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Report Produced: 07/06/2025 15:19 PM

Report Question ID Question Discussion Answer Year
20100113 Reportability--Heme & Lymphoid Neoplasms: Is hemophagocytic lymphohistiocytosis reportable?

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

No. This is not a reportable hematologic condition. When you do not find a hematologic or lymphoid condition listed in the Heme DB, it is not reportable. Hemophagocytic lymphohistiocytosis is an uncommon hematologic disorder. The patient usually presents with fever, splenomegaly, and jaundice. Laboratory findings are lymphocytosis and histiocytosis. Pathology findings are hemophagocytosis.

Appendix F lists this term as non-reportable.

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.

2010
20100099 Histology--Heme & Lymphoid Neoplasms: Should all cases of precursor B acute lymphoblastic leukemia diagnosed 1/1/10 and later with histology coded to 9836/3 have the values changed to 9811/3 per the Heme DB Abstractor Notes section or should they remain coded 9836/3.

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

For cases diagnosed 2010 and forward, code histology to 9811/3 [B lymphoblastic leukemia/lymphoma, NOS] which is the new classification for pre-BALL. The histology code 9836/3 is obsolete as of 2010 and should not be used for cases with diagnosis date after 12/31/2009.

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.

2010
20100079 Reportability--Heme & Lymphoid Neoplasms: Does the fact that the Hematopoietic Database states the ICD-O-3 code 9970/1 [Lymphoproliferative disorder/disease, NOS] mean that the ICD-O-3 books should be updated to indicate that as of 2010 the code 9970/1 [Lymphoproliferative disorder/disease, NOS] is no longer applicable?

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

Lymphoproliferative disorder/disease, NOS [9970/1] is not a reportable neoplasm. There are also new codes that define lymphoproliferative disorder/disease more specifically. If you do a "smart search" and enter only the word "lymphoproliferative" into the Heme DB, you will get a listing of all of the reportable and non-reportable terms. That enables you to look at your record and compare the words in the Heme DB to those in the record you are reviewing.

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.

2010
20100102 Behavior--Breast: How is behavior coded when a biopsy shows in situ carcinoma with a focus suspicious for invasion and a subsequent excision/resection shows only in situ carcinoma? Code this case as in situ. The specimen from the excision/resection is the more reliable source for determining behavior, compared to a biopsy, especially in this case where the behavior is ambiguous on the biopsy. 2010
20100014 Reportability: Are there criteria other than a pathologist or clinician's statement that a registrar can use to determine reportability of gastrointestinal stromal tumors (GIST)? See Discussion.

Per SINQ 20091021 and 20021151, GIST cases are not reportable unless they are stated to be malignant. A pathologist or clinician must confirm the diagnosis of cancer. There are cases that are not stated to be malignant in the pathology report or confirmed as such by a clinician; however, these cases do have information that for other primary sites would typically be taken into consideration when determining reportability. The final diagnosis on the pathology report for all 16 cases is "GIST." The additional comment(s) for each of the 16 different cases is reported below. Are any of the following cases reportable?

1) Pathology report indicates that the bulk of the tumor is submucosal. It extends through the muscularis propria and abuts the serosa.

2) Pathology report states tumor extends to serosal surface of transverse colon, but not into muscularis propria. CD 117 and CD 34 are positive.

3) Pathology report indicates that tumor invades through the gastric wall to the serosal surface.

4) Pathology report indicates that tumor invades pericolic fat tissue.

5) No further information in pathology report, however, scans indicate omental caking.

6) No further information in pathology report, however, scans indicate hepatic metastases. Hepatic metastases are not biopsied.

7) Tumor stated to be unresectable and extends into pancreas. Chemotherapy given.

8) Pathology report states tumor is low to intermediate grade and involves serosal (visceral peritoneum).

9) Tumor size is 17.5 cm. Pathology report states "malignant risk".

10) Pathology report states tumor "into muscularis propria" or tumor "involves muscularis propria" or "infiltrates into muscularis propria".

11) Pathology report states, "high malignant potential; omentum inv by tumor." It is not stated in path report or final diagnosis to be malignant GIST.

12) Pathology report states that tumor arises from wall of small bowel and extends into thin serosal surface.

13) Pathology report states minimal invasion of lamina propria; does not penetrate muscularis propria.

14) Pathology report states, "high mitotic activity >10/50 HPF; high risk for aggressive behavior; moderate malignant potential."

15) Pathology report states tumor size is >5 cm. Intermediate risk for aggressive behavior; CD117+ KIT exon 11+.

16) Pathology report states "high risk of malignancy."

 For GIST to be reportable, the final diagnosis on the pathology report must definitively state that the GIST is malignant, or invasive, or in situ. Case 6 is the only exception. It would be reportable assuming the scan actually states "hepatic metastases." Based only on the information provided, none of the other examples are reportable. The type of extension and/or invasion mentioned in the other examples are not sufficient to confirm malignancy. Borderline neoplasms can extend and invade, but do not metastasize. Only malignant neoplasms metastasize. 2010
20100091 Reportability/Histology--Heme & Lymphoid Neoplasms: How many primaries are accessioned and how is histology coded when a patient has a history of chronic myelogenous leukemia diagnosed in 1997 and a "blast crisis with myeloid markers" of this disease in 2010? See Discussion. The patient was initially diagnosed with CML in 1997. In February 2010 the disease went into a "blast crisis with myeloid markers." The patient received induction chemotherapy and the disease went back into a chronic phase. To capture the 2010 diagnosis of a blast crisis, is the histology code 9875/3 [chronic myelogenous leukemia, BCR/ABL1 positive] or 9861/3 [acute myeloid leukemia, NOS] used?

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

Per Rule M2, there is a single primary. Code histology to 9863/3 [CML, BCR-ABL1 status unknown, Blastic phase (BP)]. The blast phase is not recorded as a new primary because this disease does NOT change histologies.

Code 9875 [Chronic myelogenous leukemia, BCR-ABL1 positive] does not apply to the 2010 diagnosis because BCR/ABL status unknown. Code 9861/3 [Acute myeloid leukemia, NOS] also does not apply because the diagnosis was not acute.

It is not clear which chronic myelogenous leukemia (CML) this patient has. Each CML is unique in that it has a blast phase without the histology itself changing. See the Abstractor Notes section in the Heme DB under any of the chronic myelogenous leukemias for a further explanation of this disease process.

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.

2010
20100022 Multiple primaries/Histology--Heme & Lymphoid Neoplasms: Is a 2010 diagnosis of ALK+ anaplastic T cell lymphoma following a 2008 diagnosis of follicular B cell lymphoma, grade 1 a new primary? If so, how is the histology coded? See Discussion. A patient has a history of Stage 4 follicular B cell lymphoma, grade 1 [9695/3] diagnosed in 2008. The patient was treated with Adriamycin, Cytoxan, Rituxan, and Prednisone. In 2010, the medical oncologist states the patient has progression/recurrence of lymphoma with pathology that has changed to anaplastic T cell lymphoma ALK+. There was immunophenotyping, but there was no more specific diagnosis made. The patient died within 3 months.

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

Abstract the anaplastic T cell lymphoma as a new primary. Code the histology to 9714/3 [Anaplastic large cell lymphoma, ALK-positive].

Rule M15 applies to this cases which instructs you to use the Multiple Primaries Calculator. The result for 9695/3 and 9714/3 is "New Primary."

Apply Rule PH30 to code histology which instructs you to use the Heme DB to determine the histology when rules PH1-PH29 do not apply. In searching the Heme DB for "anaplastic" the first term returned is Anaplastic large cell lymphoma, ALK-positive [9714/3].

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.

2010
20091106 Multiple Primaries--Urinary: How many primaries should be coded for an 8/9/07 invasive transitional cell carcinoma of right ureter; 7/9/08 non-invasive urothelial carcinoma of bladder; 11/18/08 non-invasive urothelial carcinoma of left ureter; 6/20/09 invasive urothelial carcinoma of left ureter? One primary. This is a good example of how the field effect occurs in the urinary system. From 2007 to 2008, Rule M8 says bladder and ureter tumors are not new primaries and would be documented as recurrences. Because other urinary sites are involved by 11/08 and by 06/09, do not make second primary of left ureter (Rule M4 does not apply). 2009
20091098 MP/H Rules/Histology: How is histology coded for a partial vulvectomy showing "vulvar intraepithelial neoplasia III, basaloid type"? See Discussion. Is this VIN III (8077/2) or basaloid squamous cell carcinoma (8083 and change the behavior code from 3 to 2)? It seems that H4 and H6 both lead to 8083.

For cases diagnosed 2007 or later, assign 8077/2 [Squamous intraepithelial neoplasia, grade III] for VIN III diagnoses, regardless of the type. According to the WHO Classification of Tumours (page 319), "VIN is predominately of the warty or basaloid types...."

Use the multiple tumors module to determine the histology code for VIN. Rule H21 applies.

 2009
20091036 CS Mets at DX/CS Extension--Ovary: Is carcinomatosis always captured in the CS Mets field? Can the term carcinomatosis be used to describe peritoneal implants as well? See Discussion.

1/18/06 CT guided biopsy of abdominal mass & ant peritoneum nodule: Extensive carcinomatosis affecting the paracolic gutters, liver surface & pelvis. 6 cm tumor mass was visibly engulfing the small bowel & tube; poorly differentiated adenoca, mullerian derived, shows attributes of clear cell carcinoma, high grade (FIGO III), 2.5 cm size, does not involve fallopian tube. R&L abdominal wall & mesentery, mets adenoca.

5/31/06: tumor debulking with right salpingo-oophorectomy. Final DX: Poorly differentiated adenocarcinoma, clear cell type, right ovary (FIGO III), stage IV per MD.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.In the case of ovarian cancer, the term carcinomatosis may refer to peritoneal implants, especially when the implants are numerous. It does not refer to distant metastases in this context.

This issue has been forwarded to the CS version 2 committee.

 2009