Reportability--Brain and CNS: Is benign neural tissue compatible with a glioneuronal hamartoma of the cerebellopontine angle reportable?
No. A glioneuronal hamartoma is not neoplastic and not reportable. See page 2 of the 2004 SEER Program Coding and Staging manual for the list of reportable brain/CNS tumors. There is no ICD-O-3 code for hamartoma.
Reportability--Skin: Is this case not reportable if the intranasal polyp is covered with cutaneous epithelium (essentially skin) or, is it reportable as a primary intranasal basal cell carcinoma? I have found one article regarding primary intranasal basal cells, which are described as being "very rare". But, I am not sure whether, in those cases, cutaneous epithelium was found.
FINAL DIAGNOSIS: (A) Nasal cavity, polyp, excision: Sinonasal inflammatory polyp with overlying cutaneous epithelium showing foci of superficial (noninvasive) basal cell carcinoma
Report this case as a basal cell carcinoma, noninvasive, of the nasal cavity, based on the information provided.
The polyp was removed from the nasal cavity (C300) which is a reportable site for basal cell carcinoma.
MP/H Rules/Histology--Breast: How is histology coded for an "infiltrating papillary carcinoma" of the breast when there is no mention of ductal or adenocarcinoma in the pathology report?
For cases diagnosed 2007 or later, assign histology code 8503 [Papillary adenocarcinoma]. Rule H14 applies.
ICD-O-3 code 8050 does not apply in this case. Refer to the numeric listing in ICD-O-3. 8050 is a squamous cell neoplasm. Papillary carcinoma of the breast is NOT a squamous cell neoplasm. It is a neoplasm of the breast parenchyma - ducts, lobules or connective tissue. 8503 is the correct code in this case.
Diagnostic confirmation--Heme & Lymphoid Neoplasms: Is Diagnostic Confirmation coded as 5 (positive laboratory test/ marker study) or code 8 (clinical diagnosis only) for a case that has a positive JAK2 mutation, and based on the results of the JAK2, the physician diagnosed the patient with polycythemia vera? There were no blood smears or bone marrow biopsies done.
Assign diagnostic confirmation code 5 for a positive laboratory test/marker study. A note was added to the Hematopoietic manual to state that code 5 now includes cases with no histological confirmation but there is positive immunophenotyping or genetic studies.
Reportability--Brain and CNS: Are spinal schwannomas and neurofibromas reportable or non-reportable?
The most accurate and most current instruction is to report these spinal tumors when they arise within the spinal dura or spinal nerve roots, or when they are stated to be "intradural" or "of the nerve root." Do not report these tumors when they arise in the peripheral nerves. The peripheral nerves are the portion of nerve extending beyond the spinal dura.
EOD-Extension--Lymphoma: Would a lymphoma involving mesenteric and retroperitoneal nodes (both site code C77.2) be coded to extension 10 [Involvement of a single lymph node region; Stage I], based on the fact that while more than one "chain" is involved only one "region" is involved?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 20 [Involvement of two or more lymph node regions on the same side of diaphram]. The AJCC lists mesenteric as a core nodal region, but does not list retroperitoneal lymph nodes as a part of this region, so retroperitoneal is a separate region.
The EOD staging scheme for lymphoma uses lymph node REGIONS as the criteria for assigning the extension code. Use the AJCC Cancer Staging Manual as the definitive source for classifying lymph node regions, not the ICD-O-3. If it is a separate LN region per the AJCC, it is coded in the EOD as a separate region.
According to the AJCC curator, the nodal regions are defined in Kaplan's book on Hodgkin disease. Bilateral cervical, or axillary, or hilar, or pelvic, or inguinal nodes count as two regions. Mediastinal and para-aortic lymph nodes count as one region regardless of laterality as they are centrally located. A large mediastinal mass constitutes one region involved regardless of the size.
Reportability--Cervix: The SEER Program Code Manual lists CIN III and carcinoma in situ of the cervix as not being reportable for cases diagnosed in 1996 or later, but does not list "adenocarcinoma in situ" or "squamous cell carcinoma in situ." Are these histologies still reportable?
For primary site cervix uteri, only histologies with behavior codes of 3 [invasive] are reportable to SEER for all registries.
Some SEER registries have opted to continue to collect behavior codes of 2 [in situ] for cervix uteri primaries.
Reportability--Heme & Lymphoid Neoplasms: For cases diagnosed 2010 and later, are idiopathic thrombocytopenia and autoimmune thrombocytopenia reportable?
Idiopathic and autoimmune types of thrombocytopenia are not reportable. Thrombocytopenia and thrombocythemia are not synonyms. Cytopenia and cythemia have different definitions. See Appendix F: Non-Reportable List for Hematopoietic Diseases.
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.
Primary Site--Ovary/Peritoneum: Should this field be coded to ovary or peritoneum when the bulk of the tumor is in the peritoneum and there is only surface involvement of the ovary?
If it is not clear where the tumor originated, use the following criteria to distinguish ovarian primaries from peritoneal primaries.
The primary site is probably ovarian, unless:
--Ovaries have been previously removed
--Ovaries are not involved (negative)
--Ovaries have no area of involvement greater than 5mm.
Descriptions such as "bulky mass," "omental caking" probably indicate an ovarian primary.
Descriptions such as "seeding," "studding," "salting" probably indicate a peritoneal primary.
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