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Report Produced: 06/10/2026 05:47 AM

Report Question ID Question Discussion Answer Year
20000547 Histology (Pre-2007): What code is used to represent the histology "non-small cell carcinoma, NOS"? See discussion. Should a non-small cell carcinoma histology be assumed to be a large cell carcinoma [8031/3] or should the histology be coded to carcinoma, NOS [8010/3]?

For tumor diagnosed 2001-2006: Code the Histology field to 8046/3 [non-small cell carcinoma].

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.

 2000
20000465 Grade, Differentiation--Lymphoma: What code is used to represent this field when the only grade/differentiation given is "low grade", "intermediate grade" or "high grade"?

Code the Grade, Differentiation field to 9 [cell type not determined, not stated or not applicable]. For lymphomas, do not code the descriptions "high grade," "low grade," and "intermediate grade" in the Grade, Differentiation field. These terms refer to categories in the Working Formulation and not to histologic grade for lymphoma histologies.

Generally, for histologies other than Non-Hodgkin lymphoma, the Grade, Differentiation field is coded to 2 [low grade], 3 [intermediate grade] and 4 [high grade] for most cancers.

 2000
20000532 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: Should a lymph node biopsy be counted in these fields or are these fields for lymph node dissections only? See discussion. Example: 1) Lymph node biopsy: adenocarcinoma. 2) Lymph node dissection: 4/15 regional lymph nodes positive for adenocarcinoma.

For cases diagnosed 1998-2003:

These fields record the number of regional lymph nodes examined pathologically whether from a biopsy or from a dissection. If the single lymph node biopsied was a regional lymph node, code the Number of Regional Lymph Nodes Positive field to 05 and the Number of Regional Lymph Nodes Examined field to 16. If the lymph node biopsied was a distant node, code these fields to 04 and 15 respectively.

 2000
20000851 Primary Site: What site code is used to classify a femur biopsy with pathologic diagnosis of "Ewing sarcoma/primitive neuroectodermal tumor (PNET)"? See discussion. ICD-O-3 lists PNET as being site specific to C71._. The pathology report states "some authors consider both Ewing sarcoma and PNET to be the same histologic entity given that they share the same translocation between chromosomes 11 and 23." Code the Primary Site field to C40.2 [femur] based on Rule H in the ICD-O-3 that states, "Use the topography code provided when a topographic site is not listed in the diagnosis. This topography code should be disregarded if the tumor is known to arise at another site." 2000
20000249

EOD-Lymph Nodes--Melanoma: Should we assume that positive lymph nodes are regional if the primary site for a melanoma is not identified (i.e., C449)?

For cases diagnosed 1998-2003: Code the EOD-Lymph Nodes field to 8 [Lymph Nodes, NOS].

 2000
20000280 Primary Site--Breast: Is there a hierarchy for coding subsite for breast cases when there is conflicting information in the physical exam, mammogram, operative and pathology reports as to the exact location of the primary? See discussion.

Example: Two mammograms were performed. One report indicates the lesion is at 12:00 and the other indicates it is in the upper central quadrant. However, the pathology report from the modified radical mastectomy specimen indicates the mass is in the UIQ.

According to one of our physicians, when a pathologist has a mastectomy specimen with attached axillary contents, the location of the lesion (subsite) is very accurate.

Code the Primary Site field to C50.2 [upper inner quadrant]. In general, the priority for using information is pathologic, operative, and clinical findings. The pathology report would take precedence in this case.

The 2004 SEER Program Code manual will include the following instructions for determining breast subsite.

Priority Order for Coding Subsites

Use the information from reports in the following priority order to code a subsite when the medical record contains conflicting information:

1 Pathology report

2 Operative report

3 Physical examination

4 Mammogram, ultrasound

If the pathology proves invasive tumor in one subsite and insitu tumor in all other involved subsites, code to the subsite involved with invasive tumor.

 2000
20000431

Surgery Fields--Multiple sites: What code is used to represent these fields for the following surgical procedures?

1. Tongue, NOS - Hemiglossectomy with lymph node dissection

2. Choroid - Eye enucleation

3. Vulva, NOS - Vulvectomy with bilateral lymph node dissection

4. Gallbladder - Cholecystectomy

5. Lung - Laminectomy with partial removal of tumor

For cases diagnosed 1/1/03 and later:

1. Code Surgery of Primary Site to 30 and Scope of Regional Lymph Node Surgery to 3.

2. Code Surgery of Primary Site to 41.

3. Code Surgery of Primary Site to 40 and Scope of Regional Lymph Node Surgery to 3.

4. Code Surgery of Primary Site to 40.

5. Code Surgical Procedure of Other Site to 4.

 2000
20000440 Grade, Differentiation--Brain and CNS: Can grade IV be implied for brain primaries with the histology of glioblastoma multiforme, even if there is no statement of grade in the path report? See discussion. Dr. Platz has instructed the Iowa registry to code glioblastoma multiforme to grade IV, even when there is no corroborating statement of grade in the path report. This is also supported in some references. Code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable] in the absence of a stated grade on the pathology report. If a grade is stated, code the stated grade. SEER does not recommend adopting the rule in the Discussion. 2000
20000514

Histology (Pre-2007)--Skin: Are "atypical melanocytic hyperplasia" and "severe melanotic dysplasia" synonyms for melanoma in situ?

For tumors diagnosed prior to 2007:

No. SEER determines its reportable list from the ICD-O-3. The above terms are listed as tumor-like lesions and conditions, but are not in situ or malignant.

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.

 2000
20000527

Radiation: Is "consolidated" radiation therapy coded as part of first course therapy when there is no documentation of "planned treatment" and the radiation is done 4 months after the initiation of treatment?

Yes, "consolidation" treatment is part of a planned treatment regimen. A treatment regimen may consist of the four following phases:

1. Induction (remission induction)

2. CNS preventive therapy

3. Consolidation/intensification

4. Maintenance

 2000