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20081103 | CS Lymph Nodes--Breast: What code should be used for the the following? There is no mention of LNS clinically; the patient has neoadjuvant therapy; and the LNS are matted pathologically. | 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.Use the information from the pathologic evaluation to code CS Lymph nodes. In the nodes evaluation field, assign code 6 [Regional lymph nodes removed for examination with pre-surgical systemic treatment or radiation and lymph node evaluation based on pathologic evidence]. See CS Lymph Nodes note 4. |
2008 | |
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20081063 | MP/H Rules--Breast: How many primaries should be abstracted when a patient has a mass at 6:00 that showed poorly differentiated ductal carcinoma and a hypoechoic nodule at 9:00 that was excised with no real tumor present there though path showed angiolymphatic invasion by carcinoma throughout the entire specimen? See Discussion. | Palpable mass in right breast at 6:00. Path stated 'poorly differentiated ductal carcinoma with extensive necrosis and extensive angiolymphatic invasion. Focal high grade comedocarcinoma (1%)'. Another hypoechoic nodule was seen at the 9:00 position. This mass was excised from surrounding tissue. This mass was more like an inflammatory mass; there was no real tumor present there. Path report stated "Breast mass 9:00 excisional biopsy - angiolymphatic invasion by mammary carcinoma throughout the entire specimen." Is this two primaries because of the two different histology codes: 8500 and 8010? |
For cases diagnosed 2007 or later, abstract as a single primary using rule M3 (a single tumor is always a single primary). There was one tumor present according to the information provided. The second specimen was not a separate tumor ("There was no real tumor present there"). | 2008 |
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20081067 | CS Extension--Lymphoma: When does the coding change take effect that is referred to in SEER edit IF195, that states localized lymphoma in primary sites C024, C090-099, C111, C142, C172, C181, and C379 must be coded to CS extension 10, and cannot be coded to extension 11? See Discussion. | CS version 1.04 does have a new note 1 in the lymphoma scheme that appears this coding change. In the past, we used code 11 with these sites for localized lymphoma and SINQ 20061088 confirms this line of thinking. | 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. This change was made with the release of CS version 01.04.00 on October 31, 2007. The rules went into effect for cases diagnosed January 1, 2008 and later. A note was added to SINQ 20061088 stating that the answer pertains to cases diagnosed prior to January 1, 2008. |
2008 |
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20081042 | Primary Site/CS Extension--Lymphoma: How are these fields coded for an epidural lymphoma that extends into the bone marrow of the adjacent vertebral body? | For cases diagnosed prior to 1/1/2010:After verifying that the lymphoma originated in the epidural space, code to C729 [nervous system, NOS (epidural)]. This is a rare type of extranodal lymphoma. Assign CS extension code 80 for lymphoma with bone marrow involvement. 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 | |
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20081124 | CS Extension--Brain and CNS: How is CS Extension coded for a malignant meningioma that demonstrates extension into adjacent brain tissue? For malignant brain tumors, code 60 represents extension into the meninges. Would code 60 be the correct code for extension from a malignant meningioma into brain tissue? |
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 60 for malignant meningioma with extension to adjacent brain tissue. According to the I&R, this section of CS was taken directly from SEER Summary Staging, since AJCC does not have a staging system for these tumors. |
2008 | |
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20081096 | Computed Ethnicity: Should the Name--Alias field be used when generating Computed Ethnicity? | No, "Alias" is not used and should not be used to generate Computed Ethnicity. Computed Ethnicity records the ethnicity based on last name and/or maiden name using a computer algorithm. Alias is not part of the algorithm. | 2008 | |
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20081040 | Reportability/Histology--Hematopoietic: If a JAK2 positive myeloproliferative disorder is reportable, how should histology be coded? | Please discuss the significance of JAK2 point mutation. Example: Bone marrow biopsy showed hypercellular marrow with increased megakaryocytes associated with JAK2 point mutation consistent with myeloproliferative syndrome. Path comment: While the morphologic changes would be compatible with a myeloproliferative syndrome, they are not specific for this as similar findings can be seen in reactive conditions. However, a molecular diagnostic test demonstrated a positive JAK2 point mutation which would support the diagnosis of myeloproliferative syndrome. In summary, the combined histologic and molecular diagnostic findings support a myeloproliferative syndrome. The differential diagnosis would be between polycythemia vera and essential thrombocythemia. Subsequent clinical diagnosis: polycythemia vera. |
For cases diagnosed prior to 1/1/2010:Follow the instructions in the SEER manual on pages 1-4 to determine reportability. Code the histology using all information available for the case. If the clinician reviews the case and states a particular histology based on his/her review, code that histology. The clinician has access to all of the information available for this case. He/she uses his/her expertise to form a clinical diagnosis. 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 |
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20081106 | MP/H Rules--Breast: How many primaries for the following? Breast lumpectomy: Three foci of invasive ductal carcinoma. Tumor nodule #1 - Invasive ductal carcinoma. Tumor nodule #2 - Invasive ductal carcinoma with tubular features. Tumor nodule #3 - Invasive tubular carcinoma. See Discussion. |
According to the MP/H rules, this case is reportable as three primaries with histologies coded 8500, 8523 and 8211. However, our QC staff is having a problem accepting this. When the pathologist specifies that a ductal carcinoma has tubular features or is tubular type, isn't s/he saying that tubular is a type of duct? In addition, the first line of the FDx states, "Three foci of ductal carcinoma," which indicates that the pathologists interprets the three nodules to be ductal carcinoma. |
For cases diagnosed 2007 or later: These three tumors are three separate primaries. Rule M12 applies. According to the 2007 MP/H rules, tubular carcinoma is not a type of duct carcinoma. Among the paramount reasons for writing the MP/H rules are the non-standard usage of nomenclature by physicians and the inconsistency in interpretation of these non-standard phrases. The MP/H rules must be applied consistently by each cancer registrar in order for data to be comparable across registries. |
2008 |
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20081095 | Race, ethnicity/Spanish surname or origin: If birthplace is Brazil or Portugal, patient's last name is on the Spanish Surname list, and there is no text to further clarify ethnicity, what is the correct Spanish Ethnicity code: 0 or 7? See Discussion. | See also SINQ 20081075. | Assign code 7 [Spanish surname only] when the last name is on the Spanish Surname list. This includes cases for which the birthplace is Brazil, Portugal or the Philippines and there is no text to further clarify ethnicity. The instruction to use code 0 [Non-Spanish/Non-Hispanic] in the SEER manual on page 51 (#2) applies when the only information available is the birthplace or a statement of "Portuguese," "Brazilian" or "Filipino." |
2008 |
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20081093 | CS Extension: How is CS Ext coded for the following? Rretroperitoneal primary Cystic mucinous tumor with intraepithelial carcinoma There is no CS Extension code for intraepithelial ca in the retroperitoneal scheme. |
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.According to the American College of Surgeons I & R system, assign code 10 [confined to site of origin] for intraepithelial carcinoma of the retroperitoneum. |
2008 |
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