code is available.
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. |
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20041044 | EOD-Extension--Breast: If the pathology report states "infiltrating duct carcinoma...measuring 7mm in diameter...focal areas of intraductal carcinoma," do we code this field to 14 [Invasive and in situ components present, size of entire tumor coded in Tumor Size and in situ described as minimal] or to 16 [Invasive and in situ components present, size of entire tumor coded in Tumor Size and proportions of in situ and invasive not known]? | For cases diagnosed 1998-2003: If 7mm is the measurement of the infiltrating duct portion of this cancer, assign extension code 13 [Invasive and in situ components present, size of invasive component stated and coded in Tumor Size]. If 7mm is the size of the whole malignancy and the size of the invasive portion cannot be determined, assign extension code 14 [Invasive and in situ components present, size of entire tumor coded in Tumor Size (size of invasive component not stated) and in situ described as minimal (less than 25%)]. "Focal areas of in situ carcinoma" qualifies as minimal. |
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20041078 | Ambiguous Terminology: Is the expression "has the markings of a malignancy" a clinically reportable term? See Discussion. |
12/02 Baseline mammogram: spiculated mass with associated marked retraction located in UOQ lt breast. This has the markings of malignancy. Several microcalcifications in outer aspect of rt breast. BI-RADS 5 higly suggestive of malignancy. |
Do not accession cases using only the term "has the markings of malignancy." This term is not on the list of ambiguous terms that are reportable. If the term does not appear on either the reportable or not reportable list, the term is not diagnostic of cancer. Do not accession the case. Please see SINQ 20010094 in reference to BI-RADS terminology. |
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20041086 | Histology (Pre-2007)/CS Tumor Size/CS Extension--Colon: How are these fields coded if a 3 cm sessile polyp is snared and removed piecemeal during a colonoscopy and the path microscopic description indicates a polypoid lesion with foci of malignant transformation found associated with bundles of smooth muscles followed by a LAR with no residual invasive tumor but the final path diagnosis is stated to be a M.D. adenocarcinoma? See Discussion. | 3/04 colonoscopy 3cm sessile polyp snared & removed piecemeal. Path Micro: Polypoid lesion consists of branching & complex neoplastic glands lined by tall columnar epithelial...These foci of malignant transformation are assoicated with large polygonal epithelial...associated with desmoplastic stromal reaction & neoplastic glands can be found associated with bundles of smooth muscle. 4/04 LAR: focus of residual HG dysplasia: no residual invasive tumor. Final path dx: MD adenocarcinoma. Physician staged: T2 N0 M0. Histology: 8140 vs 8210 Tumor Size: 030 vs 999 vs 990 Extension: 12 vs 20 |
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. For tumors diagnosed prior to 2007:
Based only on information provided: Histology: 8210 [Adenocarcinoma in a polyp] Tumor Size: 999 [Unknown] CS Extension: 20 [Muscularis propria invaded]
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. |
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20041092 | CS Extension--Bladder: How would the following statements be coded for bladder extension -- Code 03 [inferred description of non-invasion] vs code 15 [invasive confined to subepithelial connective tissue]. See Discussion. | 1) no smooth muscle invasion 2) no muscle invasion 3) without muscle invasion 4) no invasion of muscularis propria |
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. For cases diagnosed in 2004 and later code CS extension: 1) no smooth muscle invasion -- 15 2) no muscle invasion -- 15 3) without muscle invasion -- 15 4) no invasion of muscularis propria -- 03 |
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20041047 | Multiple primaries (Pre-2007)/EOD-Extension--Fallopian Tube: How many primaries are coded when endometrioid adenocarcinoma involves bilateral fallopian tubes? See Discussion. | The pathologist states "because of the intimate association with the luminal line of the fallopian tube it is felt that this represents synchronous primaries rather than mets." The SEER Code Manual only lists ovary, retinoblastomas, and Wilms Tumors under the bilateral code stated to be a single primary. | For tumors diagnosed prior to 2007:
Complete two abstracts, one for left fallopian tube and one for right fallopian tube. This case has been determined to be two primaries by the pathologist. Bilateral involvement of paired sites (other than ovary, retinoblastoma and Wilms tumor) with the same histology within two months requires a determination of whether there are one or two primaries. The pathologist in the case above has made this determination.
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. |
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20041070 | Primary Site: What would the primary site be for carcinoma of the renal pelvis, status post transplant? Please see details below. See Discussion. | The patient has a renal pelvis urothelial carcinoma confined to the pelvis but is status post renal pelvic transplant of the same renal pelvis. | Code the primary site to renal pelvis [C659]. Code the site in which the primary tumor originated. The transplant status in this example does not affect the primary site. | 2004 |
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20041039 | Multiple Primaries (Pre-2007)--Kidney/Bladder/Renal Pelvis: Would transitional cell carcinoma of the left renal pelvis, diagnosed two years after a diagnosis of invasive bladder cancer, be a second primary when the discharge is "recurrent transitional cell carcinoma, left kidney"? | For tumors diagnosed prior to 2007:
This is an example of the term "recurrent" being used loosely to refer to another primary in the urinary tract. It is highly unlikely that a bladder tumor would metastasize to the kidney. Much more likely is the field defect or regional breakdown of the urothelial tissue that lines the tract from the renal pelvis to the urethra. Furthermore, bladder tumors don't spread retrograde to the kidney. Code as two 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. |
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20041072 | Histology (Pre-2007)--Colon: Must a case be specifically labeled "familial adenomatous polyposis" or is the mere presence of numerous/multiple polyps sufficient for coding the histology to FAP? | For tumors diagnosed prior to 2007:
The presence of numerous/multiple polyps is not necessarily adenomatous polyposis coli. Adenomatous polyposis is an extreme condition usually characterized by the presence of hundreds of polyps and should be identified as such either clinically or pathologically. Look for the term "Familial adenomatous polyposis," FAP or one of its synonyms: Adenomatosis of the colon and rectum [ACR] Familial adenomatous colon polyposis Familial colonic polyposis Multiple familial polyposis In the absence of these terms, the following probably indicate a diagnosis of FAP: Hundreds of adenomatous polyps throughout large intestines, and at times, throughout the digestive system Development of polyps as early as ten years of age, but more commonly at puberty History of colectomy
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. |
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20041046 | CS Tumor Size--Breast: When the diagnosis is inflammatory carcinoma of the breast, must the CS tumor size always be 998? See Discussion. |
I have no specific example of a situation; I am writing an edit check and wondering if there would be any exceptions to this rule. | 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.No. For inflammatory carcinoma, code the size of the tumor in CS tumor size. Use code 998 [diffuse] when the tumor is stated to be "diffuse." Page 27 in Part I of the CS manual will be corrected to define code 998 for breast as only "diffuse." The errata should be distributed in July 2004. |
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