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Report Produced: 11/29/2024 18:57 PM

Report Question ID Question Discussion Answer Year
20021176 Histology (Pre-2007)/Multiple Primaries (Pre-2007)--Breast: What code is used to represent histology for a case with a biopsy specimen that reveals "infiltrating ductal carcinoma with ductal carcinoma in situ, comedo subtype, non-extensive" in one quadrant of the breast and a mastectomy specimen with "invasive pleomorphic lobular carcinoma with lobular carcinoma in situ" in another quadrant of the breast? Paget disease is identified in the nipple section.

For tumors diagnosed prior to 2007:

Code the Histology field to 8522/3 [infiltrating duct and lobular carcinoma]. We are choosing the ductal and lobular combination over the Paget disease and lobular combination because it is more important for analysis purposes.

Be careful in using combination codes to code separate tumors in different locations of the same breast as a single primary. Currently there are only three combination codes for the breast that allow for this situation, 8522 [duct and lobular], 8541 [Paget disease and infiltrating duct] and 8543 [Paget disease and intraductal]. Other histologic type differences that occur as separate tumors in different parts of the same breast are coded as multiple primaries.

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
20031029 Histology (Pre-2007)/Grading--Head & Neck: Can terms that commonly modify histologic types or grades be used if they are only expressed in the microscopic portion of the pathology report? See Description. Final path diagnosis on a biopsy of the base of tongue is squamous carcinoma. The micro portion of the path report states the following: Multiple fragments of abnormal epithelium with a complex growth pattern. Many of the cells are small and poorly differentiated, interspersed with areas of well-differentiated keratinized epithelium. This is consistent with squamous cell carcinoma in situ with areas of invasive carcinoma. Do we code histology to 8070/3 or 8071/3?

For tumors diagnosed prior to 2007:

Yes, code using terms from the microscopic description if there is a definitive statement of a more specific histologic type.

Code the case example as 8070/33 [Squamous cell carcinoma, NOS, poorly differentiated]. The microscopic description adds grade information, but does not make a definitive statement of a more specific histologic type. "Keratinized epithelium" is not the same as keratinizing squamous cell carcinoma (8071/3). The mention of "areas of well-differentiated keratinized epithelium" refers to "normal" tissue within the specimen, in contrast to a type of neoplastic tissue.

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
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.

 2002
20000852 Histology (Pre-2007)/Grade, Differentiation: What code is used to represent the histology "cystadenocarcinoma with multiple foci of high grade anaplastic and undifferentiated sarcoma"? See discussion. The case was presented at tumor conference. The physicians indicated that the patient would not have the same disease course as a patient with cystadenocarcinoma of the ovary. The physicians advised the use of a mixed histology code. However, there is no appropriate mixed histology code for cystadenocarcinoma, anaplastic carcinoma, and sarcoma. It doesn't seem as though these cases should be grouped and analyzed with cases having a single histology of cystadenocarcinoma.

For tumors diagnosed prior to 2007:

Code the Histology and Grade, Differentiation fields to 8440/34 [cystadenocarcinoma, anaplastic] because a combination code for the specified histologic type does not exist.

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.

 2000
20021044 Histology (Pre-2007)/Grade, Differentiation: Can histology and/or grade be coded from a metastatic site? See discussion.

Example 1: No pathology specimen is available from the primary site for a lung primary. Rib biopsy demonstrated "anaplastic adenocarcinoma."

Example 2: Lung tissue biopsy revealed "poorly differentiated non-small cell carcinoma" for a lung primary. Pleural effusion cytology was consistent with "adenocarcinoma".

For tumors diagnosed prior to 2007:

Example 1: Code the Histology and Grade, Differentiation fields to 8140/39 [adenocarcinoma, NOS, grade not stated]. Because there was no microscopic examination of tissue from the primary site, the histology may be coded from the microscopic examination of the tissue from a metastatic site. Do not code grade from a metastatic site regardless of whether the involvement of the metastatic site is by direct extension or by discontinuous metastases.

Example 2: Code the Histology and Grade, Differentiation fields to 8046/33 [non-small cell carcinoma, poorly differentiated]. Because there is a microscopic examination of tissue from the primary site, that information should be used to code histology rather than a cytology of a metastatic site.

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
20021157 Histology (Pre-2007)/Grade, Differentiation--Lung: What code is used to represent the histology for a lung biopsy of "non-small cell carcinoma with features of poorly differentiated adenocarcinoma"? See discussion. Non-small cell carcinoma does not appear to be an NOS term in ICD-O-3. The term "with features of" indicates a majority of tumor. Which rule should be used to code histology?

For tumors diagnosed prior to 2007:

Code the Histology and the Grade, Differentiation fields to 8140/33 [adenocarcinoma, poorly differentiated].

The term "non-small cell carcinoma" is used to represent a broad category of epithelial cancers. Non-small cell carcinoma [8046/3] is grouped in the ICD-O-3 under "Epithelial Neoplasms, NOS." The term can be used by a pathologist when he rules out the fact that the patient has a small cell cancer by stating that the malignancy is a non-small cell type of cancer. In this case, the type of non-small cell cancer present in the specimen is adenocarcinoma.

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
20000530 Histology (Pre-2007)/Grade, Differentiation--Brain and CNS: What code is used to represent the histology and grade for "WHO-II astrocytoma, grade II" of the brain when the WHO-II classification is different from the classification systems previously used? See discussion. According to the WHO-I classification system, this is a moderately anaplastic astrocytoma. According to the Duke criteria, this is an astrocytoma. By Dauma-Dupont criteria, this is a grade 2 astrocytoma.

For tumors diagnosed prior to 2007:

Code the Histology and Grade, Differentiation fields to 9401/34 [anaplastic astrocytoma].

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.

 2000
20021174 Histology (Pre-2007)/Grade, Differentiation--All Sites: When the original pathology reports diagnosis indicates a grade and the review of slides (ROS) pathology report does not give a grade, can you code the histologic type from the ROS and the grade from the original pathology report? See discussion. For example, if the original diagnosis is "poorly differentiated carcinoma" and the ROS diagnosis is "squamous cell carcinoma," would the morphology code be 8070/33?

For tumors diagnosed prior to 2007:

Yes. Code the Histology and Grade, Differentiation fields to 8070/33 [poorly differentiated squamous cell carcinoma]. Code the higher grade when different grades are specified for the same specimen and code the more specific morphology (i.e., squamous cell carcinoma rather than carcinoma, NOS).

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
20021101 Histology (Pre-2007)/Grade, Differentiation--All Sites: How do we code these fields for a tumor that is predominantly a "well differentiated liposarcoma" [8851/31] that has a less predominent type of "dedifferentiated liposarcoma" [8858/33]? If we code the predominant cell type [8851/3] and the worst grade [3], the case will not pass edits because well-differentiated liposarcoma requires a differentiation code of 1. See discussion. Example: Dedifferentiated liposarcoma, with the following features: size 22 cm, FNCLCC grade 3 of 3 [high grade]. Path comment: The tumor consists of predominantly well-differentiated sclerosing subtype liposarcoma and areas of high grade spindle cell (non-lipogenic) sarcoma. The area of high grade spindle cell sarcoma measured up to 7.5 cm.

For tumors diagnosed prior to 2007:

Code the Histology field to 8858/33 [Dedifferentiated liposarcoma, grade 3]. The pathologist gives a final designation of Dedifferentiated liposarcoma and then provides further details in the comment that do not negate the final designation.

Grade is usually coded independent of the cell type. There are a few Catch-22 situations, like this one, in which the grade is built into the name of the cell type.

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
20061107 Histology (Pre-2007)/Flag--Pancreas: How is histology coded given that 8046 [non-small cell carcinoma] of the pancreas is not on the SEER Site/Type validation listing?

For tumors diagnosed prior to 2007:

Assign 8046 [non-small cell carcinoma] for "non-small cell carcinoma" of the pancreas. If necessary, override any site/type edits.

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.

 2006