MP/H Rules/Histology--Brain and CNS: How is histology coded for a left occipital parietal area tumor stated to be a "low grade neuroectodermal neoplasm most consistent with neuronal tumor but lacking classic features of ganglioma" if the pathologist states the tumor is not malignant?
Code 9505/0 [Ganglioglioma, benign] is the best option according to our pathology expert. He states, "There recently has been a spate of tumors called low grade glio-neuronal tumors that are not PNETs and have no propensity to become malignant."
Reportability--Brain and CNS: Is pseudotumor cerebri reportable?
Pseudotumor cerebri is not reportable. It is not a neoplasm. The pressure inside the skull is increased and the brain is affected in a way that appears to be a tumor, but it is not a tumor.
Tumor Size/Bladder: The 2018 SEER Coding and Staging Manual says to use imaging over physical exam as priority for determining tumor size. If a bladder tumor is 4 cm visualized on cystoscopy, and is 2.8 cm on CT scan, which should be used as the clinical size? Is cystoscopy (endoscopy) a clinical exam or imaging?
For the case described here, use the size from the CT scan. Physical exam includes what can be seen by a clinician either directly or through a scope. A tumor size obtained visually via cystoscopy is part of a physical exam. Therefore, the imaging (CT) tumor size is preferred. Use text fields to describe the details.
EOD-Extension--Corpus Uteri: How is this field coded for a stage III A endometrial primary with positive pelvic washings, involvement of the omental serosa, and negative lymph nodes?
For cases diagnosed 1998-2003: Code EOD-extension as 85 [Metastasis]. According to our TNM consultant, Omental metastasis is M1, Stage IVB [EOD 85].
Diagnostic confirmation--Heme & Lymphoid Neoplasms: What is the diagnostic confirmation code for a death certificate only (DCO) diagnosis of acute myeloid leukemia?
Always code diagnostic confirmation to 9 [Unknown whether or not microscopically confirmed; death certificate only] for DCO cases.
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.
CS Lymph Nodes/CS Mets at Dx--Ovary: How are renal lymph nodes coded for ovary primaries?
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 involvement of renal lymph nodes under CS Mets at Dx. Renal lymph nodes are not listed as regional lymph nodes for ovary; therefore, code involvement of renal lymph nodes under CS Mets at Dx.
CS Reg LN Pos/Exam--Colon: For a patient with both a prostate and colon primary, if the pathology report indicates that 2 of the 3 regional lymph nodes to the colon are positive for a prostate malignancy, how should these fields be coded for the colon primary?
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.For the colon primary, code Reg LN Pos 00 [all nodes negative]. Code Reg LN Exam 03 [three nodes examined].
Three lymph nodes were examined and found to be negative for metastatic colon cancer.
MP/H Rules/Histology--Lung: Per SINQ 20110115, why is micropapillary adenocarcinoma of the lung coded to 8260 [papillary adenocarcinoma] rather than 8050 [papillary carcinoma]?
The histology codes for lung tumors are based on the World Health Organization Classification of Lung Tumors. Chart 1 in the MP/H Lung Equivalent Terms, Definitions, Charts, Tables and Illustrations (2007 MP/H Rules Manual) illustrates the WHO Classification of Lung Tumors.
Using Chart 1, note that papillary adenocarcinoma [8260] is located under the Adenocarcinoma (NOS) branch. The histology in question was stated to be "micropapillary adenocarcinoma" and not "papillary carcinoma." Papillary carcinoma, NOS [8050] is not actually located on the chart. However, papillary squamous cell carcinoma is listed under the Squamous Cell Carcinoma, NOS branch, histology code 8052.
Next, look up papillary carcinoma [8050] in the Morphology - Numerical listing section of the ICD-O-3. Papillary carcinoma, NOS is a Squamous Cell Neoplasm. (Refer also to SINQ 20091040.)
The key word used to determine the appropriate histology in this case is "adenocarcinoma." This is a papillary adenocarcinoma and not a papillary squamous neoplasm.
Update to current manual/Lymphovascular invasion: Are lymphvascular invasion and lymphvascular space invasion on a pathology report the same thing or do they describe different things?
We confirmed with our expert pathologist consultant that lymphovascular invasion and lymphovascular space invasion are synonymous.
Primary Site--Peritoneum: During a second look staging lap following a diagnosis of serous carcinoma of the left ovary, did the physician correctly indicate a new peritoneum, NOS primary for disease described as an endometrioid adenocarcinoma in a "paracaval cyst" that appears to have arisen in endometriosis?
The primary site is C482 [Peritoneum, NOS]. "Paracaval" means alongside or near the vena cava.
Code the site in which the primary tumor originated.