| Report | Question ID | Question | Discussion | Answer | Year |
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20021040 | Other Therapy: What code is used to represent treatment with "Epithilone" or "Epothilone"? | Code the Other Cancer-Directed Therapy field to 2 [Other experimental cancer-directed therapy (not included elsewhere)], until the exact mechanism of action is determined for this drug. This drug is in phase I clinical trials. It has a similar action to Taxol, but is derived from a different source. | 2002 | |
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20021173 | Histology (Pre-2007): What code is used to represent a review of slides histology of "in situ squamous cell carcinoma and multiple detached fragments of atypical papillary squamous epithelium; highly suspicious for invasive carcinoma"? See discussion. | The original pathologist indicated a final diagnosis of moderately differentiated squamous cell carcinoma. The slides were sent for review to another facility. The reviewing pathologist rendered the diagnosis stated in the question section. | For tumors diagnosed prior to 2007:
Code the Histology field to 8070 [squamous cell carcinoma].
The review diagnosis was also squamous cell carcinoma. The expression "atypical papillary squamous epithelium" does not modify the cancer histology.
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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20020024 | Reportability--Cervix: The SEER Program Code Manual lists CIN III and carcinoma in situ of the cervix as not being reportable for cases diagnosed in 1996 or later, but does not list "adenocarcinoma in situ" or "squamous cell carcinoma in situ." Are these histologies still reportable? | For primary site cervix uteri, only histologies with behavior codes of 3 [invasive] are reportable to SEER for all registries.
Some SEER registries have opted to continue to collect behavior codes of 2 [in situ] for cervix uteri primaries. |
2002 | |
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20020018 | EOD-Lymph Nodes/EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Cervix: What codes are used to represent these fields for a cervix primary when the only information on lymph nodes is a CT of the pelvis showing "pelvic adenopathy" (no surgery was done)? | Code the EOD-Lymph Nodes field to 9 [unknown]. Code the Pathologic Review of Number of Regional Lymph Nodes Positive field to 98 [No nodes examined] and the Lymph Nodes Examined to 00 [No nodes examined] because there was no resection of the primary organs. Adenopathy, NOS, per SEER guidelines, is not coded as lymph node involvement | 2002 | |
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20021096 | Grade, Differentiation--Bladder: What codes are used to represent this field for the four bladder cases described in the discussion section that have a combination of grades mentioned in the pathology reports? See discussion. | 1) Final path diagnosis: papillary transitional cell carcinoma, high grade. Micro description states: High grade, poorly differentiated carcinoma. 2) Well to moderately differentiated papillary transitional cell carcinoma, grade 1-2/3. 3) Urothelial carcinoma, high grade (poorly differentiated, grade 3 of 3). 4) High grade papillary urothelial carcinoma (papillary transitional cell carcinoma, grade 3 out of 4). |
For cases diagnosed January 2004 and forward: 1) Grade 4. High grade is coded 4. Code the grade stated in the final diagnosis. 2) Grade 3. Grade 1-2/3 is coded 3. Use the three-grade conversion table in the 2004 SEER manual. 3) Grade 4. Grade 3 of 3 is coded 4. Use the three-grade conversion table in the 2004 SEER manual. 4) Grade 3. "Grade 3 out of 4" is coded 3 and is more precise than "high grade." |
2002 |
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20020030 | EOD-Size of Primary Tumor: 1) Can we add "Imaging studies" to those EOD schemes that currently do not include this on their priority list for coding size? 2) When an EOD scheme already lists specific types of imaging studies, are we limited to only those types of procedures or can any imaging study be used to code size? See discussion. | How do we determine where to add "imaging studies" to the priority listing? Currently the hierarchy differs for primaries that currently include imaging studies on their EOD schemes. For example, on the breast EOD imaging ranks lower than the physical exam while on the thyroid EOD imaging ranks higher than the physical exam. | For cases diagnosed 1998-2003:
1) You may add "Imaging" to the size priority list for all EOD schemes that currently do not include it. Prioritize it just above the physical exam for these sites.
2) You may use the information from any imaging technique to code tumor size, even for those sites such as breast and bladder where specific imaging tests are mentioned. |
2002 |
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20021112 | Multiple Primaries/Histology--Hematopoietic, NOS: The subsequent primary table for 2001 and later indicates that 9863/3 [acute myelogenous leukemia (AML)] followed by 9980/3 [refractory anemia (RAEB)] is a new primary, but 9989/3 [myelodysplastic syndrome, NOS (MDS)] is not. Is the case below two primaries? See discussion. | Bone marrow bx states: The morphologic blast count of 7% exceeds 5%, traditionally used to define relapse in the setting of acute leukemia. Given the clinical hx that the pt's peripheral blood counts had initially normalized after induction therapy, the recent fall in counts is worrisome for the possibility of early relapse. Alternatively, therapy may have simply reverted the pt's marrow from AML to a precursor myelodysplastic syndrome (such as RAEB given the blast count) from which the AML arose, with the falling counts being progression of the underlying MDS. The identification of significant dysplasia in the bone marrow at the time of diagnosis would tend to support the possibility of an underlying MDS. Clinically, it is unlikely to make a difference whether one regards the present situation as early relapse or progression of an underlying MDS. The final clinical diagnosis is "Myelodysplasia, classified as RAEB." | For cases diagnosed prior to 1/1/2010: This case demonstrates a relapse of AML. The original classification of Histology as 9863/3 [AML] is correct. There is no second primary based on the information provided for this case. 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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20021175 | Histology (Pre-2007): What code is used to represent the histology if the final diagnosis between an electron microscopy report and the immunocytochemistry (ICC) differs and both histologies are specific (e.g., one report states papillary carcinoma and the other states squamous cell carcinoma)? | For tumors diagnosed prior to 2007:
There is no established hierarchy between electron microscopy and ICC findings. Contact the pathologists involved in these types of cases to determine the final histologic diagnosis.
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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20021130 | EOD-Extension--Breast: If a negative bone scan is followed by a bone marrow biopsy that is positive for metastatic disease, is the bony involvement used when coding extension [85] or as progression of disease (ignore mets when coding extension)? See discussion. |
Pt diagnosed with ductal carcinoma of the breast in May. On June 1, oncologist recommended chemo and XRT and planned a metastatic workup. A June 6 marrow MR consistent with mets. June 8 bone scan showed scoliosis of the L-spine with scattered focal areas of increased activity probably related to degenerative changes in the spine. On June 29, biopsies were done of the T2 vertebra with path diagnosis of metastatic adenocarcinoma consistent with breast primary. Chemo started July 15. For cases diagnosed 1998-2003, is EOD extension code 85 correct? We felt that the bone mets was found within 4 months of diagnosis and is not progression of disease. |
For cases diagnosed 1998-2003: Code the EOD-Extension field to 85 [metastasis]. Bone metastasis was documented during the original metastatic workup. Metastasis to the bone was suspected soon after diagnosis and confirmed prior to the start of treatment. The length of time between the diagnosis and the confirmation of the bone metastasis was not used to code extension on this case. The pt was still being worked up as evidenced by the fact that treatment had not yet started. |
2002 |
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20021088 | Multiple Primaries (Pre-2007)--Vulva/Vagina: SEER Program Code Manual rule #3 on page 11 states "If a new cancer of the same histology is diagnosed in the same site after two months, consider this new cancer a separate primary unless stated to be recurrent or metastatic. Should vulva and vagina be exceptions to rule #3, as are prostate and bladder? |
For tumors diagnosed prior to 2007: No. There is no exception for vulva or vagina. 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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