Reportability/Behavior Code--Melanoma: If a dermatologist states a "proliferation of atypical melanocytes confined to epidermis" is melanoma in situ, is it reportable to SEER?
For this case only, it is reportable to SEER because the physician states that it isĀ "melanoma in situ."
The phrase "proliferation of atypical melanocytes confined to epidermis" alone is not reportable to SEER. This phrase means that there are a number of (proliferation) pigmented cells (melanocytes) not showing the normal cell structure (atypical).
Code histology to 9732/3 [multiple myeloma]. The plasmablastic subtype/variant does have a prognostic indication, but the disease is still coded as multiple myeloma.
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.
EOD-Extension--Kidney: How would this field be coded when the pathology report shows a 20 mm surface neoplasm with smaller yellow metastatic implants on the surface of the kidney?"
For cases diagnosed 1998-2003: Code extension as 10 [Invasive cancer confined to kidney cortex]. Tumor involves the cortical surface of the kidney with separate surface lesions, but does not extend beyond cortex.
Histology (Pre-2007)--Breast: What code is used to represent the histology "Ductal carcinoma in situ; 6 mm focus of invasion is a pure mucinous carcinoma that appears to have arisen in the background of encysted papillary carcinoma."
Code to mucinous (8480) since that is the only clearly invasive component of this diagnosis.
According to our pathologist consultant, "Encysted papillary carcinoma is the same thing as intracystic papillry carcinoma, which I think of as an intraductal papillary carcinoma which has greatly expanded the duct to form a cyst-like structure. It generally behaves in an in-situ rather than an invasive fashion. The only clearly invasive component is the mucinous carcinoma, which is what I would code."
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).
Histology (Pre-2007)--Melanoma: How is a 2004 "malignant melanoma, nodular type, epithelioid cell type" coded?
For tumors diagnosed prior to 2007:
Assign code 8771 [Epithelioid cell melanoma]. Code the cell type when specified.
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.
Reportability--Brain and CNS: Is a skull tumor schwannoma an intracranial reportable benign tumor if the physician states it arose in the occipital nerve?
No. These schwannomas are not intracranial and therefore, are not reportable to SEER. The occipital nerve is not one of the 12 intracranial nerves (i.e., Abducens, Auditory (vestibulocochlear), Facial, Glossopharyngeal, Hypoglossal, Oculomotor, Olfactory, Optic, Spinal Accessory, Trigeminal, Trochlear, and Vagus).
Grade, Differentiation--Bone Marrow: Can we use the AJCC Cancer Staging Manual, which lists myeloma as a B cell neoplasm under non-Hodgkin lymphomas, to code Grade, Differentiation field for myeloma to B-cell (code 6)?
For cases diagnosed prior to 1/1/2010:
No. Myeloma is a malignancy of plasma cells. Plasma cells are the daughters of B cells. So technically it would be correct to call them B cell, but that is not common usage.
Cell marker (phenotype) should be coded in the Grade, Differentiation field for only leukemias and lymphomas, as classified in the ICD-O-3. In the ICD-O-3, myeloma is listed under Plasma Cell Tumors, not Lymphomas. When a cell marker is coded for a leukemia/lymphoma it should be coded only from pathology and/or cytology reports.
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.
Date Multiple Tumors--Prostate: For a prostate biopsy done 10/20/08, both lobes involved with tumor, unknown how many tumors, what would be coded in date of multiple tumors?
In this case, code the date of the biopsy in Date of Multiple Tumors [10202008]. When the number of tumors is unknown, code the date of diagnosis as the Date of Multiple Tumors. This is the date on which it was determined that there were an unknown number of tumors. This instruction will be added to next edition of the MP/H manual.
Reportability--Brain and CNS: Is schwannoma of the extracranial part of a cranial nerve reportable? Some cranial nerves, like facial nerve, have intracranial and extracranial branches.
An extracranial schwannoma is not reportable. The schwannoma must arise on the intracranial part of the nerve to be reportable.