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Report Produced: 03/01/2026 08:28 AM

Report Question ID Question Discussion Answer Year
20021002 Histology (Pre-2007)--Breast: What code is used to represent the histology "ductal carcinoma in situ with comedo necrosis"? See discussion.

SEER distributed breast questions to the Advisory Group made up of pathologists from different SEER regions. One question dealt with the terms comedo type, comedo necrosis and comedocarcinoma. Per the Advisory Group, "Do not code comedo necrosis. These three phrases each represent a different level of diagnosis and can't be compared. "Comedocarcinoma" is an established diagnosis of in situ carcinoma and should be coded as such. "Comedo type" refers to a type of intraductal cancer; whether it is considered to be a true diagnosis is probably still equivocal. "Comedo necrosis" refers to a description of cellular pathological events that occasionally occur within an intraductal tumor of comedo type, which should not be coded at all."

Per the SEER preferred answer: Comedo type = comedocarcinoma. Ignore comedo necrosis.

For tumors diagnosed prior to 2007:

Code the Histology field to 8500/2 [ductal carcinoma in situ].

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
20021106 Histology (Pre-2007)/Diagnostic Confirmation: What code is used to represent the histology that initially presents on uterine curettage as a hydatidiform mole and after pulmonary metastases develop a month later, the clinical diagnosis is "metastatic gestational trophoblastic disease"?

For tumors diagnosed prior to 2007:

Code the Histology field to 9100/3 [Choriocarcinoma]. Gestational trophoblastic neoplasia includes the diagnosis of choriocarcinoma.

Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only] based on the information above. However, if imaging, direct visualization, or another method identified the pulmonary metastases, then code the Diagnostic Confirmation accordingly.

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
20021181 Radiation/Chemotherapy: How do we code radiation and chemotherapy when the only statement we have is that the patient is "referred to either an oncologist or a radiation therapist"? For cases diagnosed 1/1/2003 and after: A referral does not mean that the radiation therapy or chemotherapy was actually recommended. These cases need follow-back to see if treatment was recommended and/or administered. Some registries code these cases as 8 [Radiation recommended, unknown if administered] or 88 [Chemotherapy recommended, unknown if it was administered] and routinely review all cases with 8 or 88 codes. Upon review, the codes are updated depending on the information found. If there is no information available, the code 8 or 88 is changed to 0 or 00 [None]. 2002
20021140 EOD-Extension--Head & Neck: How do you code extension for a supraglottic larynx primary with "pre-epigolottic space" invasion?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 65 [Pre-epiglottic tissues]. Extension to "pre-epiglottic space" is equivalent to extension to "pre-epiglottic tissue."

 2002
20021127 Histology (Pre-2007)/Behavior Code--Thyroid: What code is used to represent the histology "micropapillary carcinoma" of the thyroid? See discussion. The ICD-O-3 includes "micropapillary intraductal (C50._)" [8507/2], "micropapillary serous (C56.9)" [8460/3] and "micropapillary transitional cell (C67._) [8131/3] but does not seem to include a micropapillary code for a thyroid primary.

For tumors diagnosed prior to 2007:

Code the Histology field to 8507/3 [micropapillary carcinoma]. According to rule H, the topography code listed in the ICD-O is disregarded if the tumor is known to arise in another site. In this case, the site is thyroid [C73.9] so the topography code of breast [C50._] can be disregarded for this histology. Apply the matrix principle to change the Behavior Code from 2 to 3.

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
20021063 EOD-Pathologic Review of Number of Regional Lymph Nodes Examined: What code is used to represent this field when a path report from a lymph node biopsy or dissection describes lymph node "portions" or "fragments"? See discussion.

1) Lymph nodes, right pelvic dissection: No evidence of malignancy in 4 portions of lymph node examined. (Should we code the number examined as 01, 04, or 97?)

2) Lymph nodes, left pelvic dissection: 5 fragments of lymph nodes show no evidence of malignancy. (Should we code the number examined as 05 or 97?)

3) Biopsy of right neck mass: Malignancy in fragments of lymph nodes. The following month, pt had a right modified lymph node dissection: 16/32 lymph nodes are positive for malignancy. (Should we code the number examined as 32, 33, 97, 98?)

For cases diagnosed 1998-2003:

The total number of lymph nodes examined is recorded in EOD-Num of Reg LN Examined. If the number of actual lymph nodes represented by the "fragments" or "portions" cannot be determined, assign code 96, 97, or 98 as appropriate.

1) Based on the terminology "four portions of lymph node (singular)" code to 01 despite "dissection" terminology.

2) Code to 97 based on "fragments of lymph nodes (pleural)" terminology and procedure identified as dissection.

3) Code to 97 based on statement of "fragments of lymph nodes (pleural)" for biopsy plus dissection.

 2002
20021162

Chemotherapy: Should radiosensitizing chemotherapy agents (i.e., drugs typically coded as treatment for cancer) be coded as treatment when they are given in combination with radiation therapy with the intention of enhancing that treatment? See discussion.

Per our consultant, these drugs are given at a lower dose than that typically given to treat cancer patients.

Do not code radiosensitizers and radioprotectants as cancer-directed therapy. Drugs typically classified as chemotherapy agents would be "ancillary drugs" for the purpose of coding cancer-directed therapy because the drugs are given at a much lower dosage than that typically given to treat cancer patients. Per Book 8, ancillary drugs are not to be coded as cancer-directed therapy. Radiosensitizers and radioprotectants do not work directly on the cancer and are not coded under any of the systemic therapy fields.

 2002
20021010

Histology (Pre-2007): What code is used to represent the histology adenocarcinoma with "areas of" papillary architecture and "foci of" squamous differentiation? Even though "areas of" and "foci" are non-majority terms, should histology be coded to the combination code of adenocarcinoma with mixed subtypes [8255/3]?

For tumors diagnosed prior to 2007:

Code the Histology field to the majority of the tumor, which is 8140/3 [adenocarcinoma, NOS]. The terms "areas of" and "foci of" should be ignored because they are not terms that reflect the majority of the tumor. Therefore, we cannot use rule A on page 2 of Coding Complex Morphologic Diagnoses because this diagnosis does not represent a complex morphology.

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
20021178 Histology (Pre-2007): What code is used to represent the histology "poorly differentiated invasive transitional cell carcinoma with extensive squamous and focal glandular differentiation"?

For tumors diagnosed prior to 2007:

Code the Histology field to 8120/33 [transitional cell carcinoma, NOS, poorly differentiated]. The ICD-O-3 does not have a separate code for transitional cell carcinoma with squamous and/or glandular differentiation.

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
20021093 EOD-Size of Primary Tumor--Colon: When an adenocarcinoma is stated to be arising in an adenoma and the "tumor size" stated in the final pathologic diagnosis is the same size as the mass described in the gross description, should we assume that the entire polyp has been totally/near totally replaced by tumor and code the tumor size stated in the final path diagnosis?

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field as stated by the pathologist in the final pathologic diagnosis. If the size of the tumor is the same as the size of the polyp, assume the polyp was completely replaced by tumor.

 2002