Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Lung: How is histology coded for the tumor(s) that exist if a left upper lobe of lung resection final diagnosis states the patient has a moderately differentiated adenocarcinoma and the path indicates there are "multiple carcinoid tumorlets"?
For tumors diagnosed prior to 2007:
Histology is coded 8140/3 [adenocarcinoma]. This is one reportable tumor of the left lung. According to our pathologist consultant, the tumorlets are collections of cells which appear to be of neuroendocrine origin, but are not malignant.
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.
CS Lymph Nodes: Are lymphatic channels/vessels within an organ coded as regional 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.Lymphatic channels/vessels carry lymph fluid throughout the organs and tissues of the body. Lymph channels/vessels within an organ are not nodes. Lymph channels/vessels outside an organ are not nodes.
Collaborative Staging--Hematopoietic, NOS: Which Collaborative Staging schema is used for a connective, subcutaneous and soft tissue primary of the pelvis [C495] with the morphology of Langerhans cell sarcoma [9756/39]? See Discussion.
On page C-411 of the SEER manual for the connective, subcutaneous, and other soft tissues schema it lists exceptions for certain morphologies and the above is not listed as an exception. On the Hematopoietic scheme it lists the above morphology.
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 hematopoietic schema on page C-709 of the 2004 SEER manual. The histologically defined schemas have priority over the site schemas when both apply. See page 115 of the 2004 SEER manual.
The morphology codes listed on page C-411 pertain to the SEER Site Specific Guidelines.
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.
CS Site Specific Factor--Prostate: Is there an established range of values that can be used to code negative, borderline or elevated PSA values? See Discussion.
Previous SEER prostate coding guidelines listed a PSA range that could be used to code negative, borderline, or elevated values in the absence of any statement concerning elevated PSA in the medical record. Is this still in effect for SSF 2, or do we need a definite statement when only a numeric value is given?
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 matter is under consideration by the CS Steering Committee. The CS Steering committee is reviewing options for incorporating SEER guidelines into the CS manual.
CS Eval--Colon: Should 1 [No surgical resection done...] or 3 [Surgical resection performed...] be used to correctly reflect this field when a surgical observation is "adherent to duodenum" but the extension per the pathology is stated to be to the "subserosal tissue"? See Discussion.
7/2/04 Op Findings 5 cm mass in mid transverse colon involving also the right colon; mass was adherent to duodenum without obvious invasion. 7/2/04 Path: Rt & Transverse Colon: 6x5 cm mass, micro: MD Adenoca with invasion of subserosal tissue; margins neg. 17/17 colic LNs negative.
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 the case described above, code extension as 46 [Adherent to other organ...no microscopic tumor found in adhesion]. Code CS TS/Ext eval as 3 [Surgical resection performed...].
Surgery was performed for this case. The fact that the adherence to the duodenum was proven not to be tumor involvement should be coded as 3 in CS TS/Ext Eval. By using eval code 3, the case will map to a pathologic T indicating that the patient had resective surgery. Eval code 1 would map to a clinical T, incorrect for this case.
Reportability/In Situ--Prostate: Was there a time period when PIN III was reportable to SEER?
Per the 2004 SEER Manual, page 2, Reportable Diagnoses, Exceptions, 1.b.iii "Prostatic intraepithelial neoplasia (PIN III) of the prostate (C619). (Collection stopped effective with cases diagnosed 1/1/2001 and later.)"
CS Lymph Nodes--Prostate: How is this field coded when no scan, scope or surgical evaluation of regional lymph nodes is performed for a case with localized disease in the primary site? See Discussion.
Prior to initiation of collaborative stage, SEER prostate guidelines instructed us to code lymph node involvement as negative when clinical or pathologic extension was coded 10-34 and there was no lymph node information. Is this guideline still in effect, or do we follow the collaborative stage rules which require lymph node information or, in absence of node info, usual treatment for localized disease?
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 prostate and other "inaccessible sites" with localized disease, code the regional lymph nodes as clinically negative when not mentioned on imaging or exploratory surgery.
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