System Guide
Back to Search Results

Search Results

Display Options
Display Options
Select Fields
Export Results to CSV Create Report 0
+ Add all results to report

Report Produced: 10/05/2024 01:15 AM

Report Question ID Question Discussion Answer Year
20081084

Reportability: Is a tubular adenoma reportable if the final diagnosis is "high grade atypia" and the diagnosis comment is "atypia limited to muscularis mucosa areas of pseudostratification [formerly qualifying for carcinoma in situ]"?

This case is not reportable.

The pathologist would need to include "carcinoma in situ" as part of the final diagnosis in order for this case to be reportable.

 2008
20081071 CS Site Specific Factor 6--Breast: Should we assume that the invasive portion of the tumor is being referred to when a pathologist provides only a single tumor size but includes both invasive and in situ descriptors when discussing the size of that tumor? See Discussion.

There seems to be subtle variations in wording and punctuation in these cases. Would these three examples be coded the same way?

Examples:

  • "invasive ductal carcinoma 2.0 cm, DCIS present"

  • "2 cm invasive ductal carcinoma with DCIS present"

  • "invasive ductal carcinoma 2.0 cm. DCIS present"

    • 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 SSF6 050 [invasive and insitu components present, entire size coded in CS TS, size of invasive not stated, proportion invasive and insitu not known] when the size of the invasive portion is not provided and clarification is not available.

    If possible, obtain clarification from the pathologist for phrases like these and document in a text field. For example, a pathologist may confirm that when he/she states "invasive ductal carcinoma 2.0 cm, DCIS present" the size of the invasive portion is 2 cm. If so, code CS tumor size 020 and SSF6 020 and explain in a text field.

    		 2008
    		20081019 Multiple Primaries--Lymphoma: How many primaries are abstracted for a patient with a 1995 periaortic lymph node biopsy showing lymphocytic lymphoma, diffuse small cleaved probable intermediate grade B cell positive, followed by stomach biopsies on 6/18/05 showing diffuse large B cell lymphoma and on 6/24/05 showing malignant lymphoma, tumor cells positive for [CD20] B cell respectively?

    For cases diagnosed prior to 1/1/2010:There are two primaries:

  • Lymphocytic lymphoma, diffuse, intermediate in 1995

  • Diffuse large B-cell lymphoma in June, 2005

    • According to the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table, 9673 [Malignant lymphoma, lymphocytic, diffuse, intermediate] and 9680 [Malignant lymphoma, large B-Cell, diffuse] are separate primaries. Again, according to the table, 9680 [Malignant lymphoma, large B-Cell, diffuse] and 9591 [Malignant lymphoma, non-Hodgkin, NOS] are the same primary.

    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.

    		 2008
    		20081015

    MP/H Rules/Multiple primaries--Lung: Should a subsequent primary be abstracted using rule M8 for a patient diagnosed in January 2000 with adenocarcinoma of the right upper lung if the patient initially sought alternative therapies and presented in September 2007 for a right upper lobe lung mass with extension into the mediastinum, mediastinal lymph node mets and a pericardial effusion? See Discussion.

    After more than seven years, the patient in this case decided to proceed with the originally suggested standard therapy. Is this a multiple primary case because the tumors are "diagnosed" more than 3 years apart? Or should we assume this is further progression of the 2000 case because it was originally only treated with alternative therapies? The clinician in this case indicates the patient is being referred for treatment to the right upper lung originally diagnosed in 2000.

    For cases diagnosed 2007 or later:

    Do not abstract a 2007 primary for this case. From the information provided, there is disease progression/extension and lymph node metastasis in 2007; but there are no new lung tumors in 2007. Therefore, the 2007 MP/H rules do not apply.

    		 2008
    		20081115 CS Extension--Brain and CNS: How is this field coded for a malignant tumor presenting as a confluent lesion over right parietal, posterior frontal and thalamic regions?

    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.

    Assign CS extension code 40 [Tumor crosses the midline; Tumor involves contralateral hemisphere; Tumor involves corpus callosum (including splenium)]

    The thalamus is located between the corpus callosum and the cerebellum and brain stem. A supratentorial tumor extending to the thalamus involves the corpus callosum (extension code 40) but has not yet reached the cerebellum or brain stem. Code 40 applies, but code 50 or any higher code is not applicable in this case.

    		 2008
    		20081099 MPH Rules/Behavior--Breast: Would a positive right axillary node following DCIS of the right breast indicate the presence of a new primary? See Discussion. How would you abstract the information from 2007? A patient with a strong family history of breast cancer had bilateral simple mastectomies in 2000, after a suspicious mammogram. Results showed DCIS in the rt breast; no malignancy in the left breast. Now in 2007, the patient has a right axillary lymph node removed - positive for carcinoma of breast origin. Comment says, "recurrent breast carcinoma in rt axillary node from patient's known history of DCIS." Is this a new primary? Is this a diagnosis date in 2007? Is the site C509 and laterality right side?

    For cases diagnosed 2007 or later:

    A metastasis was diagnosed in 2007. The 2007 MP/H rules do not apply to metastases.

    Change the behavior code of the 2000 diagnosis. The breast cancer diagnosed in 2000 must have been invasive based on the metastasis in 2007.

    		 2008
    		20081109

    MP/H Rules--Breast: Patient has 2 existing primaries, both of left breast and both were pure lobular carcinoma, one was diagnosed in 1994 and the other in 2005. Now a biopsy in 2008 of a supraclavicular lymph node (laterality unknown) and subcutaneous scalp tissue show metastatic DUCTAL carcinoma. Per path report, breast is the primary site. Slides from prior tumors were not reviewed. Should this be made a new primary or assumed to be metastasis from the prior breast tumors? See Discussion.

    A modified radical mastectomy was performed on 10/6/94.

    The 2007 MP/H rules tell us that multiple ductal and lobular tumors of breast are a single primary; however, the rules do not apply to metastatic tumors.

    For cases diagnosed 2007 or later:

    Abstract the 2008 diagnosis as a new primary.

    Since the primary site is unproven but stated to be breast, and since the laterality is unknown, we cannot determine that the 2008 diagnosis is the same as the 2005 or the 1994 diagnosis.

    Revise this case accordingly if more information becomes available.

    		 2008
    		20081119

    Reportability/Date of diagnosis--Liver: Does the final diagnosis of a scan have higher priority than the findings in the discussion in the body of the report? See Discussion.

    A patient with liver cancer becomes transplant eligible when the tumor is 2 cm in size. Frequently, liver tumors will be watched (no biopsy) for months until they meet the 2 cm size criteria. In the meantime, multiple scans will describe the tumor using variations of ambiguous terms that drift in and out of reportablility. One day the tumor is labeled "presumed hepatocellular carcinoma." Weeks later it is back to "worrisome for hepatoma." A single scan will use different terms in different sections of the report.

    Example case: Abdominal CT reveals a 1 cm liver lesion. Per the discussion portion of the scan, the lesion is consistent with hepatocellular carcinoma. Per final diagnosis: 1 cm liver lesion, possibly hepatocellular carcinoma. Is this report diagnostic of cancer? Would the date of this report be the date of diagnosis? (Patient did receive a liver transplant for hepatocellular carcinoma months later.)

    When a reportable ambiguous term is used in one part of a report or the medical record and a non-reportable ambiguous term is used in another part of the report or the medical record, accept the reportable term and accession the case.

    The example above is reportable. "Consistent with" is a reportable ambiguous term. Accept "consistent with" over the non-reportable term "possibly."

    The date of this report would be the date of diagnosis if this is the earliest report using reportable terminology.

    		 2008
    		20081141

    MP/H Rules--Lung: How do we interpret 'spiculated opacities?' How many primaries do we abstract for this patient? See Discussion.

    Patient admitted for CT scan of chest. Impression: A small subpleural spiculated opacity is noted in the left upper lobe measuring 9.7x7.7mm. Right upper lobe spiculated nodular opacity measures 13.9x5.9mm. Right lower lobe scattered faint alveolar nodular opacities are noted. The lungs are otherwise clear. Abnormal soft tissue density mass is noted of the right hilum surrounding the distal main right pulmonary artery. Bronchoscopy/mediastinoscopy done: rare malignant cells present consistent with small cell carcinoma, specimen submitted as brushing of right bronchus intermedius. The tumor in the lymph node is metastatic small cell carcinoma. Patient discharged to hospice; died 5 weeks later.

    Do the MP/H rules pertain only to the measured opacities in each lung and not to the RLL scattered faint alveolar nodular opacities? The right side was cytologically confirmed. But if we abstract the left lung, what is the histology...8041 or 8000?

    For cases diagnosed 2007 or later:

    Because there was cytologic confirmation of cancer, for this case only count the spiculated opacities as tumors. Abstract as a single primary using Rule M1. Note 2 under lung rule M1 applies to this case.

    Code the histology as 8041 [small cell carcinoma] per rule H10.

    		 2008
    		20081097 DCO/Systemic Treatment, Surgery Sequence: How does SEER want systemic treatment/surgery sequence coded for a DCO case?

    Assign code 0 [No systemic therapy and/or surgical

    treatment] as a default for DCO cases.

    		 2008