CS Site Specific Factor 6--Breast: Can we interpret the in situ component as "minimal" when the pathology report states "1.1 cm infiltrating duct carcinoma and no extensive intraductal component"?
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.
Yes. Based on the information provided above, the in situ component is "mininmal" for the purpose of coding Breast CS Site Specific Factor 6. The phrase "no extensive intraductal component" suggests that there is some intraductal carcinoma present.
MP/H Rules/Histology--Thyroid: How is histology coded for a thyroid tumor described as "predominantly papillary carcinoma, tall cell variant, follicular type"?
For cases diagnosed 2007 or later, assign code 8340 [Papillary carcinoma, follicular variant] according to rule H15 for Other Sites.
"Predominantly" and "type" indicate specific histologies. "Variant" does not. See rule H13. The histology in this case is papillary and follicular. Tall cell variant is ignored.
Diagnostic confirmation: When a CT guided Fine Needle Aspiration is performed and the pathology report indicates smears and cell block were prepared, if the diagnosis is positive for cancer, can you code diagnostic confirmation as 2 (positive cytology) because of the cell block?
Yes, assign diagnostic confirmation code 2 for diagnosis based on smears and cell block from CT guided FNA. This reply pertains to solid tumors.
Histology (Pre-2007)--Breast: Is histology coded from the more representative specimen or should the combination code 8522/3 [Infiltrating duct and lobular carcinoma] be used for a case in which a right breast mass needle core biopsy revealed infiltrating ductal ca, grade III and the subsequent right mastectomy revealed a 2.3 cm lobular carcinoma?
For tumors diagnosed prior to 2007:
Code the histology using the final diagnosis on the pathology report of the procedure that resected the majority of the primary tumor. In this case, the mastectomy removed more of the tumor than the needle biopsy. The final diagnosis from the mastectomy is infiltrating lobular carcinoma. Code histology to 8520/3 [lobular 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.
CS Lymph Nodes--Breast: What code should be used for the the following? There is no mention of LNS clinically; the patient has neoadjuvant therapy; and the LNS are matted pathologically.
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.Use the information from the pathologic evaluation to code CS Lymph nodes.
In the nodes evaluation field, assign code 6 [Regional lymph nodes removed for examination with pre-surgical systemic treatment or radiation and lymph node evaluation based on pathologic evidence]. See CS Lymph Nodes note 4.
Histology (Pre-2007): Is histology for an anorectal biopsy of "Cloacogenic carcinoma (squamous cell carcinoma with basaloid features)" coded to 8124/3 [Cloacogenic carcinoma] or 8083/3 [Basaloid squamous cell carcinoma]?
For tumors diagnosed prior to 2007:
Code histology to 8124/3 [Cloacogenic carcinoma]. These are squamous cell carcinomas of basaloid type that are found in the cloacogenic (transitional) zone of the anal canal.
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.
Grade, Differentiation--Bladder: If the only indication of grade for a bladder primary is "grade 2, NOS," and we do not know the grading system being used by the pathologist, is the numeric grade 2 coded?
See the General Coding Rules on page 92 of the 2004 SEER Manual for instructions about coding grade.
If the only information available is "Grade 2," assign code 2 [Grade II].
Primary site--Melanoma: Should melanoma of the nipple be coded to C50.0 [Nipple] or C44.5 [Skin of the trunk]?
Code to C44.5 [skin of trunk]. External melanoma is an epidermal malignancy, beginning in melanocytes in the basal layer of the epidermis. C50.0 excludes skin of breast.
Histology--Heme & Lymphoid Neoplasms: How is histology to be coded for acute lymphoblastic leukemia (ALL) and/or precursor B acute lymphoblastic leukemia (Pre-B ALL) for cases diagnosed 2010 and later? The Heme Database has two histology codes for this disease, both 9811/3 and 9836/3, which is the correct histology code?
Code histology to 9811/3 [B lymphoblastic leukemia/lymphoma, NOS].
See the Abstractor Notes section in the Heme DB, when determining how to code histology for a case. It indicates the code 9811/3 is effective for cases diagnosed 2010 and forward. The 9836/3 is listed as obsolete and refers you to code 9811/3. Make sure to check for a specific subtype of B lymphoblastic leukemia/lymphoma [9812/3 - 9818/3] before assigning the NOS code [9811/3].
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.
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