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Report Produced: 02/22/2026 16:15 PM

Report Question ID Question Discussion Answer Year
20021094 EOD-Extension/EOD-Lymph Nodes--Testis: If the patient received chemo, should "bulky retroperitoneal adenopathy" be coded as involved lymph nodes in the EOD lymph node involvement field for a testicular primary treated with an orchiectomy that rendered a path diagnosis of "seminoma confined to the testicle"? See discussion. Per an orchiectomy path diagnosis a seminoma was confined to the testicle. The only other workup, other than a scrotal ultrasound, was a staging CT scan that revealed bulky retroperitoneal adenopathy in abdomen and pelvis, as well as mediastinal adenopathy. There was also a peripheral pulmonary nodule. No final clinical diagnosis or stage was provided in the chart. Following the orchiectomy the patient was treated with chemo. Should we also have coded distant site lung involvement?

For cases diagnosed 1998-2003, code the EOD-Lymph Nodes field to 9 [unknown] because "adenopathy" is not used to code lymph node involvement. The physician varied from the usual treatment for a localized testicular carcinoma, which is an orchiectomy. The physician proceeded immediately to chemotherapy as further treatment. It is not clear whether the decision to treat with chemo was based on the nodes and/or lung being involved.

Search the record for the physician's opinion regarding distant metastasis. Do not code distant involvement based on a peripheral pulmonary nodule seen on CT without further proof. If no further information is available, code the EOD-Extension field to 99.

 2002
20020018 EOD-Lymph Nodes/EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Cervix: What codes are used to represent these fields for a cervix primary when the only information on lymph nodes is a CT of the pelvis showing "pelvic adenopathy" (no surgery was done)? Code the EOD-Lymph Nodes field to 9 [unknown]. Code the Pathologic Review of Number of Regional Lymph Nodes Positive field to 98 [No nodes examined] and the Lymph Nodes Examined to 00 [No nodes examined] because there was no resection of the primary organs. Adenopathy, NOS, per SEER guidelines, is not coded as lymph node involvement 2002
20021105 Grade, Differentiation: Do we code to the highest grade even when no grade is given at the time of initial diagnosis, but a grade is obtained on tissue removed after non-surgical treatment has occurred? See discussion.

1. In 2000 a pleural fluid aspirate had no grade. Pt treated with chemo. In 2000 a BSO diagnosed high grade papillary serous adenocarcinoma of the ovary.

2. In 1993 a prostate bx had no grade. Pt treated. In 2001 prostate bx revealed a Gleason's 4+3.

Code the grade at the time of initial diagnosis (if the specimen is from the primary site) or to the grade identified as part of a first course of cancer-directed surgery to the primary site. When different grades are specified for tissue pathologically reviewed from the primary site before and after treatment, code the higher grade. This is true even if the higher grade is obtained while the pt is still undergoing first course of cancer-directed therapy.

1. Code the Grade to 4 [high grade], if the grade information from the BSO specimen represents the grade associated with primary site surgical specimen. Even though the grade was obtained after first course of cancer-directed therapy started, it was obtained during first course of cancer-directed therapy.

2. Code the Grade to 9 [Cell type not determined, not stated or not applicable]. Grade was obtained well after the first course of cancer-directed therapy ended.

 2002
20020015 Histology (Pre-2001): For cases diagnosed before 1/1/01, what code is used to represent the histology "small cell neuroendocrine carcinoma"? For tumors diagnosed prior to 2001, code the Histology field to 8041/3 [small cell carcinoma] for "small cell neuroendocrine carcinoma". 2002
20021113 Surgical Procedure of Other Site--Pancreas: Should an embolization of liver metastasis for a pancreas primary be coded as treatment?

Code "embolization" (or hepatic artery embolization, HAE) to a metastatic site in Surgical procedure of Other Site. Assign code 1 [nonprimary surgical procedure performed].

This procedure was previously coded as other therapy, experimental. Code as surgery as of July 2005.

 2002
20021028 EOD-Clinical Extension--Prostate: If the tumor arises in the prostatic apex, does that take priority over coding clinical extension based on the stage of cT1c? See discussion. Physician states prostate primary is a cT1c. Pathology states adenocarcinoma, Gleason 3+3, right apex. All other biopsies were negative. Because the primary appears to be in the prostatic apex, do we code 33 or 15 for clinical extension? Which is more important for SEER? Do you want to capture the "apex" information or the "cT1c" information?

For cases diagnosed 1998-2003:

Code the EOD-Clinical Extension field to 33 [arising in prostatic apex]. Apex information takes priority. The only statement we have is cT1c by the urologist, and we don't know how that stage was determined.

 2002
20021158 Multiple Primaries/Histology--Lymphoma: What is the primary site(s) for a patient who had a lymph node biopsy with the histology of "large B cell lymphoma arising in the setting of low grade B cell lymphoma c/w marginal zone B cell lymphoma with plasmacytic features"? See discussion. This patient also had a bone marrow biopsy that demonstrated "low grade B cell lymphoma." Per the clinician, "Pt with discordant lymphoma. We will be approaching his lymphoma as two different diseases. The large B cell had cleared after chemotherapy and radiation therapy. The low grade lymphoma is incurable."

For cases diagnosed prior to 1/1/2010:

Code as two primaries with each arising in lymph nodes [C77._]. The histology for the first primary is 9699/3 [marginal zone B cell lymphoma]. The histology for the second primary is 9680/3 [large B cell 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.

 2002
20021180

Surgery of Primary Site/Other Cancer-Directed Therapy--Head & Neck (Nasal cavity): Should a small fragment of bone removed during a maxillectomy following a turbinectomy for a nasal turbinate primary be "partial or total removal with other organ" for coding this field? See discussion.

Excision of a turbinate mass and partial turbinectomy revealed melanoma of the rt nasal turbinate. A subsequent rt medial maxillectomy was performed and a small fragment of bone was included in the resection and identified in the pathology report. Would the removed bone be "connective or supportive tissue" only for a Surgery of Primary Site code of 40 or is it another organ for a code of 60?

The piece of bone was likely removed to access the maxillary sinus and would not be a separate organ. Use the "All Other Sites" surgery coding schemes to code this primary. For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 40 [Total surgical removal of primary site]. Code the Surgical Procedure of Other Site field to 2 [Non-primary surgical procedure to other regional sites]. The maxillectomy was not performed in continuity to the turbinectomy and should be coded in this field rather than the Surgery of Primary Site field.

 2002
20021175 Histology (Pre-2007): What code is used to represent the histology if the final diagnosis between an electron microscopy report and the immunocytochemistry (ICC) differs and both histologies are specific (e.g., one report states papillary carcinoma and the other states squamous cell carcinoma)?

For tumors diagnosed prior to 2007:

There is no established hierarchy between electron microscopy and ICC findings. Contact the pathologists involved in these types of cases to determine the final histologic diagnosis.

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.

 2002
20021039 Grade, Differentiation--Breast: How do we code grade for a breast primary diagnosis of "Low grade invasive duct, modified Bloom-Richardson grade II/III (tubule formation 2, nuclear grade 1, mitotic rate 1)"? This appears to add up to a Bloom-Richardson score of 4, which does not fit with a Bloom-Richardson II/III.

Code the Grade, Differentiation field to 1 [grade I] using the information from the BR score.

For cases diagnosed 1998-2003: Grade or differentiation information from breast pathology reports is used in the following priority order:

1. Terminology (well, moderately, poorly)

2. Histologic grade (grade I, grade II)

3. BR scores

4. BR grade

5. Nuclear grade

On the hierarchical list for coding breast grade, the first two priorities do not apply to this case, but the third (Bloom-Richardson scores) does. Add the BR information (2+1+1) for a total score of 4, which translates to BR low grade (code 1). The statement of "II/III" may be a typo that should state I/III.

 2002