Reportability/Behavior--Thymus: Are "lymphocyte predominant thymoma with microscopic capsule invasion" and "Polygonal epithelial cell thymoma with invasion of the lung and pericardial fat" reportable?
Please see SINQ 20110038 for the most recent information on reporting thymoma.
2004 SEER Manual Errata/Grade--Breast: Are the codes on page 94 of the SEER manual's Breast Grading Conversion Table requiring conversion of nuclear grades 1/3 and 1/2 to code 1, 2/3 to code 2, and 2/2 and 3/3 to code 3 correct or are the codes on page C-473 in the Three-Grade System (Nuclear Grade) for breast correct that requires conversion of the same examples to codes 2, 3, and 4 respectively?
On page C-473: Delete the section titled "Three-Grade System (Nuclear Grade)" and delete the table. Use the tables on pages 94 and C-472 to code grade for breast cancer. This correction will be made in the next errata.
CS Extension--Cervix: How are "positive pelvic washings" coded for a cervical primary?
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 CS Steering Committee, positive pelvic washings for primary cervical cancer are not part of the staging criteria in the collaborative staging system (nor in TNM and FIGO). Document positive pelvic washings in a text field. The CS steering committee will add a statement to CS extension to clarify this for cervix uteri.
Grade, Differentiation--Bladder: If the only indication of grade for a bladder primary is "grade 2, NOS," and we do not know the grading system being used by the pathologist, is the numeric grade 2 coded?
See the General Coding Rules on page 92 of the 2004 SEER Manual for instructions about coding grade.
If the only information available is "Grade 2," assign code 2 [Grade II].
CS Lymph Nodes/CS Site Specific Factor 3--Breast: How are positive intramammary lymph nodes reflected in these fields? See Discussion.
Patient with breast cancer underwent mastectomy. No axillary lymph nodes were positive, but 1 out of 2 intramammary lymph nodes were positive for mets (greater than 2 mm). CS Lymph node codes describe axillary and internal mammary nodes, but do not describe intramammary lymph nodes.
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.
Intramammary lymph nodes are coded as axillary lymph nodes for staging purposes. Intramammary node are nodes within the breast tissue. Both staging and treatment suggest these are equivalent to axillary nodes.
CS Reg LN Pos/Exam--Breast: How are nodes positive/examined coded for a positive FNA of a lymph node followed by a subsequent lymph node dissection? See Discussion.
A breast cancer patient had an FNA of an axillary lymph node positive for metastases. A modified radical mastectomy with lymph node dissection showed six lymph nodes negative for metastases.
Example 1: Patient received neoadjuvant chemotherapy prior to mastectomy and lymph node dissection.
Example 2: Patient received no neoadjuvant therapy.
This question is answered for EOD in SINQ 20031059. What is the answer for Collaborative Stage?
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.Include all nodes examined by the pathologist in Regional lymph nodes positive and Regional lymph nodes examined, unless there is disease progression. These fields are cumulative -- record the total number of regional nodes positive and examined during first course of treatment. Preoperative treatment does not affect the coding of these fields.
An FNA alone, positive for regional lymph node metastasis is coded as 95 for number positive and 95 for number examined.
For the case examples above, assuming there has been no disease progression, include all nodes positive and all nodes examined from both the FNA and the lymph node dissection in the counts. Code number of regional nodes positive as 01, number examined as 07 for both examples.
Histology (Pre-2007)--Melanoma: How is histology coded if the final diagnosis is "melanoma" and only in the comment section of the pathology report is there an indication of "Type: Lentigo Maligna. Cell Type: Small Cell"?
For tumors diagnosed prior to 2007:
Code the histology as 8742 [lentigo maligna melanoma]. Code the specific histologic type, even if stated only in the comment section.
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.
First Course Treatment--Prostatic Urethra: Is Lupron coded for a papillary carcinoma of the prostatic urethra that is treated with a TUR with fulguration and beam radiation even though the prostate biopsies are negative?
Do not code lupron as treatment for a primary in the prostatic urethra.
CS Tumor Size--Rectum: Should the tumor size be coded to 080 from the colonoscopy size or 075 from the CT scan size? See Discussion.
6/29/04 Colonoscopy with biopsy: near obstructing circumferential friable mass extending from 8 to 16cm above anal verge. 6/30/04 CT Scan Abdomen/Pelvis: 7.5X7.2cm large rectal mass. The patient had radiation with concurrent 5-FU. Surgery is done after treatment.
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 tumor size as 080 (8cm). Code the largest pretreatment size recorded when there is preoperative systemic treatment.
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