Report | Question ID | Question | Discussion | Answer | Year |
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20091097 | Multiple Primaries--Lymphoma: How many primaries should be abstracted if DLBCL (9680/3) and Mantle Cell Lymphoma (9673/3) occur at the same time in different lymph nodes? How would Sequence be coded if the case is multiple primaries? |
For cases diagnosed prior to 1/1/2010:It is important to note for this case that the two different types of NHL occurred in different lymph nodes; one type in one lymph node and the other type in another lymph node. Use the fold-out table to determine single vs multiple primaries. According to the table, 9673/3 and 9680/3 would be two primaries no matter which of these was "first." Assign the lower sequence number to the primary with the worse prognosis when two primaries are diagnosed simultaneously. Base the prognosis decision on the primary site, histology, and extent of disease for each of the primaries. If there is no difference in prognosis, the sequence numbers may be assigned in any order. For cases diagnosed 1/1/10 and later, 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. |
2009 | |
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20091113 | MP/H Rules/Histology--Breast: How is histology coded when a nipple biopsy shows Paget disease but the mastectomy specimen shows only infiltrating ductal carcinoma in the breast tissue and the nipple is negative for Paget disease? See Discussion. | Biopsy of nipple showed Paget disease. Subsequent mastectomy showed two tumors proven to be infiltrating ductal carcinoma. Nipple is negative. Per MP/H rule M9, this is all counted as a single primary. Do we code histology from the most representative specimen and lose the information about the Paget disease? | For cases diagnosed 2007 or later, code the histology 8541/3 [Paget disease and infiltrating duct carcinoma]. Paget disease of the nipple and infiltrating duct are separate tumors. For each tumor, take the histology from the most representative specimen. The biopsy is the most representative specimen for the Paget disease. The mastectomy is the most representative specimen for the infiltrating duct. According to the multiple primary rules, tumors that are Paget disease and duct are a single primary (M9). According to the histology rules, assign code 8541/3 (H26). | 2009 |
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20091093 | Race--How and when is Appendix D, Race and Nationality Descriptions from the 2000 Census and Bureau of Vital Statistics, to be used? See Discussion. |
For example, if race is recorded as unknown on the facesheet of a hardcopy medical record or in the race field of an electronic medical record, how should race be coded for the following descriptions found in the history and physical or consultation reports submitted by clinicians? 1) Patient is Czechoslovakian 2) Patient is born in Czechoslovakia 3) Patient is Ethiopian 4) Patient is born in Ethiopia 5) Patient is Japanese 6) Patient is born in Japan 7) Patient is Brazilian 8) Patient is born in Brazil Would you code these cases any differently if these descriptions were actually used in the race fields in the medical record or on a death certificate? |
Code the patient's stated race when possible. Refer to Appendix D, Race and Nationality Descriptions from the 2000 Census and Bureau of Vital Statistics, for guidance. Use the lists in Appendix D when race is not stated but other information is provided in the medical record. The cases you provide are good examples of the use of Appendix D. They would be coded the same if the descriptions were used in the medical record or death certificate race fields. |
2009 |
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20091057 | CS Site Specific Factor--Lymphoma: Can the term "intermediate risk" be used to code IPI score? See Discussion. | Patient has Hodgkin disease. The physician states that the patient has bulky stage IIA intermediate risk disease. Is the term "risk" another way of stating IPI score? If so, how would intermediate risk be coded? | 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.Code SSF 3 for lymphoma based on the IPI score stated in the record. Do not attempt to interpret statements or terms in order to assign a code to SSF 3. If no further information is available for this case, code SSF 3 999 [Unknown]. |
2009 |
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20091062 | CS Site Specific Factor--Head & Neck: How is Site Specific Factor 2 coded when the pathologist describes regional lymph nodes as "matted"? See Discussion. | The primary tumor is located in the tonsil. The patient underwent neck dissection. Pathology report stated there were matted regional lymph nodes. Does the term matted describe extracapsular extension? The definition for site specific factor 2 uses the term "fixed" to describe extracapsular extension (but not matted). For breast, fixed/matted appear to be interchangeable. Would they also be interchangeable for head and neck cases? | 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."Matted" is not a synonym for "Fixed" in the CS schema for Head and Neck. "Matted" is not indicative of extracapsular extension for the Head and Neck schema. |
2009 |
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20091050 | Date of Multiple Tumors--Breast: How is this field coded when a second breast tumor is found at mastectomy two months after the original breast cancer was diagnosed, but during initial workup and treatment? See Discussion. | Breast cancer was diagnosed on core biopsy on 02-27-07. It was not known that the breast was harboring 2 tumors until mastectomy was done on 4-01-07. Both tumors are counted as one primary. | Code "Date of Multiple Tumors" field to the date of the mastectomy. That is the date that multiple tumors were discovered. | 2009 |
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20091011 | MP/H Rules/Histology--Breast: What histology is coded for a tumor diagnosed as "intraductal papillary carcinoma (neuroendocrine differentiation)"? See Discussion. | Final diagnosis states: Right breast, excisional bx with findings most consistent with intraductal papillary carcinoma (neuroendocrine DCIS). The path micro states: the morphologic features are those of a neuroendrocrine-type tumor & IHC stains confirm neuroendocrine differentiation. | For cases diagnosed 2007 or later, assign code 8503/2 [Intraductal papillary carcinoma] using Breast rule H2. Code the histology from the final diagnosis. There is no code for neuroendocrine DCIS in ICD-O-3. |
2009 |
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20091024 | MP/H Rules/Multiple primaries--Urinary: Are diagnoses in bladder, ureter, renal pelvis, and other urinary made prior to 2007 used in determining multiple primaries? See Discussion. |
Per the General Information for MPH, Rule #3, the rules are effective for cases diagnosed January 1, 2007 and after. Do not use these rules to abstract cases diagnosed prior to January 1, 2007. Example: Is a 2006 diagnosis of a renal pelvis primary with the histology 8130/3 and a 2007 diagnosis of a bladder primary with histology 8130/3 "multiple tumors" or is the bladder tumor a new primary because it is a single tumor at the time of diagnosis in 2007? |
For cases diagnosed 2007 or later: Use the 2007 MP/H rules for urinary sites to assess tumors diagnosed in 2007 or later. For the example above, use the 2007 rules to determine whether or not the bladder tumor diagnosed in 2007 is a new primary. Use the Multiple Tumors module when comparing a 2007 or later diagnosis to an earlier diagnosis. Start with rule M3. Stop at rule M8. The 2007 bladder urothelial tumor is not a new primary since there is an existing 2006 renal pelvis urothelial primary. |
2009 |
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20091096 | MP/H Rules/Multiple primaries--Breast: How many primaries should be reported when an in situ diagnosis is followed by an invasive diagnosis in the same breast 1.5 years later? See Discussion. | Patient had a core biopsy 1/07 that showed DCIS and PE showed no adenopathy. Patient refused resection, and adjuvant treatment. In 6/08, the pt returned for a modified radical mastectomy which showed infiltrating duct carcinoma and positive lymph nodes. A comment in the Correction Record stated "Per MD, patient did not see any urgency and delayed surgery 1.5 years after diagnosis." The patient did not have any treatment in that time period and there is no statement that there was progression. | For cases diagnosed 2007 or later, abstract the 6/08 invasive diagnosis as a separate primary according to rule M8. Rule M8 applies whether or not the later diagnosis in this case is progression of disease. | 2009 |
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20091109 | Surgery of Primary Site - - Esophagus/Stomach/Colon: Is an endoscopic mucosal resection (EMR) for an esophagus, stomach or colon malignancy coded to 20 [local tumor excision, NOS] or to a more specific code such as 22 [local tumor excision combined with electrocautery]? | Assign code 20 [local tumor excision, NOS] for a procedure described as an esophagus stomach or colon endoscopic mucosal resection (EMR), NOS. If there is additional information specifying electrocautery, laser or PDT (for example), assign a more specific code. | 2009 |