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For cases diagnosed 2007 or later, the correct histology code is 8244/3 [composite carcinoid]. The steps used to arrive at this decision are:

Step 1: Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Colon Histology rules because site specific rules have been developed for this primary.

Step 2: Start at the SINGLE TUMOR module, rule H1. The rules are intended to be reviewed in consecutive order within a module. Stop at rule H9. Code the histology as 8244/3 [composite carcinoid] when the diagnosis is adenocarcinoma and carcinoid tumor.

Neuroendocrine tumor, grade 1 (G1) is synonymous with carcinoid tumor [8240/3] for the purpose of rule H9.

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

The word is a reportable ambiguous term per the Hematopoietic Coding Manual (Case Reportability Instructions, Rule 4).

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

Well-differentiated neuroendocrine tumors and grade 1 neuroendocrine tumors of the appendix are reportable because these tumors have a morphology code 8240/3 per the WHO Classification of Tumors of the Digestive System. However, per the ICD-O-3, carcinoid tumors of the appendix have a behavior code of /1 [borderline].

The terminology of neuroendocrine tumors is evolving and current thinking at the international level is that carcinoid/WD NET of appendix is reportable. However, reportability in the United States is based on ICD-O-3. The histology code for "Carcinoid of appendix" is 8240/1; the histology code for a carcinoids of all other primary sites is 8240/3. Until the United States adopts the proposed changes for ICD-O-3, reportability of appendix cases is as follows:

• Carcinoid

• Well-differentiated neuroendocrine tumor

• Grade 1 neuroendocrine tumor

• Well-differentiated neuroendocrine tumor/carcinoid (Pathologist uses both terms in reporting the diagnosis and does not want to choose one diagnosis over the other.)

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

Always code diagnostic confirmation to 9 [Unknown whether or not microscopically confirmed; death certificate only] for DCO cases.

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.

This case should be accessioned as a single primary. Code the primary site to the colon and rectum [C199] and the histology to adenocarcinoma in familial polyposis coli [8220/3] per MP/H Rule H17.

For cases of familial polyposis, when the rectosigmoid or rectum are involved, assign code C199 [colon and rectum]. When the rectosigmoid or rectum are not involved, assign code C189 [colon, NOS].

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

Code the primary site to the intra-abdominal lymph nodes [C772] per Rule PH20.

Code the primary site to the specific lymph node region when multiple lymph node chains within the same region as defined by the ICD-O-3 are involved. Periportal and peripancreatic nodes are both intra-abdominal region nodes.

Based on the information provided, there is involvement of lymph nodes, the liver, spleen and bone marrow, but no other documentation of the primary site. Given that a primary lymphoma of the liver is very rare; it is unlikely that this lymphoma arose from the liver. Involvement of the liver and spleen is very common for patients with lymphoma. The involvement of the liver, spleen and bone marrow is coded in the CS fields as Stage IV involvement.

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.

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

Code the histology to 9735/3 [plasmablastic lymphoma] and the primary site to C809 [unknown] per Rule PH27.

Code the histology specified when the only histology for the case is preceded by ambiguous terminology. For this case, code the histology to plasmablastic lymphoma because it is the only histology mentioned in the diagnosis.

Per the Heme DB Abstractor Notes section for plasmablastic lymphoma, most patients present with Stage III-IV disease. The positive pleural fluid is likely due to advanced disease. In the absence of any other information for this case, Rule PH27 applies, "Code primary site to unknown primary site C809 when there is no evidence of lymphoma in lymph nodes AND the physician documents in the medical record that he/she suspects that the lymphoma originates in an organ(s) OR multiple organ involvement without any nodal involvement."

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.

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

Code the primary site to C419 [bone, NOS] per Rule PH30.

This patient has widely metastatic disease. Per Rule PH30, one needs to reference the Heme DB to determine the primary site and histology for this case. Per the Abstractor Notes section, Langerhans cell histiocytosis arises in the bone and many times can involve multiple bones, along with other organs and lymph nodes. Although the right femur was biopsied, this does not prove that the primary site is the femur [C402] because the patient has what was described as extensive bony metastatic disease.

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.

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

No. Per Appendix F, erythrocytosis of an unknown cause is not reportable.

The diagnosis must state "erythrocytosis megalosplenic" to be reportable (9950/3).

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.