| Report | Question ID | Question | Discussion | Answer | Year |
|---|---|---|---|---|---|
|
|
20110019 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are to be abstracted when bilateral testes are involved with lymphoma? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This is a single primary per Rule M2 which indicates to abstract a single primary when there is a single histology. Code the histology to 9590/3 [lymphoma] and the primary site to C629 [testes. Unless your software has edits that prevent coding laterality for lymphomas, code the laterality as bilateral. Up to half of extranodal lymphomas occur in multiple sites, particularly in paired sites.
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. |
2011 | |
|
|
20110070 | MP/H Rules/Histology--Endometrium: How is histology coded when clear cell adenocarcinoma [8310/3] is stated to involve a "1.5 cm endometrial polyp"? See Discussion. | The CAP formatted pathology report histology field states, "Clear cell adenocarcinoma, NOS 98310/3)" and the tumor size comment field states, "Carcinoma involves a 1.5 cm endometrial polyp." Does rule H11 apply? Is the histology coded to clear cell adenocarcinoma [8310/3] because this is one histologic type identified in the CAP formatted histology field? Or should rule H12 apply and the histology coded as clear cell adenocarcinoma arising in a polyp [8210/3]? Or should we code the higher histology per rule H17 apply because clear cell adenocarcinoma and adenocarcinoma in a polyp are two specific histologies?
For colon primaries, whether or not the tumor arose in a polyp is quite important. Is this also the case for primaries listed in the Other Sites category? |
Code histology to 8310/3 [clear cell adenocarcinoma]. The Multiple Primary and Histology Coding Rules Manual is the correct source for coding histology for cases diagnosed 2007 or later.
The following steps are used to determine the histology code:
Open the Multiple Primary and Histology Coding Rules manual. For an endometrial primary, use the Other Sites Histo rules to determine the histology code because endometrium does not have site specific rules.
Go to the SINGLE TUMOR: INVASIVE ONLY module, which starts at Rule H8.
. Code clear cell adenocarcinoma [8310/3] because only one histologic type is identified. |
2011 |
|
|
20110082 | First course treatment/Other therapy--Skin: How is PUVA [psoralen (P) and long-wave ultraviolet radiation (UVA)] coded when used for skin primaries such as melanoma and mycosis fungoides? | Code PUVA as "Other treatment" with Code 1 - Other. We do not have a code specifically for ultraviolet radiation. | 2011 | |
|
|
20110013 | MP/H Rules/Histology--Testis: Which MP/H rule applies in coding the histology described as a "malignant mixed germ cell tumor with the following features: Histologic type: embryonal carcinoma (97%) and yolk sac tumor (3%)"? See Discussion. |
Per MP/H rule H16, code the appropriate combination/mixed code (Table 2) when there are multiple specific histologies or when there is a non-specific histology with multiple specific histologies. The combination embryonal carcinoma and yolk sac tumor is not listed in Table 2, even though the pathology report indicates this is a mixed germ cell tumor.
Should rule H17 be applied and the numerically higher histology code be used? |
As of 2016: Code histology to 9085/3 [mixed germ cell tumor]. Combine 9065 and 9085 for analysis purposes. |
2011 |
|
|
20110092 | MP/H Rules/Multiple primaries--Breast: How many primaries are accessioned when a pathology specimen reveals one tumor with invasive mucinous carcinoma [8480/3] and a second tumor with in situ ductal carcinoma, solid and cribriform types [8523/2]? |
For cases diagnosed 2007 or later, accession two primaries, invasive mucinous carcinoma [8480/3] and in situ ductal carcinoma, solid and cribriform types [8523/2]. The steps used to arrive at this decision are: Go to the Breast MP rules found in the Multiple Primary and Histology Coding Rules Manual after determining the histology of each tumor (8480/3 and 8523/2). Start at the MULTIPLE TUMORS module, rule M4. These tumors have ICD-O-3 histology codes that are different at the second (xxx) and third (xxx) number and are, therefore, multiple primaries. |
2011 | |
|
|
20110030 | Reportability--Heme & Lymphoid Neoplasms: If and when did Langerhans cell histiocytosis (LCH) become a reportable neoplasm? See Discussion. | Per the Histiocytosis Association of America, "Over the years, cancer treatments have been used in patients with histiocytosis. Consequently, hematologists and oncologists, who treat cancer, also treat children with Langerhans cell histiocytosis. However, the disease is not cancer." | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Langerhans cell histiocytosis (LCH) [9751/3] is reportable to all agencies starting for cases diagnosed 1/1/2010 and later. See Appendix D: New Histology Terms and Codes.
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. |
2011 |
|
|
20110005 | Histology--Heme & Lymphoid Neoplasms: How is the pre-2010 histology coded for a "follicular grade 2, non-Hodgkin lymphoma with marginal zone B-cell differentiation"? See Discussion. | This patient was seen in 2010 for the same primary as diagnosed in 2006. The histology was coded to marginal zone lymphoma [9699/3] in 2006. Is this correct? Or should this have been coded as a follicular lymphoma, ignoring the modifying expression "marginal zone B-cell differentiation"? | This is a 2006 diagnosis. The histology code is 9691/3 [follicular lymphoma, grade 2]. Do not code differentiation for hematopoietic cases.
For diagnoses 2010 and forward, a small number of cases of follicular lymphoma do have marginal zone differentiation. However, there is no code for this variant of follicular lymphoma. It would simply be coded as a follicular lymphoma because that is the most accurate histology code available. The marginal zone differentiation is not to be coded as a second primary (marginal zone lymphoma). |
2011 |
|
|
20110050 | MP/H Rules/Multiple primaries: How many primaries are to be abstracted when a patient was initially diagnosed with epithelioid sarcoma in 2003, underwent multiple resections, radiation, and ultimately partial amputation of the limb in 2010, each with margins positive for residual epithelioid sarcoma? See Discussion. |
In Dec. 2003 a patient was diagnosed with epithelioid sarcoma of the left palm. In Jan. 2004 the patient had an excision with skin graft and positive margins. Amputation was recommended but the patient chose radiation instead. In May 2006 the patient had a local excision positive for epithelioid sarcoma followed by an amputation of the thumb and index finger with positive margins. Then in April 2010, the patient had an amputation of the remnant of left hand up to the middle third of the forearm. Again, there was residual distal invasive tumor positive for epithelioid sarcoma. |
This is a single primary, epithelioid sarcoma of the left upper limb, diagnosed in 2003. The sarcoma progressed over the years and the patient was never free of disease -- positive margins were documented at each surgical event. Per the 2004 SEER Manual coding rules in place at the time of pre-2007 recurrences, they would not be multiple primaries according to Rule 5, exception 1. The occurrence in 2010 is also not a new primary. The steps used to arrive at this decision are as follows. Open the Multiple Primary and Histology Coding Rules manual. For a soft tissue primary, use one of the three formats (i.e., flowchart, matrix or text) under the Other Sites MP rules to determine the number of primaries because soft tissue primaries do not have site specific rules. Start with the UNKNOWN IF SINGLE OR MULTIPLE TUMORS module, Rule M1. The rules are intended to be reviewed in consecutive order within the module that applies for this case. In this module there is only one rule. . This patient was never disease free and it is unknown if this tumor was the same tumor (single tumor) or multiple tumors. Abstract a single primary for this patient. |
2011 |
|
|
20110048 | First course treatment--Heme & Lymphoid Neoplasms: How is a "donor lymphocyte infusion" that is used in the treatment of CLL coded? | Donor lymphocyte infusion (DLI) is coded as immunotherapy. The lymphocytes are donated by the same person who donated the original stem cell transplant. The lymphocyte infusion creates an immune response in which the T-cells are activated to attack the cancer cells.
See "Treatments" for CLL/SLL (9823/3) |
2011 | |
|
|
20110040 | Reportability--Melanoma: Is a pathology report with a final diagnosis stating only non-reportable terms, followed by a re-excision pathology report that indicates "no residual melanoma" reportable? See Discussion. |
Is a case reportable if the final diagnosis on an initial pathology report states a non-reportable term (e.g., evolving melanoma, early/evolving melanoma or melanocytic nevus) and followed by a subsequent re-excision pathology report stating there is "No residual melanoma"? There is no mention in the clinical history on the subsequent pathology report that the diagnosis was thought to be melanoma following the first procedure. The first mention of the reportable term was in the final diagnosis of the subsequent pathology report that stated "no residual melanoma." |
No. This case is not reportable based on the information provided. "No residual melanoma" is not diagnostic of a reportable neoplasm. We recommend that you try to obtain more information from the clinician/pathologist for this case due to the poor documentation. Check for any additional resection performed. |
2011 |
Home
