| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20200083 | Reportability/Histology--Kidney: Is hybrid oncocytic chromophobe tumor reportable for cases diagnosed 2021 and later? If so, how is the histology coded? See Discussion. |
The ICD-O-3.2 Coding Table includes hybrid oncocytic chromophobe tumor as a related term for histology code 8317 (Renal cell carcinoma, chromophobe type). However, this related term is not discussed in the implementation guidelines as being a new term/reportable tumor. The Solid Tumor Rules do not indicate a hybrid oncocytic chromophobe tumor is reportable; however, if a registrar only looked at the ICD-O-3.2 Coding Table, it may seem as though this histology should be collected. The term hybrid oncocytic chromophobe tumor was not included in the Solid Tumor Rules as a subtype/variant of RCC, or as an equivalent term for chromophobe RCC. There is a SINQ (20180047) that states not to report renal hybrid oncocytic tumor, despite the fact these tumors exhibit mixed features of both oncocytoma and chromophobe RCC. For cases diagnosed 2021 and later, should the clarification in the SINQ apply? Or should the ICD-O-3.2 Coding Table be used which indicates this is a reportable diagnosis? If the standard setters decided not to implement use of hybrid oncocytic chromophobe tumor for 2021, can clarification be added to the Solid Tumor Rules or Implementation Guidelines? This question was prompted from preparing SEER*Educate coding exercises. We will use the answer as a reference in the rationales. |
Hybrid oncocytic chromophobe tumor is listed in ICD-O-3.2 as 8317/3 which indicates it is reportable if diagnosed in 2021 or later. For cases diagnosed 1/1/2021 and later, use ICD-O-3.2 for reportability. See page 16 of the NAACCR 2021 Implementation Guidelines. Between publication of ICD-O-3.2 and updates made to solid tumor histology tables, additional terms were added based on review by the IARC ICD-O committee. These changes were not made available in time to correct the tables. All related terms or synonyms may not be included in the histology tables and ICD-O-3.2 should be used in tandem with the solid tumor rules. |
Kidney, renal pelvis | Histology | 2020 |
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20180047 | Reportability--Kidney: Is a hybrid oncocytic tumor reportable? See Discussion. |
10/27/2017 partial nephrectomy final path diagnosis: renal oncocytic neoplasm, favor hybrid oncocytic tumor. Comment: |
Do not report renal HTOC. According to our expert pathologist consultant, "the genetic studies seem to indicate that the chromosomal changes of chromophobe renal carcinoma are not found in the hybrid tumors." |
Kidney, renal pelvis | N/A | 2018 |
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20110099 | Primary site--Heme & Lymphoid Neoplasms: How is primary site coded for bilateral pelvic lymph node involvement for lymphoma primaries? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. The PH rules for coding lymphomas (Module 7) refer to a lymph node region as defined by the ICD-O-3. Per the Appendix C, , the ICD-O-3 lymph node region for "pelvic" is C775. In this case, there is one lymph node region involved (bilaterally). Per Rule PH20, code the specific lymph node region when multiple lymph nodes within the same lymph node region (as defined by the ICD-O-3) are involved, C775. Per Note 1 under Rule PH20, use this rule when there is bilateral involvement of lymph nodes. This same table in Appendix C also provides information on how left and right pelvic lymph nodes are categorized by AJCC for purposes of coding stage. If the left and right pelvic lymph nodes are positive for lymphoma, it is involvement of two regions. The case is coded as Stage II. Keep in mind that the ICD-O-3 definition of regions is used to code the primary site, while the AJCC definition of regions is used to code stage. 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. |
Heme & Lymphoid Neoplasms | Primary site | 2011 | |
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20130084 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient is diagnosed on a 3/16/12 lymph node biopsy with diffuse large B-cell lymphoma which was followed on 4/18/12 with bone marrow biopsy diagnosis of follicular lymphoma? See Discussion. | The patient has extensive right-sided cervical, supraclavicular, hilar, mediastinal and gastrohepatic adenopathy. A cervical node biopsy on 3/16/2012 showed DLBCL. On 04/18/2012 a bone marrow biopsy showed follicular lymphoma. The patient was started on CHOP/Rituxan after the bone marrow biopsy. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case is accessioned as a single primary, diffuse large B-cell lymphoma [9680/3] per Rule M12. Abstract the acute neoplasm (DLBCL) when a patient is originally diagnosed with an acute neoplasm and the neoplasm reverts to the chronic neoplasm (follicular lymphoma) AND the patient has not been treated for the acute neoplasm.
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. |
Heme & Lymphoid Neoplasms | N/A | 2013 |
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20130086 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient is diagnosed in 2008 with chronic myeloid leukemia, chronic phase and is subsequently diagnosed with both accelerated phase (2010) and blast crisis of CML (2012)? See Discussion. | Patient diagnosed in 1/2008 with CML, Chronic phase and had a complete remission following treatment.
In 3/2010 the patient was diagnosed with CML, Accelerated phase and again had a complete remission following treatment.
In 02/2012 the patient was diagnosed with CML, Blast crisis.
How do chronic and acute neoplasms (Rules M8 - M13) relate to histologies that are stated to have Chronic, Accelerated and Blast phases per the Heme DB? These histologies don't change, does this mean Rules M8 - M13 do not apply because there isn't a change in histology? How many primaries should be accessioned in this case? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case is accessioned as a single primary, chronic myeloid leukemia, NOS [9863/3] diagnosed 01/2008 per Rule M2. The patient was diagnosed with CML, NOS [9863/3] in 2008 and again in 2010 and 2012. Abstract a single primary when there is a single histology.
CML, Chronic phase; CML, Accelerated phase; and CML, Blast phase (Blast crisis) are listed under the Alternate Names section for CML, NOS in the Heme DB.
Not all histologies have transformations. If a transformation is not listed in the Heme DB, Rules M8 - M13 do not apply.
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. |
Heme & Lymphoid Neoplasms | N/A | 2013 |
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20130091 | Treatment, NOS--Heme & Lymphoid Neoplasms: Which guidelines are used to code treatment for hematopoietic diseases diagnosed prior to 2010? | For cases diagnosed 1/1/2010 and later, use the Hematopoietic & Lymphoid Neoplasm Manual for instructions on coding aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."
For cases diagnosed 5/1/2002 12/31/2009, use the instructions in the SEER Manual and the instructions in "Abstracting and Coding Guide for the Hematopoietic Diseases" to code aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."
For cases diagnosed 1/1/2001 04/30/2002 use the instructions in the SEER Manual for collection of aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."
Prior to 1/1/2001, these treatment modalities were not collected. |
Heme & Lymphoid Neoplasms | N/A | 2013 | |
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20100046 | Heme & Lymphoid Neoplasms: Is a clinical remission sufficient to change the tumor status to "disease free" for a patient on long-term chemotherapy for a diagnosis of either a chronic hematologic disease, such as CML, or a myeloproliferative disorder, such as essential thrombocythemia? See Discussion. |
For some patients with chronic hematologic diseases, the disease/recurrence status could change frequently as chemotherapy is started and stopped over an extended period of time. Should the tumor status for these cases always be "not disease free"? When the physician documents the patient is in clinical remission, does their status change to "NED or disease free?" There seems to be a lot of variation across the US in how registrars are coding this field. Clarification would be appreciated. |
The term "disease free" is not used in a standard fashion for hematopoietic and lymphoid neoplasms.
Code the cancer status to free of disease when the physician indicates NED. For hematopoietic and lymphoid neoplasms, a physician's statement of NED, disease-free, clinical remission or no evidence of disease at this time, should be recorded with cancer status to disease free. The term "disease free" or NED means that there is no clinical evidence of disease. |
Heme & Lymphoid Neoplasms | N/A | 2010 |
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20100104 | Grade--Heme & Lymphoid Neoplasms: Is the phrase "aberrant T-cell expression" enough to code the grade field to T-cell when the final diagnosis on the pathology report is "AML with aberrant T-cell antigen expression"? | Yes. Code grade to 5 [T-cell]. The T cell receptor, or TCR, is a molecule found on the surface of T lymphocytes (or T cells). | Heme & Lymphoid Neoplasms | N/A | 2010 | |
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20110105 | Multiple primaries/Histology--Heme & Lymphoid Neoplasms: How many primaries should be reported for a bone marrow biopsy diagnosis of "lymphoproliferative disorder, small cell lymphocytic lymphoma/small cell lymphocytic leukemia consistent with marginal zone lymphoma"? | According to our hematopoietic/lymphoid neoplasm physician expert, abstract one primary with the histology code 9699/3 [marginal zone lymphoma]. The pathologist is using the expression "small lymphocytic lymphoma" in a descriptive manner (marginal zone lymphoma is comprised of small lymphocytes) rather than in a "diagnostic" manner. | Heme & Lymphoid Neoplasms | N/A | 2011 | |
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20110065 | Multiple primaries/Histology--Heme & Lymphoid Neoplasms: How many primaries are to be abstracted when a skin (right thigh) biopsy is consistent with mycosis fungoides (cutaneous T-cell lymphoma)? See Discussion. | Applying rule M15 (multiple primaries calculator) indicates this is two primaries. Is this correct? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the primary site to C447 [skin of lower limb] and code histology to 9700/3 [mycosis fungoides]. he pathologist wrote in parentheses that this was cutaneous (i.e. primary site is skin) and that it is a T-cell lymphoma (mycosis fungoides is a T-cell lineage). So the parenthetical statement was not a separate diagnosis; rather a general classification of the mycosis fungoides. "CTCL" is listed under the Alternate Names section of the Heme DB. CTCL is an abbreviation for cutaneous T-cell lymphoma. CTCL is a synonym for mycosis fungoides. This is a single primary per M2 which states to abstract a single primary when there is a single histology.
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. |
Heme & Lymphoid Neoplasms | Histology | 2011 |
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