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: 03/01/2026 19:16 PM

Report Question ID Question Discussion Answer Year
20071129

Reportability/Histology: Is a case reportable if the Final Diagnosis in a pathology report indicates a non reportable diagnosis but the Diagnosis Comment on the same report indicates a non reportable diagnosis followed by a reportable diagnosis in parenthesis? See Discussion.

08/13/2007 polypectomy final diagnosis: tubulovillous adenoma with severe epithelial atypia. Dx Comment (on same path) ...atypia including focal cribriform glandular architecture (carcinoma in situ).

This case is reportable as carcinoma in situ. The histology code is 8263/2 [adenocarcinoma in situ in a tubulovillous adenoma].

According to our pathologist consultant, a "comment" in a path report is a part of the diagnosis - it often elaborates on or clarifies the diagnosis. Placing [carcinoma in situ] in the comment, even in parentheses, indicates that is the appropriate diagnosis for our purposes.

 2007
20071084 MP/H Rules/Histology--Prostate: How is an "acinar adenocarcinoma with focal large duct adenocarcinoma" coded?

For cases diagnosed 2007 or later:

As long as this is NOT urothelial carcinoma extending to the prostatic ducts, code histology to 8140/3 [adenocarcinoma] using rule H10.

Do not code histologies designated as "focal."

 2007
20071030 Reporting Source: If the only patient record available for a physician office biopsy is the pathology report identified from a freestanding laboratory, is reporting source coded to 3 [Laboratory Only (hospital-affiliated or independent)] or 4 [Physicians office/Private Medical Practitioner (LMD)]? See Discussion. A case was identified through a pathology report from a freestanding lab. The doctor who submitted the specimen left the state. His records cannot be located. Because the patient had the specimen removed at a physician's office, not at a path lab, is Type of Reporting Source field coded to the physicians office?

Reporting Source is the source that provided the best information used to abstract the case.

For this case, assign code 3 [Laboratory Only (hospital-affiliated or independent)]. Reporting source should reflect the lab where this case was identified. The MD office added nothing to the case, not even a confirmation of malignancy.

 2007
20071073 MP/H Rules/Histology--Breast: How is histology coded for a single tumor with ductal and tubular features in only the invasive component and not in the in situ component? See Discussion.

A breast tumor diagnosed in Feb. 2007 is a single tumor with in situ and invasive components. The invasive component is diagnosed as ductal with tubular features.

The only rule that applies is H9 which says 'code the invasive histology.' Is it ductal (8500) or tubular (8211)? If you continue through the H rules, then H12 does not apply, because tubular is not a type of ductal. So then you end up at H17, which would make this 8523. Which code is correct?

For cases diagnosed 2007 or later, code the histology 8523 [duct mixed with other types of carcinoma].

After determining that the invasive histology is to be coded using rule H9, there is another decision to make in this case -- which invasive histology should be coded? Make a second pass through the histology rules, begining with rule H10. Stop at H17 and code 8523.

This advanced concept of a "second pass" through the rules is discussed in an online web training session called "Beyond the basics." Go to the SEER website to view this session http://www.seer.cancer.gov/tools/mphrules/training_advanced.html

 2007
20071059 CS Site Specific Factor--Prostate: Given that the CS Manual instruction is to code the highest PSA value recorded in the medical record, can a PSA value obtained a year prior to admission be used to code the SSF 1 and SSF2 fields?

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.

The PSA recorded in CS SSF 1 and 2 must be documented in the medical record. Record the highest PSA value prior to diagnostic biopsy or treatment. If the highest PSA value documented in the medical record is from the previous year, record it.

 2007
20071075 Flag: For cases diagnosed prior to 2001, how is the ICD-O-3 Conversion Flag set if the ICD-O-2 and ICD-O-3 histology and behavior fields are both directly coded, as registrars in this region are instructed to do when submitting late cases, and as a result no conversion is necessary? Is it to 0 [Morphology (Morph--Type&Behav ICD-O-3 originally coded in ICD-O-3)] or Blank [Not converted]?

Assign code 3 [converted with review].

In your scenario above, ICD-O-2 and ICD-O-3 are being independently coded which should yield the same result as converting the case and then reviewing it.

Otherwise, if there is an ICD-O-3 code which differs from the ICD-O-3 code based on the conversion criteria, it will trigger an edit.

 2007
20071025 Radiation Therapy: How is radiation coded when it is "recommended" but the patient dies before radiation is started? See Discussion. Code 0 seems appropriate but then we would lose the fact that it had been recommended. All of the other modalities give an option for 'recommended but patient died prior to treatment.' Is there a reason this option is not given for radiation?

Code Radiation (Rx Summ--Radiation) to 0 [None; diagnosed at autopsy].

SEER does not collect the Reason For No Radiation field. However, those who abstract using software that captures this data item can identify these cases. Code 5 [radiation not administered because patient died] reflects this situation.

Radiation (Rx Summ-Radiation) is a SEER field. This field is derived from the data collected in Rad-Boost Rx Modality and Rad-Regional TX Modality. These fields do not include a choice for "radiation not given because the patient died prior to treatment." Therefore, this information cannot be coded in the Radiation field.

 2007
20071096 Multiplicity Counter--Prostate: How is multiplicity counter to be coded for a clinically inapparent prostate cancer for which sextant needle biopsy cores on left and right sides are positive for adenocarcinoma? See Discussion.

Prostate cancer typically presents as multifocal diffuse disease. The coding exercise in the MPH rules presentations coded prostate cancer as one tumor.

Reference: SEER Training Web Casts - Other Sites Rules Practicum

 Code the number of tumors present if known. This information can be taken from any part of the record, including imaging and prostatectomy. If the only information available is "diffuse," or "multifocal," assign code 99. Do not assume there are multiple tumors just beacause there are multiple biopsies. When there is no information about the number of tumors, code Multiplicity Counter to 99 and Type of Multiple Tumors to 99. 2007
20071051 MP/H Rules/Multiple Primaries--Lung: Please clarify the multiple primary rule M6 and the explanatory note that states when there is a single tumor in each lung, they are to be reported as multiple primaries unless stated or proven to be metastasis. See Discussion. Single tumor in left lung, single tumor in right lung. The rules take you to M6. Suppose the tumor in left lung is biopsied and there is a physician statement that right lung tumor is metastatic from left lung tumor. The note under M6 is "When there is a single tumor in each lung, abstract as multiple primaries unless stated or proven to be metastatic." In this case, is it a single primary or multiple primaries?

For cases diagnosed 2007 or later:

When there is a single tumor in one lung and a single tumor in the other lung, apply rule M6 and abstract as multiple primaries. Use this rule whenever there is a single tumor in each lung, even when neither tumor is biopsied or resected.

This rule is unique to lung. Our physician advisors emphasized that it is very unlikely that a single tumor in one lung could be metastatic from a single tumor in the opposite lung. Therefore, the default is to abstract as multiple primaries.

The note at M6 means that there must be proof that one tumor is metastatic in order to abstract as a single primary. For example, a biopsy of the tumor proving that it is metastatic. An opinion or belief that one tumor is metastatic is not sufficient. In the absence of proof, use rule M6 and abstract as multiple primaries.

A list of MP/H clarifications will be available. This issue will be included on the list.

 2007
20071111 MP/H Rules/Histology--Lung: How many primaries should be abstracted when a patient has an adenocarcinoma with bronchioalveolar-like features in the right upper lobe, adenocarcinoma in the right middle lobe and non-small cell carcinoma with clear cell features in the right lower lobe? See Discussion.

A RUL lung wedge resection and RML and RLL lobectomies were performed. The RUL resection showed invasive adenocarcinoma with bronchioalveolar-like features. Tumor size 9x.9x.8cm. The RLL lobectomy showed invasive non-small cell carcinoma with clear cell features. Tumor size 4.1x2.5x1.8cm. The RML lobectomy showed invasive adenocarcinoma. Tumor size 3.0x1.6x2.2cm.

Comment: Essentially three invasive tumors and a focus of bronchioalveolar carcinoma were identified in 3 specimens. All of the tumors appear somewhat histologically different. The larger tumors in the right upper and middle lobe were somewhat similar but still appear histologically different and therefore the pathologic staging is done based on all tumors being separate. The pathologic staging for this case is pT2(4) pN0 pMX.

What histology code and what site code are to be used on each abstract?

For cases diagnosed 2007 or later:

Abstract two primaries:

  1. C349 with histology coded to 8140 - invasive adenocarcinoma (RUL and RML)

  • C343 with histology coded to 8310 - invasive non-small cell carcinoma with clear cell features (RLL)

    • First, determine the number of tumors. There are three separate tumors in right lung in the example above:

    • RUL: invasive adenocarcinoma, bronchioalveolar-like features (8140, "-like" is not on the list of ambiguous terms used to code histology)

  • RLL: invasive non-small cell carcinoma with clear cell features (8310)

  • RML: invasive adenocarcinoma (8140)

    • Because there are three tumors, begin with rule M3 in the Multiple Tumors module. Stop at rule M11, multiple primaries for the tumor in the RLL (8310) compared to the tumors in the RUL and RML (8140 and 8140).

    Now evaluate the tumors in the RUL and RML using the multiple primary rules. Start at rule M3 and stop at rule M12, single primary.

    		 2007