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Report Produced: 10/07/2026 09:43 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20031176 EOD-Patholgic Review of Number of Regional Lymph Nodes Examined: How is this field coded when there is no lymph node count in the final pathology diagnosis and the gross description states "four possible lymph nodes are dissected"? See Description. Patient with kidney cancer underwent nephrectomy and lymph node removal. Final path diagnosis was Lymph nodes, pericaval biopsy, lymph nodes with no evidence of carcinoma. Per Gross description: Received in formalin as pericaval lymph node is 2.5 cm piece of fibrofatty tissue, from which four possible lymph nodes are dissected. For cases diagnosed 1998-2003: Code the number of regional lymph nodes examined as 04. This is as accurate as possible for this situation. N/A N/A 2003
20110055

Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are to be abstracted for a bone marrow biopsy diagnosis of "acute myeloid leukemia (non-M3 type; favor FAB M1), probably arising in myelodysplastic syndrome;" and flow cytometry studies performed the same day were consistent with acute myeloid leukemia?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Ambiguous terminology is NOT used to determine histology for hematopoietic or lymphoid neoplasms. Therefore, the comment that the AML is "probably" arising in myelodysplastic syndrome is not used to determine the histology code. The term "favor" is also an ambiguous term and cannot be used to code histology.

This is a single histology per M2, abstract a single primary when there is a single histology. The histology is coded to 9861/3 [acute myeloid leukemia, NOS]

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 2011
20051094 Grade, Differentiation/Priorities: Which has priority, the differentiation or the nuclear grade for a liver biopsy histology described as "well differentiated hepatocellular carcinoma, nuclear grade 3/4"? For most sites, differentiation has priority over the nuclear grade when both are specified (excluding breast and kidney). Assign grade code 1 [well differentiated] to the example above. N/A N/A 2005
20031023 Grade, Differentiation: Can differentiation be coded from the pathology report for a biopsy from tissue involved by local recurrence? Code grade from original primary site. Do not code grade from a local recurrence. N/A N/A 2003
20081015

MP/H Rules/Multiple primaries--Lung: Should a subsequent primary be abstracted using rule M8 for a patient diagnosed in January 2000 with adenocarcinoma of the right upper lung if the patient initially sought alternative therapies and presented in September 2007 for a right upper lobe lung mass with extension into the mediastinum, mediastinal lymph node mets and a pericardial effusion? See Discussion.

After more than seven years, the patient in this case decided to proceed with the originally suggested standard therapy. Is this a multiple primary case because the tumors are "diagnosed" more than 3 years apart? Or should we assume this is further progression of the 2000 case because it was originally only treated with alternative therapies? The clinician in this case indicates the patient is being referred for treatment to the right upper lung originally diagnosed in 2000.

For cases diagnosed 2007 or later:

Do not abstract a 2007 primary for this case. From the information provided, there is disease progression/extension and lymph node metastasis in 2007; but there are no new lung tumors in 2007. Therefore, the 2007 MP/H rules do not apply.

 Lung N/A 2008
20230031

Solid Tumor Rules/Multiple Primaries--Lung:  How many primaries and what M Rule applies to a 2022 diagnosis of right upper lobe non-small cell lung carcinoma (NSCLC) when the patient has a history acinar adenocarcinoma in the right lower lobe of the lung in 2020, followed by squamous cell carcinoma in the right middle lobe of the lung in 2021? See Discussion.

The patient was not synchronously diagnosed with multiple tumors, but three separate tumors with three different histologies were diagnosed at different times and no more specific histology was provided for the NSCLC. The timing rules do not apply to this case (the tumors were not greater than 3 years apart and they were not synchronously/simultaneously diagnosed).

While NSCLC is a NOS histology for both adenocarcinoma and squamous cell carcinoma, it is unclear if Rule M8 should apply because NSCLC is not listed in Table 3 (Table 3 is not an exhaustive list). In some situations, Rule M8 would apply if the tumors were different histologies and one of the histologies was not listed in the Table. Does that logic still apply if one of the tumors is NSCLC? If NSCLC is excluded from Rule M8, is Rule M14 the appropriate M Rule for the 2022 NSCLC diagnosis?

The patient's previous acinar adenocarcinoma in the right lower lobe of the lung in 2020 and squamous cell carcinoma in the right middle lobe of the lung in 2021 were correctly abstracted as two primaries per rule M8 as they are in different rows in Table 3. The NSCLC, RUL (8046) diagnosed in 2022 would not be abstracted as a third primary because NSCLC is a broad category which includes all histologies in Table 3 (except for small cell carcinoma/neuroendocrine tumors (NET Tumors) 8041 and all subtypes), and because it was diagnosed less than 3 years after the 2021 squamous cell carcinoma, RML (8070).

 Lung N/A 2023
20041011 EOD-Clinical Extension--Prostate: Should this field be coded to 15 [Tumor identified by needle biopsy for elevated PSA] or 30 [Localized, NOS] when the only information is from a biopsy positive pathology report that includes the clinical history of "PSA elevated, DRE negative," with no mention of an ultrasound being performed?

For cases diagnosed 1998-2003: For this scenario, assign code 15 if an ultrasound was not performed, performed and negative, or when it is unknown whether or not an ultrasound was performed. Assign code 30 only if an ultrasound was performed and there is no documentation stating that it was negative or positive.

Please refer to the Prostate EOD Coding Guidelines for all of the instructions pertaining to the coding of prostate EOD.

 Prostate N/A 2004
20031208 EOD-Extension--Corpus uteri: How should EOD extension be coded when the pathology report shows adenocarcinoma arising in the endometrium with the statement "no invasive carcinoma identified?" For cases diagnosed 1998-2003: Code endometrial cancer with no invasion to EOD extension code 11 [Confined to endometrium (stroma)]. "No invasion" most likely means no invasion of the myometrium. Corpus uteri N/A 2003
20061093 Ambiguous Terminology--Breast: Is a stereotactic biopsy that is "focally suspicious for DCIS" reportable if it is followed by a negative excisional biopsy? See Discussion.

Per the 2004 SEER manual page 4, 1.a, the case is reportable based on the ambiguous term "suspicious" for DCIS.

Per the 2004 SEER manual page 4, 1.c, use these terms when screening diagnoses on pathology reports, operative reports, scans, mammograms, and other diagnostic testing other than tumor markers.

Note: If the ambiguous diagnosis is proven to be not reportable by biopsy, cytology, or physician's statement, do not accession the case.

 Do not accession this case. The needle localization excisional biopsy was performed to further evaluate the suspicious finding found on stereotactic biopsy. The suspicious diagnosis was proven to be false. Breast N/A 2006
20071044

Date of Conclusive Terminology: Is there an applicable timeframe when coding this field?

There is no strict timeframe for Date of Conclusive Terminology. The diagnosis using conclusive terminology could be made any time following the diagnostic work-up.

The date of conclusive terminology is related to code 2 [ambiguous term followed by conclusive term] in the data item "Ambiguous terminology." Assign code 2 when a conclusive diagnosis is made 60 days or more after a diagnosis using ambiguous terminology. Record the date of the conclusive diagnosis in "Date of Conclusive Terminology."

 N/A N/A 2007