Report | Question ID | Question | Discussion | Answer | Year |
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20130105 | Primary Site--Heme & Lymphoid Neoplasms: How is the primary site coded for a B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma when a biopsy of the paraspinal muscle and epidural tissue is positive, but there is no indication of lymph node involvement in the chart? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. Code the primary site to soft tissue of the back, NOS [C496] per Rule PH24 and the Abstractor Notes in the Heme DB for B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Code the primary site to the organ when lymphoma is present only in an organ. The lesion is described as epidural (tissue surrounding the dura) and involving paraspinal muscle, NOS. Both are connective or other soft tissues of the trunk, NOS [C496]. B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma is a synonym for DLBCL 9680/3. When there is no primary site listed in the Heme DB, go to the Abstractor Notes. In the Abstractor Notes section it states that patients present with lymphadenopathy OR mass lesions in extranodal sites. 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. |
2013 | |
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20140021 | Reportability--Breast: Is an inflammatory myofibroblastic tumor of the breast with metastasis to the lung reportable? | Inflammatory myofibroblastic tumor of the breast with metastasis to the lung is reportable. Metastasis to the lung from the breast tumor indicates that the breast tumor is malignant. All malignant neoplasms are reportable. | 2014 | |
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20051068 | CS Extension--Retinoblastoma: When the degree of extension differs between the retinas, how is extension coded for simultaneous bilateral retinoblastoma? | 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.Assign the CS extension code that corresponds to the greatest level of extension seen in either eye, excluding information from enucleation.
Record extension based on enucleation in Site Specific Factor 1.
Record bilateral disease under laterality. For retinoblastomas, bilaterality is not a component or consideration for staging. |
2005 | |
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20130085 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient was treated in 1999 with Vidaza for myelodysplastic syndrome and had a recent biopsy that demonstrated a transformation to acute myeloid leukemia? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case should be accessioned as a single primary, acute myeloid leukemia [9861/3]. MDS diagnosed prior to 1/1/2001 is not a reportable disease process. However, because MDS is currently a reportable disease process, it must be considered when trying to determine whether the AML represents a separate primary.
Rule M2 does not apply to this case because more than one histology is mentioned in the scenario. According to the Heme DB, MDS can transform to AML. Rules M8-M13 apply to cases involving transformation. In this case, Rule M10 applies because the patient was diagnosed with a chronic neoplasm (myelodysplastic syndrome) followed greater than 21 days later by an acute neoplasm (AML). 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. |
2013 | |
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20000244 | Behavior Code--Bladder/Lymphoma: Should the "in situ" designation on a bladder primary's pathology report be ignored that states a diagnosis of "in situ lymphoma"? | Ignore the in situ designation. You cannot assign an in situ behavior code to a lymphoma primary. The term or designation of "in situ" is limited to solid tumors; carcinoma and/or cancer. | 2000 | |
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20051041 | Histology (Pre-2007)--Melanoma: How is histology coded if the final diagnosis is "melanoma" and only in the comment section of the pathology report is there an indication of "Type: Lentigo Maligna. Cell Type: Small Cell"? | For tumors diagnosed prior to 2007:
Code the histology as 8742 [lentigo maligna melanoma]. Code the specific histologic type, even if stated only in the comment section.
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. |
2005 | |
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20031137 | Primary Site--Pancreas: Should tumors with the histology "islet cell carcinoma" be coded C25.4 [Islet of Langerhans] even though the tumor location is stated to be in head of pancreas? | Assign code C25.4 [Islets of Langerhans...Endocrine pancreas]. Islet cell carcinoma of the pancreas is a tumor of the endocrine pancreas. Although Islet cells are present throughout the pancreas, the best code is C25.4 to distinguish endocrine from exocrine cancers. | 2003 | |
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20021166 | EOD-Extension--Kidney: If a "tumor thrombus" in a renal vein is discontinuous from the primary tumor in the kidney, is it still coded to 60 [Tumor thrombus in a renal vein, NOS], rather than 85 [Metastasis]? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 60 [Tumor thrombus in a renal vein, NOS]. A thrombus can be a bolus of tumor cells within a large vein that may or may not still be connected/contiguous with the primary tumor. However, both a discontinuous and contiguous thrombus are coded to 60. |
2002 | |
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20130129 | Histology--Heme & Lymphoid Neoplasms: How is histology coded for a diagnosis of composite lymphoma (follicular lymphoma and small lymphocytic lymphoma, BCL-2 positive)? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the histology to 9823/3 [chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)] per Rule PH15. Code the histology to the non-Hodgkin lymphoma (NHL) with the numerically highest ICD-O-3 code when two or more NHLs are present in the same present in the same lymph node(s) or lymph node region(s), tissue(s), organ(s), or bone marrow. Both follicular lymphoma [9690/3] and SLL [9823/3] are types of NHL. Therefore, the histology is coded to 9823/3.
This composite histology represents a single primary per Rule M4. The rule states to abstract a single primary when two or more types of non-Hodgkin lymphoma are simultaneously present in the same anatomic location(s), such as the same lymph node or lymph node region(s), the same organ(s), and/or the same tissue(s).
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. |
2013 | |
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20210031 | Reportability--Brain and CNS: Are lipomas of the spinal column reportable as a benign tumor of the central nervous system (CNS)? This is seen occassionally at our pediatric facility. |
Spinal cord tumors (including lipomas) are reportable when they arise in the spinal dura or nerve root. The tumor must be of the spinal cord itself or within the spinal cord dura. Spinal cord tumors are reportable when they arise in the intradural space. A reportable intradural tumor can be either intramedullary or extramedullary. Extramedullary intradural spinal tumors are reportable. A spinal tumor originating in the extradural space is not reportable. If it is outside the dura, it is not reportable because it would be outside the CNS. They are not reportable when they arise in the peripheral nerves. |
2021 |