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Report Produced: 04/19/2026 08:41 AM

Report Question ID Question Discussion Answer Year
20061144 Date of Diagnosis/Histology--Hematopoietic, NOS: How are these fields coded if a 3/17/03 bone marrow biopsy diagnosis of "malignant proliferative disorder" is subsequently confirmed to be a "low grade lymphoma" per a bone marrow biopsy in early 2006? See Discussion.

3-17-03: Bone marrow biopsy from rt iliac crest: Hypercellular marrow (90%) with extensive involvement by lymphoproliferative disorder (see description). Micro: The bone marrow is diffusely (>90%) involved by a malignant lymphoproliferative disorder. This consists of small lymphocytes,histiocytes, and large atypical cells with prominent nucleoli.

12-22-05 Extensive bone marrow involvement by lymphoproliferative disorder, bone biopsy from femur.

1-27-06 Hem/Onc Physician Note:

following pt for a lymphoproliferative disorder. ...bone marrow biopsy 2003, suggestive of, but not truly diagnostic, a lymphoproliferative disorder. Therefore, I elected not to do anything, but just follow her.

3-23-06 Hem/Onc Note:

pt with a history of an apparently low-grade lymphoma involving the marrow, as well as, I believe, the liver and recently pathologically diagnosed as a T-cell-rich B-cell lymphoma. ...followed in the past by Dr. ___ and has never actually had any treatment for this lymphoma, although it is documented even three years ago by bone marrow biopsy.

For cases diagnosed prior to 1/1/2010:

Code the diagnosis date to 3/17/03. The histology code is 9970/3 [Malignant myeloproliferative disorder]. The bone marrow biopsy confirms a "Malignant" lymphoproliferative disorder. Apply ICD-O-3 rule F and assign /3 to histology code 9970.

For cases diagnosed 2010 forward, 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.

 2006
20061079 Histology--Lymphoma: Is histology for "large B-cell lymphoma evolving from extranodal marginal zone B-cell lymphoma" coded to 9680/3 [Malignant lymphoma, large B-cell, diffuse, NOS] or 9699/3 [Marginal zone B-cell lymphoma]?

For cases diagnosed prior to 1/1/2010:

Code the histology as 9699 [marginal zone B-cell lymphoma]. Code the histology from the original diagnosis.

For cases diagnosed 2010 forward, 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.

 2006
20061118 Primary Site--Unknown & Ill-defined Site: What is the primary site code for multiple malignant rhabdoid tumors (extra renal) in a newborn infant?

Search for additional information on the location of the primary in this case. A tissue specimen (biopsy) is required for a diagnosis of rhabdoid. Additionaly, there should be scans describing any tumors located in sites other than the biopsy site. If the biopsy site is not assumed to be a metastatic site and is the only location of tumor, code the site of the biopsy as the primary site.

If it is not possible to obtain further information for this case, code the primary site C809 [Unknown primary site].

According to our pathologist consultant, extra-renal rhabdoid tumors have been described in organ sites (liver, GI tract, thyroid, CNS, skin, to name a few) as well as in the soft tissue. Many of the organ site tumors are multiple/multifocal, so multiple tumors in one organ do not necessarily imply metastatic disease and therefore unknown primary site.

 2006
20061005 CS Reg LN Pos/Exam: Are lymph nodes coded as positive or negative when the pathology report for a lymph node dissection performed after radiation and chemo reveals that the nodes are negative but they demonstrated previous involvement by cancer? See Discussion. Scenario: The patient was treated with radiation and chemotherapy prior to resection for esophageal cancer. The pathology report stated, "1/3 nodes c/w treated previous ca."

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.Record lymph nodes that are pathologically confirmed as positive in Regional Nodes Positive. Evidence of previous involvement by cancer is not recorded in this data item.

In the above scenario, the lymph nodes are negative according to pathology.

Clinically positive lymph nodes are coded in CS Lymph Nodes.

 2006
20061078 Histology (Pre-2007): How is "adenocarcinoma, diffuse type, with signet ring features" coded?

For tumors diagnosed prior to 2007:

Code 8490 [Signet ring cell carcinoma]. Histology coding Rule 7 is the only rule that applies to this diagnosis. Assign the numerically higher ICD-O-3 code.

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

 2006
20061076 Laterality--Breast: Should laterality be coded to 9 [Paired site but no information concerning laterality] or to the side with the positive lymph nodes for a case in which no breast mass is found but positive axillary lymph nodes are found on only one side? Code laterality of the primary site to the side with the positive nodes when there are unilateral positive nodes and the laterality of the primary site is otherwise unknown. 2006
20061109 CS Tumor Size--Lung/Breast: Explain why the SEER instructions differ from the CS Manual regarding priority order of sources to code tumor size? See Discussion. Regarding the 2004 SEER Manual, Appendix C, Site Specific Coding Modules, Lung and Breast. The priority of sources for coding tumor size is Pathology, Operative Report, PE, imaging for breast and pathology, operative, endoscopic, and imaging for lung. This differs from the CS Manual instructions.

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.For cases diagnosed in 2007 and forward, follow the instructions in the 2007 SEER manual and the CS manual.

 2006
20061063 CS Extension--Lung: Do notes 6A and 6B in the 2004 SEER manual offer conflicting instruction for determining the significance of pleural effusion for this primary site? See Discussion.

1. Is note B to be used to modify or change what note A states?

Does note B state -- If a pleural fluid bx(s) is negative; but the fluid is bloody and/or is an exudate, and clinical judgment indicates the effusion is related to tumor -- use code 72?

If a pleural effusion is biopsied should the pathology report state the color of the pleural fluid or is an exudate? (Training issue)

2. Do the following clinical findings impact the clinical evaluation of involvement for a pleural effusion? If yes, why? (Training issue(s))

a. Heart problems?

b. The location of the pleural effusion?

i. Bilateral pleural effusion is noted; tumor in Rt or Lt lung only?

ii. Bilateral pleural effusion is noted; tumor in both lungs?

iii. Pleural effusion is noted on the opposite side from the tumor?

iv. Pleural effusion is on same side as the tumor?

SUPPORTING CS MANUAL DOCUMENTATION

Note 6: Pleural Effusion.

A. Note from SEER manual: Ignore pleural effusion that is negative for tumor. Assume that a pleural effusion is negative if a resection is done.

B. Note from AJCC manual: Most pleural effusions associated with lung cancers are due to tumor. However, there are a few patients in whom multiple cytopathologic examinations of pleural fluid are negative for tumor.

In these cases, fluid is non-bloody and is not an exudate. When these elements and clinical judgment dictate that the effusion is not related to the tumor, the effusion should be excluded as a staging element and the patient should be staged T1, or T2, or T3.

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.

1. Note B does not modify or change note A. Note B is explaining when an effusion should not be used to determine the stage. Pleural effusions are evaluated by cytology, not biopsy.

2. If relevant, the clinician should document the fact in the medical record. Heart problems can cause non-malignant pleural effusions (that are disregarded for staging). Pleural effusion will almost always be around the lower lobes due to gravity, but may envelop an entire lung. Pleural effusions can be unilateral or bilateral regardless of the location of the tumor, but are usually on the side where the tumor is.

 2006
20061036 CS Extension--Lymphoma: For lymphoma cases, can extension be coded to 80 [Nodular involvement of lungs] based on imaging or operative findings when there is no positive statement of involvement? See Discussion.

Specifically, CS Ext code 80 includes nodular involvement of the lungs. The CT report for this patient states that the lungs are nodular. Is that enough to use code 80? Can the liver be coded as involved based on the operative findings?

Scenario: The patient was diagnosed with lymphoma. The CT showed pulmonary nodules. The pt had an exploratory laparotomy with a positive mesenteric LN bx and a positive ileocecectomy. The operative findings included a nodular liver. No staging was done by the oncologist and he has the pt on CHOP-R.

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.

Extension code 80 can be assigned based on imaging or operative findings as in the lymphoma case described above. The fact that this extension was not based on pathological evidence is captured in the evaluation code. Assign CS/TS Ext-Eval code 0 [No staging laparotomy done. No autopsy evidence used (clinical)].

 2006
20061033

Reportability--Brain and CNS: Is benign neural tissue compatible with a glioneuronal hamartoma of the cerebellopontine angle reportable?

No. A glioneuronal hamartoma is not neoplastic and not reportable. See page 2 of the 2004 SEER Program Coding and Staging manual for the list of reportable brain/CNS tumors. There is no ICD-O-3 code for hamartoma.

 2006