Report | Question ID | Question | Discussion | Answer | Year |
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20061039 | CS Tumor Size/CS Site Specific Factor--Breast: Should the tumor size be coded to 1.5 cm or 2.5 cm and SSF6 coded to 020 or 030 respectively for a tumor with invasive and in situ components described as being a 2.5 cm tumor with a "greater than" 1.5 cm invasive portion? See Discussion. | Should tumor size be coded to 1.5 cm and SSF6 coded to 020 [Invasive and in situ components present, size of invasive component stated and coded in CS Tumor Size] or should the tumor size be 2.5 cm with SSF6 coded to 030 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated and in situ described as minimal (less than 25%)]? | 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 CS tumor size 992 [stated as greater than 1 cm] and SSF6 code 020. The September 2006 revision to the CS Tumor Size table now lists the 992-995 range codes as "greater than ___ cm." It is better to code the invasive size than the entire size of the tumor. In the TNM mapping, this would more accurately portray the tumor as T1c rather than T2. |
2006 |
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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 | |
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20061012 | CS Lymph Nodes--Lung: If the lymph nodes listed in codes 10 and 20 were contralateral or bilateral, and the only description was "mass", "adenopathy", or "enlargement" on mediastinoscopy or x-ray, is this field coded to 60? See Discussion. | (CS Manual page 407) Note 2: If at mediastinoscopy/x-ray, the description is "mass", "adenopathy", or "enlargement" of any lymph nodes named as regional in codes 10 and 20, assume that at least regional lymph nodes were involved. | 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. Yes. The named nodes listed in codes 10 or 20 should be coded 60 if the "mass", "adenopathy", or "enlargement" on mediastinscopy or x-ray is described as bilateral or contralateral. |
2006 |
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20061024 | Histology (Pre-2007)--Kidney: How is a "mucinous tubular and spindle cell carcinoma" coded? See Discussion. | Literature search results: "The new WHO-classification of renal tumors includes new subtypes, one of which is the mucinous, tubular, and spindle cell carcinoma. Many of these tumors had been previously diagnosed as sarcomatoid carcinoma. There are areas of cord-like growth and spindle cell configuration, sometimes with a clear cell appearance." | For tumors diagnosed prior to 2007:
Code histology to 8255 [Adenocarcinoma with mixed subtypes]. ICD-O-3 does not have a code specific to this combination histology. 8255 is the best code available.
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 |
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20061097 | Reportability--Lymphoma: Is a lymphoma diagnosed on a bone marrow biopsy reportable if the cytogenetics evaluation performed does not confirm the malignancy? See Discussion. |
Bone marrow Bx: Marginal zone lymphoma/leukemia. The morphology of the lymphoma/leukemia cells and the immunophenotypic characteristics identified by flow cytometry are consistent with marginal zone lymphoma/leukemia. Addendum Report: Cytogenetic evaluation revealed a 46,XY male karyotype. This is the normal male chromosome karyotype. Based on the limits of this methodology, no evidence of hematologic malignancy was observed in this specimen. |
For cases diagnosed prior to 1/1/2010: Yes, this case is reportable. The cytogenetic evaluation cited in the addendum report does not disprove the bone marrow biopsy 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 |
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20061124 | Reportability: Is a tumor reported as "neoplasm" or "neoplasia" per the pathology report, which is subsequently clinically referred to as "carcinoma" reportable? See Discussion. |
Example 1: Lung-Wedge resection and subsequent left lower lobe lobectomy showed papillary epithelial neoplasia. Tumor board and subsequent reports state "nonsmall cell carcinoma of lung." Example 2: Kidney-Partial nephrectomy showed epithelial neoplasm, clear cells with low grade cytology. Subsequent urology clinic notes state that path revealed clear cell renal carcinoma. 2004 SEER manual states that "cases clinically diagnosed are reportable. If the physician treats a patient for cancer in spite of the negative biopsy, accession the case." Do we also accession the case if primary site has been resected? Would diagnostic confirmation be coded 8 (clinical diagnosis only)? |
Accession the case and code Diagnostic Confirmation as 8 [clinical diagnosis only]. Accession a case with negative pathology when the clinician is aware of the negative pathology and continues to refer to the case as malignant. |
2006 |
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20061122 | CS Lymph Nodes--Head & Neck (Parotid): What code is used to represent a positive intraparotid or a periparotid lymph node for a parotid primary? See Discussion. | The CS scheme for parotid places intraparotid lymph nodes under code 10 as well as code 12. Periparotid lymph nodes are included under code 12. Should both intraparotid and periparotid lymph nodes be included under code 10 only?
For head and neck sites, several lymph node groups fall into the "Other groups" category. They are not included in the level I-VII groups. In the coding schemes for most (but not all) of the head and neck sites, the "other groups" category includes intraparotid and periparotid lymph nodes and is coded 12 (or 52). |
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 code 10 for a single positive intraparotid or periparotid lymph node. If multiple nodes are involved, assign the appropriate code from the 20 series. A recent revision to the CS lymph nodes scheme for parotid places both intraparotid and periparotid lymph nodes under code 10. Please see the August 21, 2006 update to the CS staging manual. http://www.cancerstaging.org/cstage/cshtml. |
2006 |
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20061088 | CS Extension--Lymphoma: If bilateral tonsils are involved with lymphoma, is it one or two regions of involvement and how is extension 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.For cases diagnosed 1-1-08 and later: Assign CS extension code 10 [involvement of a single lymph node region]. Bilateral tonsils are one organ/site. See Note 1 under CS Extension. Tonsil is coded the same as a lymph node region. |
2006 | |
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20061098 | CS Extension/CS Mets: For primary sites within the peritoneum (abdominalpelvic walls) such as stomach, colon, does the presence of malignant ascites affect the coding of CS Extension or CS Mets? | 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 Collaborative Staging system is governed by site-specific coding rules. Refer to each set of site rules rather than looking for a general answer for all sites in peritoneum. In particular, Ovary and Corpus allow malignant ascites to be coded in CS Extension, but not CS Mets at Dx. For each site, both CS Extension and CS Mets at Dx should be checked for the proper field to code malignant ascites. |
2006 | |
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20061062 | Reportability: Is a "pleomorphic hyalinizing angiectatic tumor of soft parts (PHAT)" reportable if the case has a TNM stage assigned and is stated by the pathologist to be a rare intermediate grade sarcoma? | Pleomorphic hyalinizing angiectatic tumors of the soft parts are not reportable. According to our pathologist consultant, PHAT is a borderline malignancy (/1). While the true nature of these tumors is under debate (reactive vs. neoplastic), so far none have metastasized. |
2006 |