Report | Question ID | Question | Discussion | Answer | Year |
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20041015 | Primary Site--Lymphoma: How should this field be coded when a diffuse large B-cell lymphoma is found in the femur and in the soft tissue of the anterior chest wall but all CT scans are negative for lymphadenopathy? | For cases diagnosed prior to 1/1/2010:Code the Primary Site field to C809 [Unknown primary site]. The primary site of diffuse large B cell lymphoma can be either nodal or extranodal. The case described above is likely extranodal because there is no evidence of lymph node involvement. Because the extranodal site of origin is unknown, code the Primary Site to C809. 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. |
2004 | |
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20041086 | Histology (Pre-2007)/CS Tumor Size/CS Extension--Colon: How are these fields coded if a 3 cm sessile polyp is snared and removed piecemeal during a colonoscopy and the path microscopic description indicates a polypoid lesion with foci of malignant transformation found associated with bundles of smooth muscles followed by a LAR with no residual invasive tumor but the final path diagnosis is stated to be a M.D. adenocarcinoma? See Discussion. | 3/04 colonoscopy 3cm sessile polyp snared & removed piecemeal. Path Micro: Polypoid lesion consists of branching & complex neoplastic glands lined by tall columnar epithelial...These foci of malignant transformation are assoicated with large polygonal epithelial...associated with desmoplastic stromal reaction & neoplastic glands can be found associated with bundles of smooth muscle. 4/04 LAR: focus of residual HG dysplasia: no residual invasive tumor. Final path dx: MD adenocarcinoma. Physician staged: T2 N0 M0. Histology: 8140 vs 8210 Tumor Size: 030 vs 999 vs 990 Extension: 12 vs 20 |
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 tumors diagnosed prior to 2007:
Based only on information provided: Histology: 8210 [Adenocarcinoma in a polyp] Tumor Size: 999 [Unknown] CS Extension: 20 [Muscularis propria invaded]
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. |
2004 |
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20041001 | Histology (Pre-2007)--Pancreas: Should pancreatic neoplasia III (PanIN III) be coded to 8010/2 [carcinoma in situ, NOS] or 8500/2 [Ductal carcinoma in situ]? See Description. |
There is no specific morphology code for PanIN-III in the ICD-O-3. In the chapter for exocrine pancreas found in the sixth edition of AJCC cancer staging manual, pg 160, reference is made to PanIN-III and its inclusion with carcinoma in situ. |
For tumors diagnosed prior to 2007:
Code PanIN-III (pancreatic intraepithelial neoplasia III) as 8500/2 [Ductal carcinoma in situ, includes DIN 3: Ductal intraepithelial neoplasia 3]. PanIN-III is a synonym for carcinoma in situ according to the WHO classification of Tumors and the College of American Pathologists' Protocol for exocrine pancreas. Do not code PanIN-I or PanIN-II as cancer.
For tumors diagnosed 2007 or later, see SINQ 20110081 andĀ 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. |
2004 |
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20041002 | CS Size of Tumor/CS Extension--Brain and CNS: How should these fields be coded for benign CNS tumors? | 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 Extension as 05 [Benign or borderline brain tumors]. Code the size of the tumor if specified. Otherwise code CS Tumor Size as 999 for benign CNS tumors. |
2004 | |
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20041091 | Primary Site/Summary Stage 2000/EOD-Extension--Lymphoma: How are these fields coded when a CT Impression states: Large retroperitoneal/abdominal mass resulting in extra-hepatic biliary obstruction & bilateral urinary tract obstruction & encasement of major vessels most c/w lymphoma? See Discussion. | CT findings state: Very lg sft tiss mass encasing pancreatic head & portion of body, splenic & portal veins, celiac axis, sup mesenteric artery & bilateral renal veins. Two components to this mass: 1) retroperitoneal mass encasing great vessels and 2) peritoneal component 10.8cm size, displaces bowel & other structures & encases vessels.
If the physician stated "this is bulky disease" would that change the EOD? |
For tumors diagnosed 1998-2003:
Based on the information provided: The topography code for this lymphoma is C772 [Intra-abdominal lymph nodes]. Code SEER Summary Stage 2000 to 5 [Regional NOS]. Code EOD Extension to 20. More than one lymph node region below the diaphragm is involved (retroperitoneal and peritoneal). The organs mentioned are not involved by the lymphoma. The bulk of the masses is causing obstruction by displacing and/or encasing organs. A physician description of "bulky disease" would not change the EOD for this case. |
2004 |
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20041044 | EOD-Extension--Breast: If the pathology report states "infiltrating duct carcinoma...measuring 7mm in diameter...focal areas of intraductal carcinoma," do we code this field to 14 [Invasive and in situ components present, size of entire tumor coded in Tumor Size and in situ described as minimal] or to 16 [Invasive and in situ components present, size of entire tumor coded in Tumor Size and proportions of in situ and invasive not known]? | For cases diagnosed 1998-2003: If 7mm is the measurement of the infiltrating duct portion of this cancer, assign extension code 13 [Invasive and in situ components present, size of invasive component stated and coded in Tumor Size]. If 7mm is the size of the whole malignancy and the size of the invasive portion cannot be determined, assign extension code 14 [Invasive and in situ components present, size of entire tumor coded in Tumor Size (size of invasive component not stated) and in situ described as minimal (less than 25%)]. "Focal areas of in situ carcinoma" qualifies as minimal. |
2004 | |
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20041029 | Ambiguous Terminology/Reportability: Are the terms "bordering on" and "may represent" diagnostic of cancer? See Discussion. |
Pathology report states "...florid micropapillary hyperplasia, focally atypical with features bordering on low grade micropapillary ductal carcinoma in situ." |
The terms "bordering on" and "may represent" are not diagnostic of cancer. These terms are not on the list of ambiguous terms that constitute a diagnosis of cancer. The diagnosis in the example above is not reportable to SEER. |
2004 |
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20041102 | CS Tumor Size--Breast: How is this field coded when a core needle biopsy removes the majority of the tumor? See Discussion. | Rule 4.j on page 128 of the 2004 SEER Manual states "Do not code the tumor size from a needle biopsy unless no residual tumor is found on further resection". Example: 3/04/04 core biopsy Rt breast grade 1 infiltrating ductal carcinoma tumor size 0.8cm. 3/10/04 Lumpectomy: 3mm focus of residual infiltrating ductal carcinoma. If we can not take the size of the core needle biopsy, do we use the residual size of 3mm or the clinical size which was 1cm on mammogram? |
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 the tumor size from the mammogram. Do not code the tumor size from the needle biopsy because residual tumor was present in the lumpectomy specimen. |
2004 |
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20041060 | Reportability/Behavior Code--Melanoma: If a dermatologist states a "proliferation of atypical melanocytes confined to epidermis" is melanoma in situ, is it reportable to SEER? |
For this case only, it is reportable to SEER because the physician states that it isĀ "melanoma in situ." The phrase "proliferation of atypical melanocytes confined to epidermis" alone is not reportable to SEER. This phrase means that there are a number of (proliferation) pigmented cells (melanocytes) not showing the normal cell structure (atypical). |
2004 | |
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20041062 | Histology (Pre-2007): Can we ever code this field using a more specific cell type from a metastatic site specimen rather than to a less specific cell type from the primary site specimen? See Discussion. | The histology for a metastatic deposit biopsy is mucin-producing adenocarcinoma. This report states that the primary site is the stomach. It is more specific than the histology from the stomach biopsy described as adenocarcinoma, NOS. | For tumors diagnosed prior to 2007:
Code the histology for the case example to 8481/3 [mucin-producing adenocarcinoma], the more specific histology.
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. |
2004 |