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This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Site Specific Factor 4 captures the status of clinical apex involvement and prostatectomy apex involvement. The first digit in codes 110-550 indicates the clinical status of apex involvement. The second digit indicates apex involvement found at prostatectomy. The third digit is always zero. For both first and second digits, the codes and definitions are the same:

1 - No involvement of prostatic apex

2 - Into prostatic apex/arising in prostatic apex, NOS

3 - Arising into prostatic apex

4 - Extension into prostatic apex

5 - Apex extension unknown

Code 150 = No clinical involvement of prostatic apex & prostatectomy apex extension unknown

Code 510 = Clinical involvement of prostatic apex unknown & No prostatectomy apex extension

Code 550 = Clinical involvement of prostatic apex unknown & prostatectomy apex extension unknown

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

Per PH27, code the primary site to C809 [unknown]. Rule PH27 states one is to code the primary site to unknown [C809] when there is no evidence of lymphoma in lymph nodes AND the physician documents in the medical record that he/she suspects that the lymphoma originates in an organ(s) OR there is multiple organ involvement without any nodal involvement.

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.

For tumors diagnosed prior to 2007:

Code this case as two primaries, an invasive true vocal cord primary in 1998 and another invasive true vocal cord primary in 2001.

If there had been no statement of recurrence for the 1999 in situ diagnosis and the 1999 diagnosis was more than two months following the 1998 diagnosis, this case would be coded as three primaries.

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.

For cases diagnosed prior to 1/1/2010:Assign code 9755 [Histiocytic sarcoma; True histiocytic lymphoma]. "Histiomonocytic" is not standard terminology, according to our expert consultant. However, 9755 is the best code to assign.

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.

Assign 8570/3 to adenocarcinoma with squamous differentiation of the endometrium. The most recent WHO classification does not list "adenocarcinoma" for tumors of the uterine corpus. WHO does state that "endometroid carcinoma of the usual type is a glandular neoplasm..." Further, WHO states "Endometroid carcinoma typically displays a glandular or villoglandular architecture..." Based on the WHO classification, the use of the term "adenocarcinoma" in this context can be interpreted as endometroid carcinoma.

Yes. Determine whether there is, in fact, at least a portion of axillary tissue present. If axillary lymph nodes (not internal mammary nodes) are present in the specimen, code the Surgery of Primary Site field to 51 [Modified Radical Mastectomy WITHOUT removal of uninvolved contralateral breast]. If there are no axillary lymph nodes present in the specimen, code the Surgery to Primary Site field to 41 [Total (simple) mastectomy WITHOUT removal of uninvolved contralateral breast].

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

No. Polycythemia, NOS is not reportable.

Polycythemia (also known as polycythaemia or erythrocytosis) is a disease state in which the proportion of blood volume that is occupied by red blood cells increases. Blood volume proportions can be measured as hematocrit level. It can be due to an increase in the mass of red blood cells, "absolute polycythemia"; or to a decrease in the volume of plasma, "relative polycythemia".

The phlebotomy is a treatment for the excessive blood volume; therefore, a diagnosis of "polycythemia" without one of the modifying terms listed in the Heme DB under Alternative Names is not reportable.

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.

Code to pleura, C384.

Per the Hematopoietic database, Diffuse Large B-Cell Lymphoma can originate in the pleural cavity.

Assign margin status as “positive” when stated as approximates margins as recommended by our expert pathologists. Approximating means coming right up to inked margin without the margin transecting the tumor.