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Report Produced: 10/07/2026 06:01 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20000511 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: What codes are used to represent these fields when only a regional lymph node (positive) aspiration is performed?

For cases diagnosed 1998-2003:

With the exception of those sites/histologies that require 99 in these fields, code the Number of Regional Lymph Nodes Positive field to 97 [Positive nodes but number of positive nodes not specified]. Code the Number of Regional Lymph nodes Examined field to 95 [No regional Lymph nodes removed, but aspiration of regional Lymph nodes was performed].

 N/A N/A 2000
20180097

Reportability/Histology--Liver: Are primary hepatic neuroendocrine neoplasm and primary hepatic neuroendocrine tumor (PHNET) reportable? What are the specific histology codes?

Primary hepatic neuroendocrine tumor (PHNET) is reportable as are other digestive system NETs. There is no specific histology code for PHNET. We suggest you assign 8240/3. Use text fields to document the details.

Unless you can obtain clarification, do not report primary hepatic neuroendocrine neoplasm with no further information. If this term is being used as a synonym for PHNET, document this in the registry's policies and procedures, and report these cases.

 N/A Histology 2018
20021101 Histology (Pre-2007)/Grade, Differentiation--All Sites: How do we code these fields for a tumor that is predominantly a "well differentiated liposarcoma" [8851/31] that has a less predominent type of "dedifferentiated liposarcoma" [8858/33]? If we code the predominant cell type [8851/3] and the worst grade [3], the case will not pass edits because well-differentiated liposarcoma requires a differentiation code of 1. See discussion. Example: Dedifferentiated liposarcoma, with the following features: size 22 cm, FNCLCC grade 3 of 3 [high grade]. Path comment: The tumor consists of predominantly well-differentiated sclerosing subtype liposarcoma and areas of high grade spindle cell (non-lipogenic) sarcoma. The area of high grade spindle cell sarcoma measured up to 7.5 cm.

For tumors diagnosed prior to 2007:

Code the Histology field to 8858/33 [Dedifferentiated liposarcoma, grade 3]. The pathologist gives a final designation of Dedifferentiated liposarcoma and then provides further details in the comment that do not negate the final designation.

Grade is usually coded independent of the cell type. There are a few Catch-22 situations, like this one, in which the grade is built into the name of the cell type.

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 2002
20150035

Primary site--Anus/Anal Canal: What site do you code squamous cell carcinoma of the anal verge?

Assign C211 for anal verge. Anal verge is defined as the lower (distal) end of the anal canal, junction between the skin of the anal canal and the perianal skin, http://www.seer.cancer.gov/manuals/2015/AppendixC/rectosigmoid/coding_guidelines.pdf

N/A Primary site 2015
20031151 EOD-Size of Primary Tumor: Can size be coded from a needle bx that removes all of the invasive tumor and just leaves a "focus of in situ"? See Description. For example: needle bx diagnosis is "tiny focus of tissue highly suspicious for tubular ca." The lumpectomy path states "single focus of low grade DCIS, no residual ductal ca." Can size be coded 001? Code tumor size to 001 [Microscopic focus or foci only] for the invasive component. Code the tumor size 990 for cases diagnosed in 2004 and forward. Disregard the microscopic tumor found at further resection. N/A N/A 2003
20160047

Reportability--Eye: Is conjunctival intraepithelial neoplasia (CIN III) from an excision of the left eye conjunctiva reportable?

Conjuctival intraepithelial neoplasia grade III (CIN III) is reportable. Intraepithelial neoplasia, grade III, is listed in ICD-O-3 as /2. It is reportable for sites other than skin.

N/A N/A 2016
20160053

MP/H Rules/Histology: How is the histology coded for an invasive adenocarcinoma arising in a papilloma with high-grade dysplasia? See Discussion.

Patient has a perihilar bile duct primary with a microscopic focus of invasive moderately differentiated adenocarcinoma arising in a large papilloma. The MP/H Rules do not address adenocarcinomas arising in a papilloma, only adenocarcinomas arising in an adenoma (or polyp). Should the histology be coded as 8140 for the invasive adenocarcinoma component? Or should the matrix principle be applied and the histology coded as a malignant glandular papilloma (8260/3)?

Assign 8503/3 for invasive adenocarcinoma arising in a papilloma with high-grade dysplasia, perihilar bile duct primary. Neither ICD-O-3 nor the WHO classification have a code for this specific histology; however, our expert pathologist consultant states 8503/3 is the best available choice based on pages 264 and 273 in the WHO Digestive system classification.

N/A Histology 2016
20000515

Multiple Primaries (Pre-2007)--Ovary/Endometrium: Is endometrioid adenocarcinoma occuring simultaneously in the left ovary and the endometrium one primary or two? See discussion.

Pathology Final Diagnosis:

Left Ovary: Moderately differentiated endometrioid adenocarcinoma squamous differentiation grade 2 (scale of 3)

Uterus: Moderately differentiated endometrioid adenocarcinoma with squamous differentiation, grade II (scale of III). Focal, very superficial invasion to inner third myometrium with extension to lower uterine segment. Endocervix, cervix, right ovary and fallopian tubes negative for tumor.

For tumors diagnosed prior to 2007:

Code the case you describe as two primaries. The endometrioid adenocarcinoma can arise in the endometrium without a concomitant ovarian 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.

 N/A Histology 2000
20210070

Histology/Reportability--Digestive System: Is “neuroendocrine neoplasm” reportable?  See Discussion.

We are confused by SINQs 20180097, 20150001, and 20140051.  The latter two indicate that “well-differentiated neuroendocrine neoplasms” of the duodenum and appendix are reportable because they’re synonymous with neuroendocrine tumor (NET).  Yet 20180097 states “primary hepatic neuroendocrine neoplasm” is NOT reportable unless there is documentation that it’s being used as a synonym for Primary Hepatic Neuroendocrine Tumor (PHNET).  In addition, we see in the 2021 ICDO-3.2 update that only “poorly differentiated neuroendocrine neoplasm” is listed with behavior code /3 and noted to be reportable for 2021+ on the companion annotated histology list.  Does reportability of neuroendocrine neoplasms depend on primary site, differentiation terminology within the histology name, or something else?  Our casefinding staff is hoping for a general reportability guideline to follow when they come across “neuroendocrine neoplasms” NOS.  For example, we have a 2020 pathology report for a core biopsy of a soft tissue pelvic mass with final diagnosis of low grade neuroendocrine neoplasm; there is no further clarification as to whether it is felt to be primary or metastatic, and we have no other associated records for this patient in our central registry.

Reportability of neuroendocrine neoplasms depends on primary site, terminology, and differentiation. "Neuroendocrine neoplasm" is an umbrella term for a variety of neuroendocrine tumors and carcinomas.

Neuroendocrine neoplasm, not otherwise specified (NEN, NOS) is not reportable as in your example unless it is being used as a synonym for neuroendocrine tumor (NET), as with digestive system tumors.  According to WHO Classification of Digestive System Tumors, 5th ed., NENs of the appendix and liver are epithelial neoplasms with neuroendocrine differentiation, including well-differentiated tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs).

The guidance in SINQ 20180097, 20150001, and 20140051 is still valid.

 N/A Histology 2021
20220022

Tumor Size--Pathologic--Anus: In 2019, the pathology report of an anal canal squamous cell carcinoma stated the tumor size is 2.5 cm from proximal to distal (3.5 cm in circumference).  Is the pathologic tumor size tumor size 025 or 035? 

Based on the information provided, code the tumor size as 035.  We asked an expert pathologist to review this question and she said to use the larger measurement.  She also said "the pathologist usually cuts the anus and rectum open like a tube; the “circumference” would be measured flat."

 N/A Tumor size 2022