| Report | Question ID | Question | Discussion | Answer | Year |
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20021046 | Behavior Code/EOD-Extension--Bladder: If an in situ lesion of the urinary bladder involves the von Brunn nests, is it still in situ? See discussion. | Von Brunn nests: Compact, rounded aggregates of urothelial (transitional) cells in the lamina propria, with or without connection to the surface epithelium. Urothelial (transitional cell) carcinoma in situ...may involve von Brunn nests... Histologic Typing of Urinary Bladder Tumours, Second Edition, WHO, pp 12 & 21 |
For cases diagnosed 1998-2003:
Code the Behavior Code and the EOD-Extension field according to the pathology report.
If the pathology report states the tumor to be noninvasive or in situ, whether or not von Brunn nests are involved, code behavior as 2 [in situ] and extension as in situ.
If the tumor is described as invasive and involves the von Brunn nests, code the EOD-Extension field to 15 [invasive tumor confined to subepithelial connective tissue] because code 15 includes extension to the lamina propria and von Brunn nests are within the lamina propria. |
2002 |
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20021072 | EOD-Size of Primary Tumor--Breast: The path report provides a size for both the Paget disease and the underlying intraductal component in the breast. Should we assume the Paget disease to be invasive and code the size of the primary tumor to that invasive component? See discussion. | For example, path diagnosis for resection gave the size of the Paget disease as 1 mm and the size of the underlying intraductal tumor as 4 cm. Should size for this breast case be coded to 040 or 003, less than 3 mm. | For cases diagnosed 1998-2003:
Code the EOD-Size of Primary Tumor field to 040 [4 cm], the size of the larger underlying intraductal tumor. Paget disease is classified according to the size of the underlying in situ or invasive tumor. Paget with an underlying in situ tumor is staged as in situ to match the AJCC classification of this disease process. |
2002 |
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20021070 | CS Extension/CS Lymph Nodes--Breast: How would you interpret the phrase "axillary lymph node tissue, not clearly a lymph node" or the phrase "satellite nodule of invasive tumor, left axillary lymph node or chest wall tissue"? See discussion. | A lumpectomy with axillary lymph node dissection and removal of nodule in anterior axillary line revealed negative lymph nodes. The nodule specimen was labeled "axillary lymph tissue, not clearly a lymph node". The microscopic description for that specimen stated "Fibroadipose tissue. A fragment of a lymph node is incidentally sampled in block 4 and it is free of tumor". The final path dx stated "Satellite nodule of invasive tumor, left axillary lymph node, or chest wall tissue. Comment: If the tissue is considered chest wall this would be a stage IIIB. If it is considered an intramammary satellite nodule, this is a stage I". The clinician repeated what the comment said, and added "If lymph node mets, this is a stage II." | Code the invasive tumor in the axillary area as a regional lymph node metastasis. According to the AJCC, cancerous nodules in the axillary fat adjacent to the breast, without histologic evidence of residual lymph node tissue, are classified as regional lymph node metastases. | 2002 |
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20021194 | Grade/Histology (Pre-2007)--All Sites: What code is used to represent these fields for the histology "High grade dysplasia (adenocarcinoma in situ)" or "AIN III/High grade AIN"? |
For tumors diagnosed prior to 2007: Code the Histology field for the first example to 8140/2 [Adenocarcinoma, NOS, in situ] and for the second example to 8077/2 [AIN, grade III]. For both of the cases code the Grade, Differentiation field to 9 [Cell type not determined not stated or not applicable]. The 6th digit (grade code) of ICD-O-3 describes how much or how little a malignant tumor resembles the normal tissue from which it arose. In contrast, "grade" is used in the examples above to describe the degree of dysplasia, from mild dysplasia (low grade) to severe dysplasia (high grade). Do not record the degree of dysplasia in the 6th digit grade field. For tumors diagnosed 2007 or later, refer to the MP/H rules for histology coding instructions. 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 | |
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20020056 | Multiple Primaries (Pre-2007)--Bladder: Is a 1998 transitional cell carcinoma of the bladder, followed by a 2001 squamous cell carcinoma of the bladder reportable as a second primary? | For tumors diagnosed prior to 2007:
Yes. This case is reportable as a second primary. The rule in the SEER Program Code Manual says that invasive bladder cancers with histology codes 8120-8130 [papillary, transitional] are always coded as a recurrence and are an exception to the multiple primary rule. Squamous cell carcinoma [8070] is not a part of that exception.
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 | |
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20021179 | Primary Site/EOD Fields--Head & Neck: In the absence of an actual resection and a pathologic evaluation of the affected area, would a laryngoscopy or CT scan provide a better assessment of the EOD and the primary site? | For cases diagnosed 1998-2003:
For Primary Site and EOD, CT information has higher priority than laryngoscopy. The CT scan gives a better picture of the involvement of the deeper tissues. A laryngoscopy falls into the "physical exam" category more than the "operative" category. The laryngoscopy report is not an "operative" report like those generated from a surgical procedure. |
2002 | |
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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 |
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20021082 | Multiple Primaries (Pre-2007)/Primary site/EOD-Extension--Head & Neck: How many primaries are represented by an invasive squamous cell carcinoma of the floor of mouth with in situ squamous cell carcinoma involvement of the frenulum? |
For tumors diagnosed prior to 2007: Code the Primary Site field to C04.9 [floor of mouth]. Because the cancer did not INVADE into a neighboring site (through wall, through soft tissue), it just spread along the mucosa (in situ) to involve the frenulum, this is one primary. For cases diagnosed 1998-2003, in situ extension via mucosal spread to the frenulum is ignored for purposes of coding EOD-Extension. 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 | |
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20021021 | Reportability--Hematopoietic, NOS: Should we add the missing terms listed in the Abstracting and Coding Guide for the Hematopoietic Diseases to ICD-O-3 because these absent synonyms would not be identified during hematology casefinding? See discussion. | The Abstracting and Coding Guide for the Hematopoietic Diseases gives a preferred term for each code followed by a list of synonyms, not all of which are listed in the ICD-O-3. Two examples are: 1) 9962/3 [Essential Thrombocythemia] has 6 synonymous terms listed, but the last three of them are not in ICD-O-3. 2) 9930/3 [Myeloid Sarcoma] has the synonym "extramedullary myeloid tumor" which is not in ICD-O-3. | For cases diagnosed prior to 1/1/2010:Do not add these synonyms to ICD-O-3. The Abstracting and Coding Guide for the Hematopoietic Diseases lists synonyms for the preferred terms to assist in the classification of these other terms. In the absence of a specific code for the synonym, code to the preferred term. For casefinding, these terms would be grouped in a broader category of hematologic diseases under an ICD-9-CM or ICD-10 code and, therefore, will be identified during casefinding procedures using the disease index. 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. |
2002 |
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20021055 | EOD-Extension--Liver: Can we use CT scan descriptions such as "portal vein thrombosis" or "extensive infiltration of the liver" or "diffuse infiltration of the liver" to code extension for liver primaries? See discussion. | 1. Would you code portal vein involvement for a CT scan description of "portal vein thrombosis"?
2. Would you code more than one lobe of the liver as involved for CT scan descriptions of "extensive infiltration of the liver" or "diffuse infiltration of the liver"? |
For cases diagnosed 1998-2003:
1. No. Thrombosis can be caused by non-cancerous conditions.
2. Yes. Code the EOD-Extension field to 65 [Multiple (satellite) nodules in more than one lobe of the liver] when "extensive infiltration" or "diffuse infiltration" is stated. |
2002 |
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