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Report Produced: 02/16/2026 05:56 AM

Report Question ID Question Discussion Answer Year
20041055 Primary Site/Grade, Differentiation, Cell indicator--Lymphoma: Will a Grade, Differentiation code of 6 [B-cell] for a lymphoma coded to primary site C80.9 [unknown] fail edits? See Discussion. Patient had a large mass in chest wall that was excised and found to be large B cell lymphoma. Scans mentioned no involvement of lymph nodes but indicated nodules in the liver thought to be lymphoma as well.

For cases diagnosed prior to 1/1/2010:The combination of a primary site C809 with a Grade, Differentiation code of 6 when used for a lymphoma will not fail SEER edits. Avoid coding primary site to C809 when possible. Code primary site for the example above to C761 [Chest wall, NOS]. The chest wall is the only area of involvement, except for "liver nodules." Liver is an unlikely primary site for lymphoma.

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
20041081 Reporting Source: Is an ER patient who is diagnosed on peripheral smear with an acute leukemia coded as an outpatient if the patient died while in the process of being admitted for treatment or is the patient coded as a death certificate case? Code reporting source as 1 [Hospital Inpatient/Outpatient or Clinic] for the case above. This case will be abstracted using information from the outpatient/ER record (and the death certificate). 2004
20041096 Behavior Code--Breast: How is this field coded for a "non-invasive Paget disease of the breast?" See Discussion. Historically, SEER collected Paget Disease of the breast with a behavior code of 3 [invasive]. There is no documentation to support this. The SEER EOD Manual only states that if the code is "05" [Pagets disease (without underlying tumor)], the behavior must be a 2 [in situ] or a 3 [invasive].

Code the behavior as /2 [in situ] for noninvasive Paget disease of breast. Noninvasive is a synonym of in situ.

If the pathology report documents that the Paget disease is in situ, the matrix principle in ICD-O allows you to change the behavior code to match the pathologist's statement.

 2004
20031088

First-Course of Cancer-Directed Therapy Fields/Hematopoietic, NOS: How do you code treatment for a myelodysplastic syndrome when a patient is admitted to receive a "second transfusion 7 months after diagnosis"?

The first course of treatment for these hematopoietic primaries lasts until there is a treatment change. For the case you cite the second transfusion (7 months after diagnosis) would be first course treatment. Code the Other Cancer-Directed Therapy Field to 1 [Other cancer-directed therapy].

 2003
20031150 Histology (Pre-2007)--Breast: Should the histology "non-invasive papillary carcinoma" along with the comment "solid intraductal papillary proliferation includes cytologically atypical cells with scattered mitotic figures" be coded to 8503/2 [intraductal papillary carcinoma] or 8050/2 [papillary carcinoma in situ]?

For tumors diagnosed prior to 2007:

The best histology code for this breast case is 8503/2 [Noninfiltrating intraductal papillary carcinoma]. According to the WHO Classification of Tumors for Breast, Papillary carcinoma, non-invasive is a synonym for Intraductal papillary carcinoma. Further, code a more specific histologic type when found in the microscopic description, according to the SEER Program Code manual.

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.

 2003
20031042 Histology (Pre-2007): How are the following four histologies coded: 1) Adenocarcinoma with focal mucinous adenocarcinoma; 2) Adenocarcinoma with focal areas of bronchioalveolar adenocarcinoma, 3) Mixed infiltrating duct and focal medullary carcinoma, and 4) Mixed infiltrating duct and focal medullary carcinoma? See Description.

1. How do we code colon: Adenocarcinoma with focal Mucinous adenoca? 8140/3 or 8255/3?

2. A lung lesion with predominant adenoca with focal areas of bronchioalveolar adenoca? 8140/3 or 8255/3?

3. Mixed infiltrating duct carcinoma and medullary ca? 8510/3 or 8255/3?

4. Mixed infil duct ca and focal medulary ca? 8510/3 or 8255/3?

For tumors diagnosed prior to 2007:

1. 8140/3, Adenocarcinoma. Mucinous has a specific rule (see sinq 20010075): Include the mucinous component only if it is 50% or more of the tumor. "Focal" is not a majority term.

2. 8250/3, Bronchiolo-alveolar adenoca. Code the more specific histology.

3. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of carcinoma.

4. 8523/3, Infiltrating duct mixed with other types of carcinoma. Combination of infiltrating duct and another type of carcinoma.

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.

 2003
20031148 EOD-Systemic Symptoms at Diagnosis--Lymphoma: Would the description, "three days of typical cold symptoms including congestion, sneezing, chills and advanced difficulty breathing and some fever" qualify as B-Symptoms?

For cases diagnosed 1998-2003:

Use the following criteria to determine whether or not certain clinical findings qualify as "B" symptoms.

1. Fevers. Unexplained fever with temperature above 38 degrees C.

2. Night sweats. Drenching sweats that require change of bedclothes.

3. Weight loss. Unexplained weight loss of more than 10% of the usual body weight in the 6 months prior to diagnosis.

Pruritus alone does not qualify for B classification, nor does alcohol intolerance, fatigue, or a short, febrile illness associated with suspected infections.

The clinical description in the example above does not meet the criteria for B symptoms. Generally, the symptoms in the B category have to occur over an extended period of 7 to 30 days. In this case the fever is explained by "typical cold symptoms" and in addition, three days of fever is not a long enough period.

 2003
20031091 EOD-Pathologic Extension--Prostate/Lymphoma: How is this field coded for a prostatic lymphoma? For cases diagnosed 1998-2003: Do not code the prostate pathologic extent of disease field for prostatic lymphoma. Leave the path extension for prostate field blank. Code the extent of disease using the lymphoma scheme. Use ONLY the lymphoma scheme - do NOT try to code both lymphoma and prostate extension fields for prostatic lymphoma. 2003
20031024 Surgical Fields--Head & Neck: How does one code the removal of benign submandibular and sublingual glands performed during a neck dissection for a head and neck cancer? See discussion. Should the removal be coded as incidental in the surgical Procedure if the Other Site field? Does it make a difference if the submandibular gland is removed en toto with lymph nodes or if the gland is submitted as a separate specimen? Does it make a difference if the glands are involved?

Removal of the lower salivary glands is part of a radical neck dissection and is not recorded in Surgery of Primary Site or Surgery of Other Site. Radical neck dissection is coded under "Scope of Regional Lymph Node Surgery."

It does not matter whether or not the gland is submitted as a separate specimen. It does not matter whether or not the gland is involved.

 2003
20031192 EOD-Extension--Breast: How is this field coded when the diagnosis includes both invasive and in situ disease, and the pathology report stated the tumor size may or may not include the size of the in situ portion of the tumor? See Description.

Examples:

1. Invasive ductal carcinoma well differentiated, 1.2 cm, gross tumor size, ductal carcinoma in situ.

2. Gross tumor size 3.2 x 2.5 x 2.3 cm. well differentiated to moderately differentiated invasive ductal ca, accompanying component well differentiated ductal carcinoma in situ, solid, cribiform.

For cases diagnosed 1998-2003: Use extension codes 16, 26, or 36 depending on extent of involvement. These codes indicate that invasive and in situ components are present, the size of the entire tumor is coded in Tumor Size, the size of the invasive component is not stated, and the proportions of in situ and invasive are not known.

Both examples above measure the entire tumor including invasive and in situ components. Assign extension code 16, unless there is evidence of further involvement.

 2003