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Report Produced: 11/25/2024 10:12 AM

Report Question ID Question Discussion Answer Year
20031167 Primary Site/Histology--CLL/SLL: How should these fields be coded when the pathological diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma is made on bone marrow biopsy only but scans show lymphadenopathy? See Description.

What histology would we give these two examples?

1. Bone marrow bx: CLL/SLL. CT chest/abdomen: Mediastinal and retroperitoneal adenopathy.

2. Bone marrow bx: CLL/SLL. CT chest/abdomen: Mediastinal and retroperitoneal adenopathy suspicious for lymphoma.

For cases diagnosed prior to 1/1/2010:If a lymph node or other solid tissue is involved initially, code to SLL. For lymphoma, any mention of lymph nodes is indicative of involvement. Involvement does not have to be proven pathologically in order to code to Small Lymphocytic Lymphoma (SLL). Code both of the examples to SLL.

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.

 2003
20021156 Primary Site/Histology (Pre-2007): What codes are used to represent site and histology for BSO specimen with a diagnosis, "Left and right adnexa: poorly differentiated serous carcinoma. Comment: The carcinoma occurs as multiple nodules within adnexal soft tissues. Direct involvement of ovaries is not seen, supporting an extraovarian origin." See discussion. Per our pathologist consultant, the site should be pelvic peritoneum [C481] and the histology is primary serous papillary carcinoma of peritoneum [8461/3]. Does SEER agree?

For tumors diagnosed prior to 2007:

Code the Primary Site to C481 [Specified parts of peritoneum] and the Histology field to 8461/3 [primary serous papillary carcinoma of peritoneum].

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.

 2002
20031085 Primary Site/Histology (Pre-2007): What are the correct site and histology codes for "tubal serous adenocarcinoma" identified in a fallopian tube? See Description. The pathology report of a laparoscopic left salpingo-oophorectomy states: 1.5 cm intraluminal mass left fallopian tube: micro: tubal serous adenocarcinoma, poorly differentiated, infiltrates the muscular wall of the fallopian tube; serosa does not appear to be penetrated. The left ovary is negative for malignancy.

For tumors diagnosed prior to 2007:

Code histology as 8441 [serous adenocarcinoma].

The primary site for this case is fallopian tube, not the suggested site code of ovary.

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.

 2003
20031067 Primary Site/Histology (Pre-2007)/Sarcoma: How do you code these fields for a vulvar tumor diagnosed by FISH analysis as "extra-osseous Ewing sarcoma?" See Description. A literature search relates soft tissue malignancy described as "extra-osseous Ewing sarcoma/PNET." Neither are compatible with site.

For tumors diagnosed prior to 2007:

Code histology as 9260/3 [Ewing sarcoma]. ICD-O-3 does not have a code for extra-osseous Ewing sarcoma (EOE). Ignore the topography code listed in ICD-O and use the code for the primary site (vulva).

Site codes associated with morphology codes in the ICD-O are the most common sites and are not intended to limit coding only to those sites.

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.

 2003
20021079 Primary Site/Histology (Pre-2007)/EOD Fields/Surgery of Primary Site--Abdomen, NOS: What codes are used to represent these fields for a case with a resection of the rectosigmoid and adjacent tumor mass that demonstrated no tumor in the rectosigmoid but extramural to the colon there was an endometrioid adenocarcinoma arising in association with an area of endometriosis (possibly within the pericolic soft tissue or in an ovarian remnant)?

For cases diagnosed in 2003, code to:

Primary Site: C76.2 [abdomen, NOS]

Histology: 8380/3 [Endometrioid adenocarcinoma]

EOD size, extension, lymph node: 999, 99, 9 [Unknown]

Surgery of Primary Site: 98 [All unknown and ill-defined disease sites, WITH or WITHOUT surgical treatment]

Scope of Regional LN Surgery: 0 [None]

Surgical Procedure of Other Site: 2 [Non-primary surgical procedure to other regional sites].

 2002
20051058 Primary Site/Histology (Pre-2007)--Rectum: How are rectal biopsies with the histology of "poorly differentiated carcinoma with mixed basaloid and squamous features" coded if, per the SEER site/histology validation table, the histology 8094/3 [basosquamous carcinoma] histology cannot be coded to the rectum for the primary site?

For tumors diagnosed prior to 2007:

Code primary site C209 [rectum] and histology 8094/3 [basosquamous carcinoma]. As of 6/9/2003, this is no longer an impossible site/histology combination.

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.

 2005
20041063 Primary Site/Histology (Pre-2007)--Mediastinum: How do we code these fields for a case described as a "neuroendocrine carcinoma" of the "anterior mediastinum" without failing the SEER "impossible" site/histology combination edit? See Discussion. Two different facilities state that the patient has "neuroendocrine carcinoma of the anterior mediastinum." This coded combination failed SEER edit (SEERIF38). We can not correct it because that edit flag does not appear on our system. Both facilities indicate that the mediastinum is the primary. In addition, there is text to support both the histology and primary site codes.

For tumors diagnosed prior to 2007:

The combination of C381 [anterior mediastinum] and 8246 [neuroendocrine carcinoma] will be removed from the list of "impossible" site/histology combinations. There are rare cases of neuroendocrine carcinoma of the anterior mediastinum. As illustrated in the discussion, verify that the primary site is anterior mediastinum, the histology is neuroendocrine ca, and document those findings in the text.

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.

 2004
20031089 Primary Site/Histology (Pre-2007)--Bone: How are these fields coded for a squamous cell carcinoma in bone? See Description. The consult path report says "I believe that there is definitely high grade malignant tumor in this amputation specimen, and that this tumor represents an invasive squamous cell carcinoma, which is extending into the bone and permeating in between the bone trabeculae. ... The fact that squamous cell carcinoma can arise from the sinuses of chronic osteomyelitis is well recognized."

For tumors diagnosed prior to 2007:

Based on the information provided, code the primary site as C40._ or C41._ [bone] because the tumor originated in the sinuses of chronic osteomyelitis. Code to the site in which the tumor arises. Override the SEER site/histology edits to allow this rare combination of bone and squamous cell carcinoma.

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.

 2003
20041055 Primary Site/Grade, Differentiation, Cell indicator--Lymphoma: Will a Grade, Differentiation code of 6 [B-cell] for a lymphoma coded to primary site C80.9 [unknown] fail edits? See Discussion. Patient had a large mass in chest wall that was excised and found to be large B cell lymphoma. Scans mentioned no involvement of lymph nodes but indicated nodules in the liver thought to be lymphoma as well.

For cases diagnosed prior to 1/1/2010:The combination of a primary site C809 with a Grade, Differentiation code of 6 when used for a lymphoma will not fail SEER edits. Avoid coding primary site to C809 when possible. Code primary site for the example above to C761 [Chest wall, NOS]. The chest wall is the only area of involvement, except for "liver nodules." Liver is an unlikely primary site for lymphoma.

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.

 2004
20031081 Primary Site/EOD-Size of Primary Tumor--Lung: If the only lung mass described in CXR is a "hilar mass," is the primary site coded to C34.9 [Lung, NOS] or C34.0 [Main Bronchus; incl. Carina]? Also, can the size of the hilar mass be used to code the size of tumor field?

Because the only description available is "hilar mass," code primary site as C34.0.

For cases diagnosed 1998-2003: Use size of mass for EOD-Size of Primary Tumor.

 2003