Report | Question ID | Question | Discussion | Answer | Year |
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20051127 | Reportability--Brain and CNS: Is an "intradural extramedullary schwannoma (neurilemoma)" of the spine reportable? See Discussion. | Example: Pt underwent laminectomy and excision of intradural extramedullary tumor. Is there a default decision for tumors described as intradural extramedullary tumors, NOS? |
For cases diagnosed 2011 and later: A spinal "intradural extramedullary schwannoma (neurilemoma)" is reportable. This schwannoma originated in the spinal nerve root, C720.
See #2 under Reportability in the Data Collection Answers from the CoC, NPCR, SEER Technical Workgroup, http://www.seer.cancer.gov/registrars/data-collection.html#reportability |
2005 |
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20130075 | Reportability/Ambiguous terminology--Heme & Lymphoid Neoplasms: Is 'suspicious for an evolving acute leukemia' reportable? |
For cases diagnosed 2010 and later Please see the Hematopoietic database, https://seer.cancer.gov/seertools/hemelymph/ |
2013 | |
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20100100 | Primary site/Histology--Heme & Lymphoid Neoplasms: How are these fields coded for a Langerhans cell histiocytosis diagnosed on an excisional biopsy of the T8 vertebral bone? See Discussion. | The patient had an excisional biopsy of the T8 vertebral bone, but no other tissue biopsy. The doctor confirms the case is malignant. However, Langerhans cell histiocytosis, NOS is listed as /1 (borderline) in the ICD-O-3. | For cases diagnosed 2010 and forward, do not use the ICD-O-3 book to determine the hematopoietic and lymphoid histology codes. Use the Hematopoietic Database and access it at http://seer.cancer.gov/seertools/hemelymph.
Code the histology to 9751/3 [Langerhans cell histiocytosis] and the primary site for unifocal disease to C412 [bone, vertebral column]. Per Rule PH 30, use the Heme DB to determine the primary site and histology when PH1-PH29 do not apply. Per the Abstractor Notes section in the Heme DB, lytic bone lesions are the most common primary site.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2010 |
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20130208 | Histology--Heme & Lymphoid Neoplasms: How is histology coded when a bone marrow shows slightly hypercellular marrow with acute myeloid leukemia, non-M3 type and the flow cytometry is also consistent with acute myeloid leukemia, non-M3 type? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. Without further information as to the type of acute myeloid leukemia, code the histology to 9861/3 [acute myeloid leukemia, NOS]. If further information on the specific acute myeloid leukemia becomes available, update the histology code. Document that the pathology report states the acute myeloid leukemia is a "non-M3 type" in a text field. This documentation will help explain the choice of 9861/3 for this case. M3 refers to one of the eight FAB subtypes described by a group of French, American, and British leukemia experts in the 1970's who divided acute myeloid leukemias into subtypes, M0 through M7. They classified the disease based on the type of cell from which the leukemia developed and how mature the cells were. This was based largely on how the leukemia cells looked under the microscope after routine staining. In this case, all we know is that the histology does not pathologically represent the M3 (acute promyelocytic leukemia (APL)) form of acute myeloid leukemia. We do not know which type of acute myeloid leukemia it does represent. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 | |
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20110143 | Multiple primaries--Heme & Lymphoid Neoplasms: How many and what primary site(s) are to be accessioned when biopsies of clavicular and neck skin lesions are both consistent with mycosis fungoides? See Discussion. |
Per the Heme DB and Manual, this is a single primary; however, per the MP/H Rules, this would be multiple primaries. Which rules apply to this case? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. When there is a question of whether the SEER MP/H Rules or Hematopoietic and Lymphoid Neoplasm Rules apply, check the histology and refer to the Case Reportability Instructions in the Hematopoietic and Lymphoid Neoplasm Manual. All ICD-O-3 morphology codes in the range 9590 - 9992 are included in the Hematopoietic Rules. Mycosis Fungoides [9700/3] is included in this range. Therefore, the SEER MP/H Rules do not apply to mycosis fungoides. This case should be accessioned as a single primary: mycosis fungoides [9700/3] of the skin, NOS [C449]. Per Rule M2 abstract a single primary when there is a single histology. Note that in the Primary Site(s) section of the Heme DB, it states the primary site must always be coded to skin (C440 - C449) for mycosis fungoides. Because the primary site is stated in this section of the Heme DB, it is not necessary to use the Primary Site Rules to determine the primary site. Code the primary site to C449 [skin, NOS] because the patient has multiple sites of skin involvement and there is no documentation indicating which subsite of skin was the origin of the mycosis fungoides. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2011 |
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20100080 | Reportability--Heme & Lymphoid Neoplasms: Is the term "thrombocytopenia" equivalent to the term "refractory thrombocytopenia" and should be a subsequent primary if it follows a treated diagnosis of pancreatic cancer? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. Thrombocytopenia NOS is not a reportable diagnosis per Appendix F. Thrombocytopenia and Refractory Thrombocytopenia are not the same disease. Thrombocytopenia is caused by a decreased number of platelets in the blood. Non-malignant causes include disseminated intravascular coagulation (DIC), drug-induced non-immune thrombocytopenia, drug-induced immune thrombocytopenia, hypersplenism, immune thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura, and infections of the bone marrow. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2010 | |
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20110109 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are to be abstracted when a patient is simultaneously diagnosed with multiple myeloma/plasma cell myeloma, plasmacytoma and plasma cell leukemia? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This is accessioned as one primary and the histology is coded to 9732/3 [multiple myeloma]. To arrive at this answer, it is important to first try to determine how many different unique neoplasms there are to correctly identify the number of primaries to report. Per the Heme DB, plasma cell leukemia is an obsolete term. The current term and histology code for this diagnosis is 9732/3 [plasma cell myeloma]. Plasma cell myeloma and multiple myeloma are synonyms per the Heme DB. Therefore, per Rule M2 a single primary exists when there is a single histology. That takes care of the multiple myeloma/plasma cell myeloma and plasma cell leukemia, but not the plasmacytoma. In checking the Heme DB, the terms plasma cell myeloma and multiple myeloma are not synonyms for plasmacytoma. Therefore, we are left to determine whether the multiple myeloma/plasma cell myeloma vs the plasmacytoma represents one or two primaries. Under the Transformation section of the Heme DB, it indicates that plasmacytoma (a chronic disease process) transforms to multiple myeloma (an acute disease process). Per Rule M9, abstract a single primary and code the acute histology when both a chronic and an acute neoplasm are diagnosed simultaneously. The histology is coded to the acute neoplasm when there is no information on the biopsy regarding which is the "later" histology. This update will be added to the Heme Manual. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2011 | |
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20130030 | Histology--Heme & Lymphoid Neoplasms: How is histology coded for a patient diagnosed with diffuse large B-cell lymphoma, immunoblastic [9684/3] in 2009 and a recurrence in 2010 at another facility was referred to as plasmablastic lymphoma [9735/3]? See Discussion. |
Which code is correct for the merged record? Is code 9735/3 [plasmablastic lymphoma] correct because code 9684/3 [DLBCL, immunoblastic] is now obsolete? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case was originally diagnosed in 2009, prior to the development of Hematopoietic Database. Therefore it is necessary to use the ICD-O-3 to code histology to 9684/3 [diffuse large B-cell lymphoma, immunoblastic]. Use the original histology diagnosed for the merged record because DLBCL, immunoblastic, and plasmablastic lymphoma are the same primary. Do not change the histology to code 9735/3 [plasmablastic lymphoma]. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |
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20110142 | Reportability--Heme & Lymphoid Neoplasms: Is the pathologic final diagnosis of "follicular lymphoma, WHO grade 1-2, findings may represent in situ follicular lymphoma" reportable if the clinician also states this may be an "in situ follicular lymphoma"? See Discussion. |
2/16/11 mesentery biopsy showed "follicular lymphoma, WHO grade 1-2, findings may represent an "in situ" follicular lymphoma." 3/7/11 clinician note stated, "nodularity of the mesentery which upon biopsy may be in situ follicular lymphoma. No treatment is necessary. This is not a proven malignancy. It may evolve into one. Plan 6 month follow-up and CT scans. Do the notes from the oncologist and pathologist stating that this "may be" or "may represent" an in situ lymphoma make this case non-reportable? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case should not be accessioned. In situ lymphoma is not reportable for any of the standard setters (CoC, NPCR, or SEER). In the Case Reportability Instructions, the NOTE under Rule 3 states, "Do report in situ (/2) lymphomas." SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2011 |
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20130138 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2010 diagnosis of a preleukemic condition is subsequently diagnosed in 2012 with a specific leukemia that is not listed as a transformation? See Discussion. |
10/02/10 bone marrow biopsy showed myelodysplastic syndrome, unclassified [9989/3]. 6/19/12 bone marrow biopsy showed chronic myelomonocytic leukemia (CMML-2) [9945/3]. CMML-2 is not listed as an acute neoplasm for MDS. Is this the same disease? Per the pre-2010 rules, this would be the same disease. The current Heme DB indicates these are separate primaries. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case should be accessioned as two primaries, myelodysplastic syndrome (MDS) [9989/3] diagnosed 10/2/10 and chronic myelomonocytic leukemia (CMML-2) [9945/3] diagnosed 6/19/12 per Rule M15. Per Rule M15, use the Multiple Primaries Calculator when rules M1-M14 do not apply. When myelodysplastic syndrome (MDS) became reportable, the rules in effect at that time resulted in MDS often being the only diagnosis reported when both MDS and a leukemia were diagnosed. Statistics for some leukemias were impacted. Now we report both the MDS and the leukemia for greater accuracy. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |