Report | Question ID | Question | Discussion | Answer | Year |
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20020031 | Multiple Primaries--Hematopoietic, NOS: When the SEER Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table indicates that a disease is not a new primary, but a pathologist or clinician states that it is a new primary, do we use the physician information or the table? | For cases diagnosed prior to 1/1/2010:If the physician clearly states that this is a new primary, submit it as a new primary. Otherwise, use the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table.
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 | |
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20021074 | Tumor Markers--Breast: If the ERA/PRA results reported differ for separate breast specimens removed for a single primary, do we code the results as positive or negative? | For cases diagnosed 1998-2003:
Code both the Tumor Marker 1 and Tumor Marker 2 fields to 1 [positive] when a single primary breast tumor has both positive and negative ERA/PRA receptors. |
2002 | |
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20020024 | Reportability--Cervix: The SEER Program Code Manual lists CIN III and carcinoma in situ of the cervix as not being reportable for cases diagnosed in 1996 or later, but does not list "adenocarcinoma in situ" or "squamous cell carcinoma in situ." Are these histologies still reportable? | For primary site cervix uteri, only histologies with behavior codes of 3 [invasive] are reportable to SEER for all registries.
Some SEER registries have opted to continue to collect behavior codes of 2 [in situ] for cervix uteri primaries. |
2002 | |
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20021115 | EOD-Lymph Nodes--Testis: In coding lymph node involvement for a testicular primary, should we use code 5 (Size not stated) when there is not a pathologic size of the lymph node provided? See discussion. | Should Note 1 in the testis EOD be changed to "Metastases in lymph nodes are now measured by the size of the lymph node as stated in pathology report"? The SEER EOD-88, 3rd Edition, states that "when size of regional lymph nodes is required, code from the pathology report." | For cases diagnosed 1998-2003:
For testis cases only, "metastasis in lymph nodes" is measured by the size of the lymph node or the lymph node mass. It is acceptable to code the size of this metastasis from a CT scan or other imaging when a pathology specimen is not available for testicular primaries. |
2002 |
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20020039 | Multiple Primaries (Pre-2007)/EOD-Extension--Bladder/Prostatic Urethra: When noninvasive papillary transitional carcinoma of the bladder and invasive papillary transitional cell carcinoma of the prostatic urethra are diagnosed at the same time, and staged by the pathologist as two primaries, should they reported as two primaries? If reportable as a single primary what site code should be used? | For tumors diagnosed prior to 2007:
No. This is one primary. Mucosal spread of noninvasive cancer from a hollow organ (bladder) into another hollow organ (prostatic urethra) is coded as a single primary. The prostatic urethra is seldom a primary site. The cancer usually starts in the bladder and spreads to the prostatic urethra via the mucosa. In this case the cancer in the prostatic urethra became invasive. Code primary site as bladder, NOS [C67.9].
For cases diagnosed 1998-2003: Code EOD Extension using the invasive information (prostatic urethra).
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 | |
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20021157 | Histology (Pre-2007)/Grade, Differentiation--Lung: What code is used to represent the histology for a lung biopsy of "non-small cell carcinoma with features of poorly differentiated adenocarcinoma"? See discussion. | Non-small cell carcinoma does not appear to be an NOS term in ICD-O-3. The term "with features of" indicates a majority of tumor. Which rule should be used to code histology? | For tumors diagnosed prior to 2007:
Code the Histology and the Grade, Differentiation fields to 8140/33 [adenocarcinoma, poorly differentiated].
The term "non-small cell carcinoma" is used to represent a broad category of epithelial cancers. Non-small cell carcinoma [8046/3] is grouped in the ICD-O-3 under "Epithelial Neoplasms, NOS." The term can be used by a pathologist when he rules out the fact that the patient has a small cell cancer by stating that the malignancy is a non-small cell type of cancer. In this case, the type of non-small cell cancer present in the specimen is adenocarcinoma.
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 |
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20021096 | Grade, Differentiation--Bladder: What codes are used to represent this field for the four bladder cases described in the discussion section that have a combination of grades mentioned in the pathology reports? See discussion. | 1) Final path diagnosis: papillary transitional cell carcinoma, high grade. Micro description states: High grade, poorly differentiated carcinoma. 2) Well to moderately differentiated papillary transitional cell carcinoma, grade 1-2/3. 3) Urothelial carcinoma, high grade (poorly differentiated, grade 3 of 3). 4) High grade papillary urothelial carcinoma (papillary transitional cell carcinoma, grade 3 out of 4). |
For cases diagnosed January 2004 and forward: 1) Grade 4. High grade is coded 4. Code the grade stated in the final diagnosis. 2) Grade 3. Grade 1-2/3 is coded 3. Use the three-grade conversion table in the 2004 SEER manual. 3) Grade 4. Grade 3 of 3 is coded 4. Use the three-grade conversion table in the 2004 SEER manual. 4) Grade 3. "Grade 3 out of 4" is coded 3 and is more precise than "high grade." |
2002 |
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20021092 | Histology/Primary Site--CLL/SLL: How should these fields be coded for a "chronic lymphocytic leukemia/small lymphocytic lymphoma" [CLL/SLL] diagnosed on a lymph node biopsy that is referred to by the clinician as CLL? See discussion. | Does the clinician's reference to this disease as CLL change the SEER rule to code to SLL if the disease arises in a lymph node or solid tissue? | For cases diagnosed prior to 1/1/2010:Code the Histology field to 9670/3 [Malignant lymphoma, small lymphocytic, NOS] and the Primary Site field to C77._ [lymph nodes] when CLL/SLL is diagnosed in lymph node or solid tissue, even if the clinician refers to CLL. When CLL/SLL is diagnosed in the blood, code as leukemia.
Refer to clarification #6 on the ICD-O-3 Errata and Clarifications. "...if disease is diagnosed only in the blood or bone marrow, code the primary site to C42.1, bone marrow and assign the leukemia morphology code. If the diagnosis is made on any other tissue (typically lymph nodes, lymphatic structures, breast, and stomach), code to the tissue involved and assign the lymphoma morphology. If the diagnosis is made on both blood or bone marrow and a tissue biopsy, code the tissue involved and assign the lymphoma morphology." 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 |
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20021190 | Histology (Pre-2007)--Bladder: What code is used to represent the histology "transitional cell and small cell carcinoma" of the bladder? See discussion. | Code 8045/3 is used for combination codes that represent a mixture of small cell carcinoma and any other carcinoma. When we use this histology code for bladder primaries with mixed transitional cell and small cell carcinoma, we encounter a problem with the SEER edits (site and morphology conflict). | For tumors diagnosed prior to 2007:
Please see SEER Inquiry question ID number 20041104.
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 |
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20021060 | EOD-Size of Primary Tumor: The EOD Manual instructs us not to code the size of a cyst. Can we code the size of tumor lesions described as being multicystic, multiloculated, or as a complex mass with cystic areas? See discussion. | Example 1: Large multicystic ovarian mass lesion measuring 10 cm. Sections through the specimen show a multicystic and solid mass with abundant fluid exuding from the cut surfaces (Size of the solid portions is not stated).
Example 2: A brain MRI: 9-cm. complex mass with cystic areas. |
For cases diagnosed 1998-2003:
Yes, if the cystic mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field based on the size of the mass in the absence of a more precise tumor size description. For the examples in the discussion section, code the EOD-Size of Primary Tumor field to: 1) 100 [10 cm]. 2) 090 [9 cm].
As a point of interest, the size of tumor for ovarian and brain primaries is not used in either analysis or as a prognostic indicator for survival. Therefore, spending time separating the cystic and solid portions of the tumor is unnecessary. |
2002 |