EOD-Size of Primary Tumor--Breast: How would this field be coded, using the revised and expanded breast code, for a lesion described as "1.3 cm infiltrating ductal carcinoma, associated DCIS?"
For cases diagnosed 1998-2003: Code size of primary tumor as 013. The phrasing suggests that the infiltrating ductal carcinoma measures 1.3 cm. DCIS is also present, but no size mentioned.
EOD-Lymph Nodes--Lung: What code is used to represent this field when the only information is a description of:
1. "hilar mass"
2. "mediastinal mass"
3. "enlarged" or "greater than 1 cm" used to describe any of the lymph nodes listed under code 2 in the EOD Lymph Nodes field?
For cases diagnosed 1998-2003:
Code EOD-Lymph Nodes fields as follows for the examples given:
1) 9 [Unknown; not stated] for a "hilar mass"
2) 2 [Mediastinal] for a "mediastinal mass"
3) 2 [Mediastinal] for "enlarged" or "greater than 1 cm," if used to describe any of the named lymph nodes listed under code 2 in the EOD-Lymph Nodes field.
CS Lymph Nodes/CS Mets at DX--Ovary: How are the following lymph node regions/chains coded in the Collaborative Stage schema for ovary?
1. pericolonic
2. pelvic, NOS
3. mesenteric, NOS
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.Revised 7-17-09
Assign CS Lymph Nodes code 10 for involvement of pelvic lymph nodes, NOS.
Code involvement of pericolonic nodes or mesenteric nodes, NOS in CS lymph nodes.
CS Extension--Breast: Is the term "erosion" the same as "ulceration"?
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.
"Erosion" is not synonymous with "ulceration" when coding CS extension for breast.
Histology (Pre-2007)--Stomach: What code is used to represent the histology of "mucin-secreting adenocarcinoma, intestinal type "for a stomach primary?
For tumors diagnosed prior to 2007:
For this specific example, code histology to 8481 [Mucin-producing adenocarcinoma] as it is a more specific cell type with inherent prognostic information.
Code 8255/3 [Adenocarcinoma with mixed subtypes] is not appropriate for this case because "intestinal type" is a more specific description of this cancer and not another type of cancer. There are two broad categories of gastrointestinal adenocarcinomas: Intestinal and Diffuse.
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.
Primary Site/Sarcoma--Breast: How should the primary site and stage be coded for osteosarcoma of breast? Is C509 correct or should the code be a different primary site? When assigning C509, the Collaborative Stage (CS) still pertains to breast cancer and AJCC stages it as a breast cancer and not as a sarcoma.
Code primary osteosarcoma of the breast to breast, C500-C509. Not all site and histology combinations can be staged in CS or AJCC. 9180/3 of breast cannot be staged using the CS breast schema. Breast (C500-C509) cannot be staged using the CS soft tissue schema. The same is true for AJCC. You can stage this case using SEER Summary Stage.
Important: Do NOT change the primary site or histology code based on whether or not the case can be CS or AJCC staged. We need to know how many cases are unable to be staged because of their primary site and histology combinations.
Reportability--Skin: Is a pilomatrix carcinoma of the skin reportable if it is described as being a malignant diagnosis based on poor circumscription, infiltrative growth pattern, and focal abundant mitoses?
No. Pilomatrix carcinoma is not reportable to SEER. Please see page 1 of the 2004 SEER manual. Skin primaries with histology codes from 8090 to 8110 are not reportable. Pilomatrix carcinoma is coded 8110/3.
Primary site--Heme & Lymphoid Neoplasms: Is the primary site coded to C778 or C779 for a diffuse large B cell lymphoma with abdominal lymph node, neck lymph node, and spleen involvement?
Use Rule PH21 to code the primary site to C778 [lymph nodes of multiple regions]. The spleen is not listed under the Primary Site(s) section in the Heme DB for diffuse large B-cell lymphoma. Per Rule PH21 code the primary site to multiple lymph node regions, NOS (C778) when multiple lymph node regions, as defined by ICD-O-3, are involved and it is not possible to identify the lymph node region where the lymphoma originated. The spleen is a primary site for only a few lymphomas (noted in the Heme DB). Because the spleen filters blood, it is often reactive (splenomegaly) or frankly involved with the lymphoma. That reaction or involvement, however, does not affect the primary site coding. Only the involved nodes are used in coding primary site.
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.
MP/H Rules/Histology--Lung: What would the histology code be for a wedge bx of the left lung, lower lobe, that was read out as well differentiated adenocarcinoma with micropapillary features?
Code papillary adenocarcinoma 8260/3. The ICD-O-3 codes for micropapillary have specific associations such as ductal, serous or transitional. None of those associations fit lung primaries.
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.