Report | Question ID | Question | Discussion | Answer | Year |
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20250005 | Reportability/Behavior--Ovary: Is ovarian mucinous borderline tumor with foci of multifocal intraepithelial carcinoma reportable? |
Report ovarian mucinous borderline tumor with foci of multifocal intraepithelial carcinoma. The foci of intraepithelial carcinoma makes this reportable. See the list of synonyms for in situ in the SEER Manual, Behavior Code data item. |
2025 | |
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20250008 | Diagnostic Confirmation--Heme & Lymphoid Neoplasms: How is Diagnostic Confirmation coded for hematopoietic and lymphoid neoplasms (heme) when immunophenotyping, genetics, etc. confirm the diagnosis. |
Assign Code 3 (Positive histology PLUS positive immunophenotyping or genetic testing) for 1. Cases with positive histology for the neoplasm being abstracted (including acceptable ambiguous terminology and provisional diagnosis), AND
2. A not otherwise specified (NOS) histology diagnosed and not a provisional diagnosis, AND genetic/immunophenotyping was performed and positive Refer to the current version of the Heme Manual for specific notes and examples when coding Diagnostic Confirmation. |
2025 | |
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20250003 | Solid Tumor Rules/Histology--Fallopian Tube: How is histology coded for a high-grade serous carcinoma with admixed yolk sac tumor of the right fallopian tube? See Discussion. |
There was a single right fallopian tube tumor with two distinct morphologies. The diagnosis comment states, “The combined morphologic and immunohistochemical features are best classified as primary fallopian tube high grade serous carcinoma with a somatically derived yolk sac tumor.” |
Assign high-grade serous carcinoma of the fallopian tube (8461/3). There is currently no code to capture this rare mixed histology. Yolk sac tumors rarely occur in the fallopian tubes of postmenopausal patients and are associated with poor outcome. It is important to document the findings in the appropriate text field. | 2025 |
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20250006 | Reportability/Histology--Appendix: Is carcinoid of the appendix reportable? If yes, when did this take effect? |
Report carcinoid, NOS of the appendix. As of 01/01/2015, the ICD-O-3 behavior code changed from /1 to /3. |
2025 | |
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20250009 | Sequence Number--Central/Reportability--Heme & Lymphoid Neoplasms: Is a hematolymphoid disease included in the sequencing if it was not reportable at the time of diagnosis? |
Do not include the disease in the sequencing if the original hematolymphoid disease was not reportable at time of diagnosis.
The 2025 SEER Manual Sequence Number--Central Coding Instruction 1.a advises: A ‘reportable’ primary refers to the site/histology/behavior of the tumor and the years when reporting was required. Review of the reportability requirements in effect during the diagnosis year will be needed. |
2025 | |
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20250010 | Immunotherapy/Other Therapy--Heme & Lymphoid Neoplasms: Is the elimination of immunosuppression treatment coded as other treatment? An example is when a post-transplant patient develops a malignant myeloproliferative neoplasm that subsides when immunosuppression drugs are stopped. |
Do not code as a treatment. Record the cessation of immunosuppressive drug treatment in text to explain the patient’s change in disease status. |
2025 | |
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20250001 | Reportability/Histology--Endometrium: Are the following terms and diagnoses synonymous with endometrioid intraepithelial neoplasia (EIN) and therefore reportable? 1. Atypical glandular epithelium 2. Isthmic-type mucosa with focal severe atypia 3. Simple hyperplasia without atypia 4. EIN/complex atypical hyperplasia (EIN/CAH) or focal EIN/CAH (on biopsy but the resection pathology or operative note states no EIN/CAH/atypical hyperplasia) |
We have questions regarding reportability of some terms/diagnoses after a review of EIN cases back to 2021. While some seem synonymous with EIN, others have different terms in the pathology report though the physician is treating as if they have the diagnosis. 1. Atypical glandular epithelium Scenario: Endometrium biopsy with ablation performed at Facility A on 8/7/2024 showed atypical glandular epithelium. Patient was sent to Facility B where the total abdominal hysterectomy/bilateral salpingo-oophorectomy (TAH/BSO) on 9/20/2024 showed other reactive fibrosis and obliterated architecture compatible with history of ablation. Is atypical glandular epithelium synonymous with and coded as EIN? 2. Isthmic-type mucosa with focal severe atypia Scenario: Endometrium biopsy showed isthmic-type mucosa with focal severe atypia. Then Facility B did TAH/BSO that showed no evidence of high grade dysplasia, atypical hyperplasia, or carcinoma. 3. Simple hyperplasia without atypia Scenario: Endometrial biopsy pathology states simple hyperplasia without atypia and the TAH/BSO is either negative or has the same histology; however, the treating physician is stating EIN. 4. EIN/CAH or focal EIN/CAH Scenario: Biopsy showed EIN/CAH but the total abdominal hysterectomy/bilateral salpingo-oophorectomy (TAH/BSO) pathology or the Mirena IUD treatment operative note states no EIN/CAH/Atypical hyperplasia. Are these reportable, similar to an in situ when the re-excision lumpectomy or mastectomy is negative or no residual disease? |
Reportability for EIN became effective in 2021. 1. Do not report atypical glandular epithelium. Atypical glandular epithelium, also referred to as atypical glandular cells (AGC), refers to abnormal looking cells that may be found in the tissue lining the inside of the endometrium or the cervix. While not malignant (in situ or invasive), they can be associated with a range of lesions in the female reproductive system. 2. Do not report isthmic-type mucosa with focal severe atypia. The NCI data dictionary defines atypia as an abnormality in cells in tissue. Report the case when further defined as atypical hyperplasia. 3. Do not report simple hyperplasia without atypia. WHO Classification of Tumors online, Female Genital Tumors (5th ed.), defines endometrial hyperplasia without atypia as a proliferation of endometrial glands of irregular size and shape without significant atypia. There is no ICD-O code for this term. Simple endometrial hyperplasia without atypia is an acceptable related term for endometrial hyperplasia without atypia. Pathology has priority over a physician statement. 4. Report EIN/CAH or focal EIN/CAH (8380/2) based on the biopsy. WHO Classification of Tumors online, Female Genital Tumors (5th ed.), defines EAH/EIN as a simultaneous change of epithelial cytology and an increased number of endometrial glands in a defined region. The preferred term is atypical hyperplasia of the endometrium; terms not recommended include complex atypical endometrial hyperplasia; simple atypical endometrial hyperplasia; endometrial intraepithelial neoplasia.
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2025 |
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20250007 | Reportability/Behavior: Our registry collects some borderline (behavior /1) cases that are not reportable to SEER or any other standard setters. Can we assign a behavior code of /2 to these cases? |
Do not assign a behavior code of /2 to these cases unless you have a way to flag them so that they are not reported to the standard setters as in situ cases. Work with your state central registry to ensure that these cases are not unintentionally included in state case submission. |
2025 | |
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20250004 | Reportability/Histology--Heme & Lymphoid Neoplasms: Is a diagnosis of myeloid stem cell disorder or myeloid stem cell neoplasm reportable when the differential diagnosis includes only reportable neoplasms? If so, how should histology be coded? See Discussion. |
Pathologists are increasingly using the terms "myeloid stem cell disorder" and "myeloid stem cell neoplasm" to describe reportable myeloid neoplasms. If the pathologist uses these terms and indicates the differential diagnosis includes only reportable neoplasms such as myelodysplastic syndrome, myeloproliferative neoplasm, and acute myeloid leukemia (AML), should this be accessioned as a reportable primary? Example: The 01/2023 peripheral blood shows high grade myeloid stem cell disorder, and the differential diagnosis includes chronic myelomonocytic leukemia(CMML) and AML. The patient refused further work-up and expired several days later. No additional information is available. |
Report the case when the differential diagnosis includes only reportable neoplasms in the absence of additional information. We are unable to provide general instructions for provisional diagnoses as each situation will need to be reviewed and assessed individually when no further work-up information is available.
Assign myeloid leukemia, NOS (9860/3) to the case described in the example. Assign a generic histology code because a specific histology code cannot be assigned when there are several differential diagnoses. Since the differential diagnoses include a chronic and an acute leukemia, code as myeloid leukemia, NOS since it is not clear if this is chronic or acute. |
2025 |
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20250002 | Reportability/Histology--Soft Tissue: Is superficial CD34 positive fibroblastic tumor reportable and if so what histology code should be used? See Discussion. | Patient had a left thigh soft tissue mass excision on 7/24/24 and was diagnosed with superficial CD34 positive fibroblastic tumor. Margins were narrowly free of disease. Tumor size was 5.5 cm x 4.4 cm x 3.9 cm. The diagnosis was confirmed. |
Do not report superficial CD34-positive fibroblastic tumor (8810/1) of the thigh. WHO Classification of Soft Tissue and Bone Tumors, 5th ed., defines superficial CD34-positive fibroblastic tumor as a distinctive low-grade neoplasm of the skin and subcutis, most frequently occurring in the lower extremities, especially thigh, followed by arm, buttock, shoulder, and rarely, vulva. |
2025 |