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| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20031128 | Histology (Pre-2007): What code is used to represent the histology "PD infiltrating duct ca with focal sarcomatoid pleomorphic features?" | For tumors diagnosed prior to 2007:
Code histology as 8500/33 [Infiltrating duct carcinoma, poorly differentiated]. "Features" is a term from the list indicating a majority of the tumor, however; in this case "features" is modified by "focal" which does not indicate a majority of the tumor.
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. |
N/A | Histology | 2003 | |
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20021015 | Ambiguous Terminology/Reportability: How should the expressions "suspicious for but not diagnostic of" and "suspicious for the possibility of early invasive adenocarcinoma" be interpreted for reportability? Would the interpretation be different depending on the primary site? | For reportability, interpret "suspicious for but not diagnostic of" as NOT diagnostic of cancer.
The phrase "suspicious for the possibility of early invasive adenocarcinoma" may indicate that the case is in situ. If no further information is available, this is not reportable.
The site of the cancer diagnosis does not change the interpretation. |
N/A | N/A | 2002 | |
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20071063 | Reportability/Diagnostic Confirmation: If a diagnosis based solely on positive flow cytometry is reportable even if a bone marrow biopsy is negative, how is diagnostic confirmation coded? |
For cases diagnosed prior to 2010 The case is reportable if a recognized medical practitioner says the patient has cancer. A flow cytometry alone is not diagnostic but it may be supported by either a positive bone marrow or a clinician's statement. If the clinicians statement is based only on flow cytometry, code diagnostic confirmation to 8 [Clinical diagnosis only]. |
N/A | Diagnostic confirmation | 2007 | |
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20210011 | Primary site: Is C720 the correct primary site for a diagnosis of a paraspinal neuroblastoma on autopsy in a nine month old with Noonan syndrome? See Discussion. |
Autopsy/Pathology Report (2020) excerpts External Examination Nervous System: There is an 8.5 cm mass located in the right thoracic paraspinal area. Final Anatomic Diagnosis Clinical History: Paraspinal mass suspicious for neuroblastic tumor (detected by imaging studies) Nervous System: Right thoracic paraspinal neuroblastoma, poorly differentiated |
Assign primary site code C473 for this case based on the information provided (peripheral nerves and autonomic nervous system of thorax). From our expert pathologist consultant: The origin of neuroblastomas is generally in the adrenal medulla or one of the sympathetic ganglia on either side of the vertebral column (although they have been reported in many other locations given the migration of the neural crest cells embryologically). |
N/A | Primary site | 2021 |
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20081119 | Reportability/Date of diagnosis--Liver: Does the final diagnosis of a scan have higher priority than the findings in the discussion in the body of the report? See Discussion. |
A patient with liver cancer becomes transplant eligible when the tumor is 2 cm in size. Frequently, liver tumors will be watched (no biopsy) for months until they meet the 2 cm size criteria. In the meantime, multiple scans will describe the tumor using variations of ambiguous terms that drift in and out of reportablility. One day the tumor is labeled "presumed hepatocellular carcinoma." Weeks later it is back to "worrisome for hepatoma." A single scan will use different terms in different sections of the report. Example case: Abdominal CT reveals a 1 cm liver lesion. Per the discussion portion of the scan, the lesion is consistent with hepatocellular carcinoma. Per final diagnosis: 1 cm liver lesion, possibly hepatocellular carcinoma. Is this report diagnostic of cancer? Would the date of this report be the date of diagnosis? (Patient did receive a liver transplant for hepatocellular carcinoma months later.) |
When a reportable ambiguous term is used in one part of a report or the medical record and a non-reportable ambiguous term is used in another part of the report or the medical record, accept the reportable term and accession the case. The example above is reportable. "Consistent with" is a reportable ambiguous term. Accept "consistent with" over the non-reportable term "possibly." The date of this report would be the date of diagnosis if this is the earliest report using reportable terminology. |
N/A | Date of diagnosis | 2008 |
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20000474 | Date of Diagnosis: If a clinician states his current diagnosis of malignancy is based on a CT scan done at an early date that contained a diagnosis of only "neoplasm" or "worrisome for carcinoma" should the date of diagnosis be the date of the scan? | Yes. Code the Date of Diagnosis field to the date of the scan. The physician's clinical impression upon reviewing the earlier scan, is that the malignancy was confirmed by the scan. If there is a medical review of a previous scan that indicates the patient had a malignancy at an earlier date, then the earlier date is the date of diagnosis, i.e., the date is back-dated. | N/A | Date of diagnosis | 2000 | |
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20031036 | Histology--Hematopoietic, NOS: When both the path and clinical diagnoses simultaneously reflect reportable diagnoses but one is a worse form of the same disease process, which diagnosis do we code? See Description. | Would this case be coded to RAEB or AML? Bone marrow diagnosis: Hypercellular marrow with profound trilinieage dyspoietic changes. Comment: the features are consistent with RAEB. Clinical diagnosis five days later states: Myelodysplastic syndrome, early acute myelocytic leukemia (likely AML). | When several diagnoses are made as part of the diagnostic process within two months, code the one with the worst prognosis. Code the case example as acute myelocytic leukemia. 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. |
N/A | Histology | 2003 |
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20000248 | Date of Diagnosis: When doing follow-back at nursing homes on DCO cases, we find it difficult to code diagnosis date because the nursing home records are often vague or incomplete. Should the diagnosis date be coded as unknown (excluded from SEER database), the date of death, or the approximate date of diagnosis as reported on the death certificate? | If the nursing home record indicates that the patient had cancer, use the best approximation for date of diagnosis.
If the record says the patient had cancer when admitted, but it does not provide a date of diagnosis, use the date of admission as the date of diagnosis.
If there is no mention of cancer in the nursing home record and/or all work-up in the record is negative, assume the cancer was discovered at autopsy. Use the date of death as the date of diagnosis, and leave as a Death Certificate Only case. |
N/A | Date of diagnosis | 2000 | |
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20020047 | Scope of Regional Lymph Node Surgery/Radiation Sequence with Surgery/Date Therapy Initiated: Is the Scope of Regional Lymph Node Surgery field used to code date of first therapy and radiation sequence with surgery? See discussion. | Example: There is no primary site surgery and only an aspirate of a lymph node and the date of therapy is based on this procedure. | Yes, the Scope of Regional Lymph Node Surgery field is used to code the Date Therapy Initiated field and the Radiation Sequence with Surgery field. | N/A | Date therapy initiated, Radiation Therapy, Scope Regional LN Surgery | 2002 |
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20021132 | EOD-Extension: The medical record lacks a clear statement that metastatic workup was complete. A metastatic deposit is identified within 4 months of diagnosis and while the patient is undergoing first course of treatment. How do you code the EOD-Extension field? |
For cases diagnosed 1998-2003: In coding the EOD-Extension field, ignore metastasis that is discovered after the initial workup is completed regardless of the timeframe from diagnosis date until the date the metastatic deposit was discovered. The metastasis is progression of disease. Any of the following represents progression of disease. Do not code the subsequently identified metastatic involvement in the EOD: 1) The metastatic workup was complete and treatment started before the procedure was done that found the metastatic involvement. 2) A procedure, such as a scan, was negative initially and a repeat of that procedure is now positive. 3) The treatment plan is developed for a localized disease process. If you are unable to determine whether the newly discovered metastasis represents progression or is part of the initial workup, regard the metastasis as progression. Do not code the metastasis in the EOD-Extension field. |
N/A | N/A | 2002 |
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