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Report Produced: 05/26/2026 16:15 PM

Report Question ID Question Discussion Answer Year
20130003

MP/H Rules/Histology--Head & Neck: How is the histology coded for a mammary analogue secretory carcinoma (MASC) of the parotid gland? See Discussion.

There is no histology listed in the ICD-O-3 for a mammary analogue secretory carcinoma. The pathologist stated that, "MASC is a recently described salivary gland tumor type which, as the name implies, resembles secretory carcinoma of the breast." Should the histology be coded 8550/3 [acinar carcinoma] or 8502/3 [secretory carcinoma of breast]?

Assign code 8502/3 [secretory carcinoma of breast].

Acinar carcinoma [8550/3] describes a very typical type of salivary gland tumor only. This histology code does not adequately capture the histology in this case which describes a secretory carcinoma that is similar to mammary cancer. Both of these elements are reflected in the histology code 8502/3 [secretory carcinoma of breast].

 2013
20130212 Reportability--Heme & Lymphoid Neoplasms: Is a case reportable in which the pathology report is negative for plasmacytoma but a subsequent physician's clinical diagnosis is plasmacytoma?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This case is reportable if the patient was treated for plasmacytoma. When the physician calls the case plasmacytoma and treats the patient accordingly, report the case.

See Case Reportability Instructions #6: Report the case when there is a clinical diagnosis (physician's statement) of a reportable hematopoietic or lymphoid neoplasm.

Note 1: The clinical diagnosis may be a final diagnosis found within the medical record or recorded on a scan (CT, MRI for example)

Note 2: Report the case even if the diagnostic tests are equivocal. A number of hematopoietic neoplasms are "diagnoses of exclusion" in which the diagnostic tests are equivocal and the physician makes the clinical diagnosis based on the equivocal tests and the clinical picture. See the Heme DB for definitive diagnostic methods for the specific neoplasm being abstracted.

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.

2013
20130211 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are reported if a bone marrow shows low grade mature B cell lymphoma with IgM paraprotein - macroglobulinemia? See Discussion.

Physician note: Bone marrow shows 10% involvement with low grade lymphoma. Assessment: Low grade mature B cell lymphoma with IgM paraprotein - macroglobulinemia.

The multiple primaries calculator indicates two primaries are to be reported. However, the physician stated that Waldenstrom's macroglobulinemia is another name for this patient's lymphoma.

There were no enlarged lymph nodes seen on the CT scan. The proposed treatment for this patient is Rituxan for the macroglobulinemia.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Per Rule M2, this is a single primary because there is a single histology. The bone marrow initially showed a non-specific B-cell lymphoma. WM is a type of B-cell neoplasm. After immunophenotyping, a more specific histologic diagnosis of WM was made. In this case a single histology (WM) is diagnosed by the definitive diagnostic method (serum paraprotein demonstrating IgM), so it accessioned as a single primary.

Per PH16, code the histology to 9761/3 [Waldenstrom Macroglobulinemia (WM)] and the primary site to C420 [blood].

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.

2013
20130219 Date of diagnosis/Ambiguous terminology--Breast: Can a mammogram BIRADS 4 or 5 assessment be used to assess reportability and can the date of the mammogram be used to code the date of diagnosis? See Discussion.

  1. Assessment: BIRADS category 4-suspicious. Findings are considered suspicious/indeterminate for malignancy

  • Assessment: BIRADS 5- highly suspicious. Findings are highly suggestive of malignancy.

  • Assessment: BIRADS 4- suspicious abnormality consider biopsy

    • Can the BIRADS number be used to assess reportability? Can a BIRADS assessment of "suspicious" be used to code the date of diagnosis?

    		BIRADS category 4 and category 5 mammograms are not to be interpreted as a reportable "malignancy" for cancer registry purposes nor are they to be used to code the date of diagnosis should the patient subsequently have a malignancy confirmed. 2013
    		20130101 Reportability--Heme & Lymphoid Neoplasms: Is plasma cell dyscrasia, favor MGUS vs. smoldering myeloma reportable? See Discussion. The pathology report states, "plasma cell dyscrasia, favor MGUS vs. smoldering myeloma." The patient then died of a heart attack and no further information is available. If this is reportable, what histology code applies?

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    This case is not reportable. Neither plasma cell dyscrasia nor MGUS are reportable. Smoldering myeloma was given as a possible diagnosis, but never confirmed.

    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.

    		2013
    		20130109

    Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2004 diagnosis of acute myeloid leukemia is followed by a 2013 diagnosis of myeloid sarcoma? See Discussion.

    Patient was diagnosed in 2004 with acute myeloid leukemia [9861/3] and treated with chemotherapy and transplant. Now the patient has a biopsy of an umbilical mass that is positive for myeloid sarcoma (granulocytic sarcoma) [9930/3].

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    Accession a single primary, acute myeloid leukemia [9861/3] diagnosed in 2004 per Rule M3.

    When there is a myeloid sarcoma diagnosed simultaneously or after a leukemia of the same lineage, it is a single primary. The myeloid sarcoma is actually caused by the AML progressing. The myeloid cells in the bone marrow or blood literally "seep out" and implant in the tissue.

    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.

    		2013
    		20130167

    Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are reported if a 2013 diagnosis of right leg skin nodules, consistent with plasmacytoma/plasma cell myeloma, follows a 3/20/07 biopsy diagnosis of multiple myeloma?

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    Abstract this case as a single primary. Code the histology to 9732/2 [multiple myeloma].

    Review the Abstractor Notes section in the Heme DB for multiple myeloma. It states that in multiple myeloma there is generalized bone marrow involvement and that extramedullary involvement is diagnostic of advanced disease. This is a case of advanced multiple myeloma.

    		 2013
    		20130102

    Histology--Heme & Lymph Neoplasms: Is follicular lymphoma, high grade synonymous with grade 3 lymphoma [9698/3] or is the "high grade" ignored and the histology coded to follicular lymphoma, NOS [9690]?

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    Code histology to 9698/3 [follicular lymphoma, grade 3].

    Follicular lymphoma, high grade is listed under the Alternate Names section of the Heme DB for Follicular lymphoma, grade 3.

    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.

    		 2013
    		20130129 Histology--Heme & Lymphoid Neoplasms: How is histology coded for a diagnosis of composite lymphoma (follicular lymphoma and small lymphocytic lymphoma, BCL-2 positive)?

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    Code the histology to 9823/3 [chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)] per Rule PH15. Code the histology to the non-Hodgkin lymphoma (NHL) with the numerically highest ICD-O-3 code when two or more NHLs are present in the same present in the same lymph node(s) or lymph node region(s), tissue(s), organ(s), or bone marrow. Both follicular lymphoma [9690/3] and SLL [9823/3] are types of NHL. Therefore, the histology is coded to 9823/3.

    This composite histology represents a single primary per Rule M4. The rule states to abstract a single primary when two or more types of non-Hodgkin lymphoma are simultaneously present in the same anatomic location(s), such as the same lymph node or lymph node region(s), the same organ(s), and/or the same tissue(s).

    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.

    		2013
    		20130077 Reportability--Heme & Lymphoid Neoplasm: What is the histology code if a myeloproliferative disorder is reportable should a physician suspect this diagnosis and treats the patient? See Discussion. Physician suspects patient has a myeloproliferative disorder and treats her with a phlebotomy and Hydrea. Patient receives Hydrea during an inpatient stay, but does not see the Heme/Onc again. The patient is subsequently only seen by a Palliative Medicine physician who also states she has an underlying myeloproliferative disorder. The patient died while an inpatient.

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    This is a reportable diagnosis and should be accessioned with the histology coded to 9975/3 [myelodysplastic/myeloproliferative neoplasm, unclassifiable].

    The term is a reportable ambiguous term per the Hematopoietic Coding Manual (Case Reportability Instructions, Rule 4). Also, the patient was treated for a myeloproliferative disorder, making this a reportable clinical diagnosis per the SEER Manual (Reportability, Pg 4, Exception 1).

    Myeloproliferative disorder is synonymous with myeloproliferative disease. Myeloproliferative disease is listed as an alternate name for myelodysplastic/myeloproliferative neoplasm, unclassifiable.

    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.

    		2013