Reportability/Histology--Pituitary Gland: How are Rathke cleft cyst and Rathke pouch tumor distinguished and are they both reportable?
Rathke cleft cyst is not reportable. Cysts are not neoplastic. However, Rathke pouch tumor (C751, 9350/1) is a reportable neoplasm for cases diagnosed 2004 and later. The Rathke pouch is coded to the pituitary gland. Benign and borderline pituitary tumors have been reportable since 2004.
Grade/Histology--Digestive System: What is the grade for neuroendocrine tumor (NET) or neuroendocrine carcinoma (NEC) of gastrointestinal morphologies described as: 1) NET G1 (M8240/3) and NET G2 (M8249/3) or 2) neuroendocrine carcinoma, low grade (M8240/3) and neuroendocrine carcinoma, well differentiation (M8240/3) and neuroendocrine carcinoma, moderate differentiation (M8249/3)? The SEER Instructions for Coding Grade for 2014+, Coding for Solid Tumors section, #3 state: Code the grade shown below (6th digit) for specific histologic terms that imply a grade. NET and NEC are not included in the specific terms.
You may code grade as follows.
Grade 1 – NET G1 (M8240/3)
Grade 2 – NET G2 (M8249/3)
Grade 1 – neuroendocrine carcinoma, low grade (M8240/3) or neuroendocrine carcinoma, well differentiation (M8240/3)
Histology (Pre-2007)--Lung: What code is used to represent the histology "mucin-producing bronchoalveolar carcinoma?" Is mucin-producing synonymous with mucinous?
For tumors diagnosed prior to 2007:
Code histology as 8253 [Bronchiolo-alveolar carcinoma, mucinous]. Mucin-producing bronchoalveolar carcinoma is best classified in ICD-O-3 as Bronchiolo-alveolar carcinoma, mucinous.
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.
Date of Conclusive Terminology: Is there an applicable timeframe when coding this field?
There is no strict timeframe for Date of Conclusive Terminology. The diagnosis using conclusive terminology could be made any time following the diagnostic work-up.
The date of conclusive terminology is related to code 2 [ambiguous term followed by conclusive term] in the data item "Ambiguous terminology." Assign code 2 when a conclusive diagnosis is made 60 days or more after a diagnosis using ambiguous terminology. Record the date of the conclusive diagnosis in "Date of Conclusive Terminology."
Ambiguous terminology: Is the phrase "malignancy is highly considered" reportable given that the phrase "considered to be malignant" is reportable per SINQ 20061094?
"Malignancy is highly considered" is not a reportable ambiguous term.
Diagnoses qualified by the phrase "considered to be malignant" are reportable because this phrase is interpreted as "This diagnosis is malignant."
Reportability/Recurrence (Pre-2007)--Bladder: If a patient has had recurrent invasive bladder cancers since 1971, should the latest recurrence in 2003 be SEER reportable because the case has yet to be reported to SEER?
For tumors diagnosed prior to 2007:
Because this 2003 recurrent bladder cancer was initially diagnosed prior to 1973, it is not reportable to SEER.
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.
Date of Diagnosis--Bladder: Should the date of diagnosis be based on the 1/7/04 urine cytology with low grade transitional cell carcinoma or the subsequent 1/27/04 pathology findings of papillary transitional cell carcinoma?
In this case, the date of the cytology is the date of diagnosis, 01-07-2004.
Behavior/Date of Diagnosis--Lung: If the term "Pancoast tumor, NOS" is malignant by definition, should the date of diagnosis be coded to the date of the clinical diagnosis when the clinical diagnosis is made prior to the histologic confirmation of the malignancy?
Yes, Pancoast tumor is by definition malignant. It is defined as a lung cancer in the uppermost segment of the lung that directly invades into the brachial plexus (nerve bundles) of the neck, causing pain. If a Pancoast tumor was identified on imaging prior to the biopsy, the date of diagnosis should be linked to the Pancoast tumor report.
EOD-Extension--Lung: If a CT scan indicates that a patient has evidence of "long-standing pneumonia," is that synonymous with "pneumonitis" for the purposes of coding extension for lung primaries?
No. These terms are not synonymous. For cases diagnosed 1998-2003, disregard the pneumonia and use the other available information to code extension.
Reportability/Histology--Skin: Is dermatofibrosarcoma protuberans (DFSP) with fibrosarcomatous overgrowth, DFSP with fibrosarcomatous component Grade 2, or DFSP with focal myxoid features (2022) reportable for 2021-2022 diagnoses?
Yes. DFSP with fibrosarcomatous overgrowth and DFSP with fibrosarcomatous component Grade 2 are synonymous with fibrosarcomatous DFSP (8832/3). Our expert pathologist also advises that DFSP with focal myxoid features is the same as DFSP, myxoid (8832/3).
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