Histology/Grade, Differentiation--Lymphoma: What code is used to represent the histology "high grade malignant lymphoma with features of so called blastic NK cell cutaneous lymphoma [hematodermic lymphoma]" found on punch biopsy?
For cases diagnosed prior to 1/1/2010:Code the Histology field to 9709/3 [cutaneous lymphoma, NOS]. Code the Grade, Differentiation field to 8 [NK cell].
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
Histology (Pre-2007)--Breast: Should the histology "non-invasive papillary carcinoma" along with the comment "solid intraductal papillary proliferation includes cytologically atypical cells with scattered mitotic figures" be coded to 8503/2 [intraductal papillary carcinoma] or 8050/2 [papillary carcinoma in situ]?
For tumors diagnosed prior to 2007:
The best histology code for this breast case is 8503/2 [Noninfiltrating intraductal papillary carcinoma]. According to the WHO Classification of Tumors for Breast, Papillary carcinoma, non-invasive is a synonym for Intraductal papillary carcinoma. Further, code a more specific histologic type when found in the microscopic description, according to the SEER Program Code manual.
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.
First course treatment/Chemotherapy/Drug category: Instructions in SEER*Rx state that Ibrance should be coded as chemotherapy. They also state that it is an endocrine-based therapy. Local physicians refer to Ibrance as hormone therapy. Please clarify.
For cancer registry data collection, follow the instructions in SEER*Rx. It is important for all data collection to be consistent for reporting of cancer information.
Per the FDA: Ibrance is a chemotheraputic agent which was approved for use WITH Letrozole. Letrozole is a hormonal drug which may be why the physicians are stating the patient is receiving hormones. Ibrance should not be given alone to treat breast cancer. This drug will not be changing categories in SEER*Rx.
Reportability/Histology--Pancreas: Is mucinous cystic neoplasm of pancreas reportable?
Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with low or intermediate grade dysplasia is NOT reportable.
Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with high grade dysplasia is reportable. For neoplasms of the pancreas, the term MCN with high grade dysplasia replaces the term mucinous cystadenocarcinoma, non-invasive.
Primary site--Breast: Patient was diagnosed with invasive ductal carcinoma of the left breast. Site of mass is 2:00 to 3:00. What is the correct site code, C504 upper outer quadrant (UOQ) or C50.8 (overlapping)?
Histology--Heme & Lymphoid Neoplasms: How is the histology coded for a "cutaneous diffuse large B-cell lymphoma, leg type" that has been verified as a valid diagnosis with prognostic factors including age and number of lesions on the legs?
Code this histology to 9680/3 [diffuse large B-cell lymphoma]. Primary cutaneous DLBCL, leg type, is listed as an Alternate Name for DLBCL per the Heme DB.
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.
EOD-Extension--Pancreas: Should these terms be ignored when coding extension to 10 or 30, or do they indicate involvement for non-surgically treated pancreas primaries?
1) Stricture of the common bile duct
2) Common bile duct is narrowed
3) Common bile duct is obstructed
4) Common bile duct dilation
5) Malignant stricture of the common bile duct
6) Ampullary or common bile duct stricture with a negative biopsy or brush.
For cases diagnosed 1998-2003:
Ignore these terms when coding extension to 10 or 30. These terms do not verify involvement by pancreatic cancer of the organs mentioned. Other non-malignant circumstances could cause these conditions.
FIGO grade is something completely different from FIGO stage. FIGO stage is used to code EOD. FIGO grade is based on the percentage of non-squamous (i.e., solid) portions of the tumor and corresponds roughly to a three grade differentiation system: grade I, well differentiated (=<5% solid component); grade II, moderately differentiated (>5 - 50% solid); and grade III, poorly differentiated (> 50% solid). SEER is evaluating whether the ICD-O-3 6th digit differentiation codes (four grade categories) accurately represent the FIGO grade. For the time being, do not code FIGO grade.
For a diagnosis that includes commonly used differentiation term with a FIGO grade, such as "Moderately differentiated, FIGO grade II," disregard the FIGO grade and code the Grade, Differentiation field according to the term "Moderately differentiated."
Multiple Primaries--Brain and CNS: How many primaries should be recorded in a patient with von Hippel Lindau disease that has a hemangioblastoma of the cerebellum in 2003 and a hemangioblastoma of the brainstem in 2007?
A tumor of the cerebellum (C716) and a tumor of the brainstem (C717) are multiple primaries because the topography codes are different at the fourth character of site.
2004 SEER Manual Errata/Surgery of Primary Site--Lymphoma: Item 9.a on page 178 is incorrect. Do not assign surgery code 98 to lymphoma, primary in lymph nodes. See Appendix C, page C-707 for Lymphoma (primary in lymph nodes) surgery codes.
Delete item 9. a. i. ii. and iii. on page 178 of the 2004 SEER Manual. This correction will be included in the next errata.