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Code Rituxan as chemotherapy. Code 90-Yttrium as radioisotope. Code 131-Iodine as radioisotope when given with Rituxan as treatment for lymphoma.

Zevalin is a monoclonal antibody conjugated to Yttrium 90. Bexxar is a monoclonal antibody conjugated to Iodine 131. In both drugs, the monoclonal antibody is only the delivery agent for the radioisotope. Both drugs should be coded as radioisotopes. The one-two-three punch of Rituxan and zevalin followed by Rituxan and Bexxar should be coded as chemotherapy plus radioisotopes. Zevalin is also used by itself for people who have not responded to Rituxan.

Code as Localized using the SEER Summary Stage Manual, Colon and Rectum, Note 6.

Localized is for subsites that are not peritonealized, including the posterior side of the ascending colon, or when the pathologist does not further describe the "pericolic/perirectal tissues" as either "non-peritonealized pericolic/perirectal tissues" vs "peritonealized pericolic/perirectal tissues" fat and the gross description does not describe the tumor relation to the serosa/peritoneal surface, and it cannot be determined whether the tumor arises in a peritonealized portion of the colon.

Refer to the coding instructions in both EOD and Summary Stage for a list of sites that are nonperitonealized or peritonealized.

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Code treatment with Iressa as chemotherapy.

Iressa is an epidermal growth factor inhibitor. While it doesn't kill cells directly, it damages the cell reproduction process. We classify it as a chemotherapy agent.

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 32 [30 + involvement of the spleen; III S]. The spleen is counted twice (once as the spleen and a second time as a lymph node region below the diaphragm). As a result, the EOD-Extension field is coded to reflect involvement of lymph node regions on both sides of the diaphragm plus involvement of the spleen. See Note 1 on the EOD scheme that states "Any lymphatic structure is to be coded the same as a lymph node region."

For tumors diagnosed prior to 2007:

Assign code 8001/3 [Tumor cells, malignant] when the only information available is a cytology report stating "malignant cells."

Assign code 8000/3 [Neoplasm, malignant] when then only information available is a CT report stating "probable malignancy."

See ICD-O-3 page 27 for an explanation of "cancer" [8000] and "carcinoma" [8010].

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 2007 or later:

As of July 2010:

Code the histology 8503 [Infiltrating papillary adenocarcinoma].

This is solid papillary, not solid AND papillary carcinoma. Solid is an adjective modifying papillary, in other words, a subtype of papillary. We do not have a code for solid papillary, so we code to the NOS, papillary using rule H14.

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.

Code the CS Extension field to 01 [Papillary transitional cell carcinoma stated to be noninvasive]. Extension into bladder diverticula does not change the code. Diverticula are pouches in the mucosa (mucous membrane).

Malignant hidroacanthoma simplex of the scalp is reportable. Malignant hidroacanthoma simplex is a synonym for porocarcinoma, 8409/3.