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Report Produced: 09/16/2026 06:10 AM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20110140 MP/H Rules/Behavior--Breast: How are behavior and histology coded when the pathology report final diagnosis is "ductal carcinoma in situ and lobular carcinoma in situ" if the microscopic examination section of the same pathology report states there are "foci suspicious for microinvasive carcinoma"? See Discussion. The pathology report microscopic examination states, "focally, between ducts involved by DCIS, there are minute tubular structures associated with stromal fibrosis and chronic inflammation. These foci are suspicious for microinvasive carcinoma."

For cases diagnosed 2007 or later, code one primary with histology and behavior coded to 8522/2 [intraductal carcinoma and lobular carcinoma in situ].

The steps used to arrive at this decision are as follows

Open the Multiple Primary and Histology Coding Rules manual. Choose one of the three formats (i.e., flowchart, matrix or text) under the Breast Histology rules. The module you use depends on the behavior and number of tumors identified in the primary site. The information provided does not specify whether this was a single tumor with DCIS and LCIS or multiple tumors with DCIS and LCIS. In this case, the number of tumors does not change the histology code for this patient. For this example, assume this disease process was a single tumor.

Start at the SINGLE TUMOR: In Situ Carcinoma Only module. The rules are intended to be reviewed in consecutive order from Rule H1 to Rule H8. Stop at the first rule that applies to the case you are processing. Code the histology as 8522/2 (intraductal carcinoma and lobular carcinoma in situ) when there is a combination of in situ lobular (LCIS) [8520] and intraductal carcinoma (DCIS).

Do not code the behavior as invasive in this case. The pathologist indicated that these findings were "suspicious" but not definite in the microscopic examination. If the pathologist decided that this was truly an invasive tubular element, it would have been included in the final diagnosis.

Breast N/A 2011
20000242 EOD-Size of Primary Tumor--Prostate: Should the size of tumor be recorded as 001 (focus) or the actual size when both are stated? See Discussion. The pathology report from a TURP identifies a 3-mm focus of adenocarcinoma. For cases diagnosed 1998-2003, code the EOD-Size of Primary Tumor field to 003 [3 mm]. The rule that says to code a focus or foci of tumor as 001 was developed for use when no tumor size is given. Prostate N/A 2000
20100029 MP/H Rules/Histology--Corpus uteri: How should histology be coded and how many primaries should be accessioned for an endometrial primary in which curettings showed malignant mixed mullerian tumor (carcinosarcoma) but hysterectomy specimen showed endometrioid adencarcinoma? See Discussion. The pathology report COMMENT for the hysterectomy specimen stated that the previous curettage was reviewed. The findings are compatible with malignant mixed mullerian tumor. No residual features of malignant mixed mullerian tumor are found in the current resection, which shows FIGO grade I adenocarcinoma in the wall of the uterus. The malignant mixed Mullerian tumor appears to have been removed with the curettage. There is no information available regarding the number of tumors in these specimens.

For cases diagnosed 2007 or later, abstract a single primary. Rule M1 applies because there is no information on the number of tumors and there is no way to know whether the curettage sample was from a separate tumor or from the tumor in the hysterectomy specimen.

Apply rule H17 and code histology to 8980/3 for malignant mixed Mullerian tumor [Carcinosarcoma, NOS].

Corpus uteri Histology 2010
20130220 Reportability--Thyroid: Is a hyalinizing trabecular neoplasm of the thyroid reportable? See Discussion. The pathology comment states: Hyalinizing trabecular neoplasm is considered by some to represent a variant of papillary thyroid carcinoma because of the similar nuclear cytology, immunoprofile and RET-oncogene rearrangements.

Hyalinizing trabecular neoplasm is not reportable.

Hyalinizing trabecular neoplasm, or hyalinizing trabecular tumor, is a synonym for hyalinizing trabecular adenoma [8336/0] in the ICD-O-3. The 2004 WHO classification states that "fine needle aspiration biopsy is often interpreted as papillary carcinoma because of the nuclear features in the tumor."

Thyroid N/A 2013
20041047 Multiple primaries (Pre-2007)/EOD-Extension--Fallopian Tube: How many primaries are coded when endometrioid adenocarcinoma involves bilateral fallopian tubes? See Discussion. The pathologist states "because of the intimate association with the luminal line of the fallopian tube it is felt that this represents synchronous primaries rather than mets." The SEER Code Manual only lists ovary, retinoblastomas, and Wilms Tumors under the bilateral code stated to be a single primary.

For tumors diagnosed prior to 2007:

Complete two abstracts, one for left fallopian tube and one for right fallopian tube. This case has been determined to be two primaries by the pathologist. Bilateral involvement of paired sites (other than ovary, retinoblastoma and Wilms tumor) with the same histology within two months requires a determination of whether there are one or two primaries. The pathologist in the case above has made this determination.

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.

 N/A N/A 2004
20021108 Histology (Pre-2007)/Grade, Differentiation: What code is used to represent the histology of "well differentiated low grade lipoma-like liposarcoma (atypical lipoma)"? See discussion. The pathologic microscopic description states, "Well differentiated lipoma-like liposarcoma, sometimes termed atypical lipoma. This tumor will behave in a low grade malignant fashion. Slow growing recurrences can be expected. Metastatic disease is very rare unless the tumor dedifferentiates."

For tumors diagnosed prior to 2007:

Code the Histology field to 8851/3 [Liposarcoma, well differentiated] and the Grade to 1 [Well differentiated]. This histology is 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.

 N/A Histology 2002
20061008 Histology (Pre-2007)--Corpus uteri: How is a polyp with "endometrial carcinosarcoma (Malignant Mixed Mullerian tumor), endometrial adenocarcinoma, and some areas of high grade spindle sarcoma" coded? See Discussion. The path report for the TAH stated the endometrium contained an endometrial polyp measuring 6x3x3cm. Within the polyp there was endometrial carcinosarcoma (Malignant Mixed Mullerian tumor), endometrial adenocarcinoma, and some areas of high grade spindle sarcoma. There is no myometrial invasion by the tumor. (The Endometrial bx before surgery was positive for Malignant Mixed Mullerian tumor.)

For tumors diagnosed prior to 2007:

Assign code 8980 [Carcinosarcoma, NOS]. According to the WHO Classification of tumors, Malignant mullerian mixed tumor is a synonym for carcinosarcoma and carcinosarcoma is now the preferred terminology rather than malignant mixed Mullerian tumor.

Carcinosarcoma has both malignant epithelial and mesenchymal components. The epithelial component is usually glandular (adenocarcinoma in this case). The mesenchymal component is usually sarcoma (as in this case).

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.

 Corpus uteri Histology 2006
20091084 Primary site--Colon: How do you determine the correct subsite when there is conflicting information in different reports? Are there priority rules for coding subsite for sites other than Head and Neck? See Discussion. The path report for a hemicolectomy says, " Specimen: left colon..." and the microscopic says, "...received in formalin designated left colon..." The Operative procedure report says, "Postoperative diagnosis - splenic flexure tumor." The text of this report says, "Mobilizing the splenic flexure mass was incredibly difficult..." and then goes on to describe exactly how and where it was resected. The discharge summary says adenosquamous carcinoma of the splenic flexure. SINQ20051010 says to use the pathology report first, but this was written before the new MP/H rules.

Use the operative report information to code primary site in this case. It is more accurate.

The operative report is usually a better source of location information compared to the pathology report. The pathologist can only reiterate the location as it was reported to him/her.

The 2007 SEER manual states "Unless otherwise instructed, use all available information to code the site," page 69.

 Colon Primary site 2009
20021173 Histology (Pre-2007): What code is used to represent a review of slides histology of "in situ squamous cell carcinoma and multiple detached fragments of atypical papillary squamous epithelium; highly suspicious for invasive carcinoma"? See discussion. The original pathologist indicated a final diagnosis of moderately differentiated squamous cell carcinoma. The slides were sent for review to another facility. The reviewing pathologist rendered the diagnosis stated in the question section.

For tumors diagnosed prior to 2007:

Code the Histology field to 8070 [squamous cell carcinoma].

The review diagnosis was also squamous cell carcinoma. The expression "atypical papillary squamous epithelium" does not modify the cancer histology.

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.

 N/A Histology 2002
20051006 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Thyroid: How is histology coded for the tumor(s) that exist when the thyroidectomy addendum diagnosis is "Morphologic and IHC evaluations reveal two tumors: papillary thyroid carcinoma and squamous cell carcinoma." See Discussion. The original final diagnosis after a thyroidectomy is "papillary carcinoma of the thyroid with an adjacent invasive squamous cell carcinoma, moderately differentiated." Per the additional addendum comment: "The findings can be interpreted in one of 2 different ways. Either there is a collision tumor of papillary thyroid and squamous cell carcinoma (with the squamous cell ca originating at a site other than the thyroid gland.) Or, less likely, there is a malignant squamous differentiation in the papillary thyroid carcinoma." A university hospital consultation report states the diagnosis as: "Spindle cell squamous cell carcinoma arising in association and from papillary carcinoma, predominantly tall cell variant..." Is this 2 thyroid primaries: 8344/3 [papillary carcinoma, tall cell] and 8074/3 [squamous cell carcinoma, spindle cell]?

For tumors diagnosed prior to 2007:

Our pathologist consultant agrees with the consultant's diagnosis. Therefore, abstract this as one primary of the thyroid. Code the histology as 8344 [Papillary tall cell]. This is the most appropriate histology code available for this complex case.

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.

 Thyroid Histology 2005