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For cases diagnosed 1998-2003: If 7mm is the measurement of the infiltrating duct portion of this cancer, assign extension code 13 [Invasive and in situ components present, size of invasive component stated and coded in Tumor Size].

If 7mm is the size of the whole malignancy and the size of the invasive portion cannot be determined, assign extension code 14 [Invasive and in situ components present, size of entire tumor coded in Tumor Size (size of invasive component not stated) and in situ described as minimal (less than 25%)]. "Focal areas of in situ carcinoma" qualifies as minimal.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

The diagnosis of "myelodysplasia" is not reportable.

Myelodysplasia covers a group of disorders that result in the inability to produce enough healthy mature blood cells. Those disorders include: anemia, leukopenia, thrombocytopenia, MDS, refractory anemia, refractory anemia with excess blasts in transformation, refractory anemia with ring sideroblasts, refractory anemia with excess blasts, chronic myelomonocytic leukemia, acute myeloid leukemia. Follow-back to the physician is necessary to determine whether or not a particular case represents a malignancy.

"Myelodysplasia" is also listed in Appendix F: Non-Reportable List for Hematopoietic Diseases.

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.

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 regional lymph nodes positive 01 [one positive lymph node] and regional lymph nodes examined 01 [one lymph node examined] (assuming the positive node was the only node examined).

If the only lymph node involvement is the positive axillary lymph node, it is reasonable to conclude that this is a regional lymph node. When only one chain of lymph nodes is involved with metastatic melanoma, the metastatic cells had to come from skin with direct drainage to those lymph nodes.

Assign ICD-O-3 code 9392/3 until code 9478/3 is implemented in 2018. Per our expert neuropathologist, embryonal tumor with multilayered rosettes was previously called ependymoblastoma.

For tumors diagnosed prior to 2007:

Code the Primary Site field to C61.9 [prostate] because the histology is adenocarcinoma.

When a malignancy is identified in the prostatic urethra, look at the histology to determine the primary site. If it is a transitional cell carcinoma, code the Primary Site field to C68.0 [urethra] and if it is an adenocarcinoma, code to C61.9 [prostate].

The EOD scheme is ultimately collapsed into the TNM scheme. The TNM system differentiates between adenocarcinoma of the prostate and transitional cell carcinoma of the urethra. Only adenocarcinoma of the prostate is staged by the prostate scheme. Transitional cell carcinoma of the prostatic urethra is coded to C68.0 [urethra] and staged with that scheme.

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.

The first course of treatment for these hematopoietic primaries lasts until there is a treatment change. For the case you cite the second transfusion (7 months after diagnosis) would be first course treatment. Code the Other Cancer-Directed Therapy Field to 1 [Other cancer-directed therapy].

Report LR-M unless there is information to the contrary. The American College of Radiology defines LR-M as "probably or definitely malignant, not necessarily hepatocellular carcinoma (HCC)."

Code the instillation of Mitomycin-C into the bladder for a bladder primary in both the Chemotherapy and Surgery to Primary Site fields. Code the Chemotherapy field to 02 [Single-agent chemotherapy administered as first course therapy]. Mitomycin-C is listed in SEER book 8 as a chemotherapeutic drug, specifically an alkylating agent.

Also, code the Surgery of Primary Site field to 15 [intravesical therapy]. Code the surgical procedure as well as the type of drug (chemotherapy in this case).

Rule M3 does not apply to adenocarcinoma followed by duct carcinoma of the prostate or vice versa. Rule M3 pertains to cases of adenocarcinoma and acinar carcinoma. These two terms, adenocarcinoma and acinar carcinoma, are equivalent for the purpose of applying the MP/H rules to prostate cases. See page 77 of the Other Sites Terms and Definitions, http://www.seer.cancer.gov/tools/mphrules/mphrules_definitions.pdf