Report | Question ID | Question | Discussion | Answer | Year |
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20020035 | First Course Treatment--Lymphoma: How should an antibiotic regimen such as bismuth or omeprazole, amoxicillin, and metronidazole be coded for a MALT lymphoma of the stomach associated with Helicobacter pylori infection? See discussion. |
If we do not count the antibiotic regimen as cancer-directed treatment but this is the only treatment given and the lymphoma disappears, is it problematic to have a cancer status of "no disease" recorded in a patient that supposedly was not "treated"? |
Do not code antibiotic regimens as Cancer-Directed Therapy. These drugs are intended to treat the bacteria and not the cancer. This type of treatment is ancillary even if it is the only type of treatment given. You may designate a user-defined field to capture this information if desired. The coding combination of a cancer status of "no disease" and all treatment fields coded to "no treatment" is allowable. |
2002 |
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20020044 | Terminology/EOD-Extension--Prostate: How does SEER define the prostatic "apex"? See discussion. |
Some pathologists define the prostatic apex as including the bottom third of the prostate whereas others regard only the bottom-most portion of the gland to be the apex. |
SEER defines the apex as being the bottom-most portion of the gland. Apex means "narrowest part," which in the prostate would be the bottom-most portion of the gland. |
2002 |
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20021173 | Histology (Pre-2007): What code is used to represent a review of slides histology of "in situ squamous cell carcinoma and multiple detached fragments of atypical papillary squamous epithelium; highly suspicious for invasive carcinoma"? See discussion. | The original pathologist indicated a final diagnosis of moderately differentiated squamous cell carcinoma. The slides were sent for review to another facility. The reviewing pathologist rendered the diagnosis stated in the question section. | For tumors diagnosed prior to 2007:
Code the Histology field to 8070 [squamous cell carcinoma].
The review diagnosis was also squamous cell carcinoma. The expression "atypical papillary squamous epithelium" does not modify the cancer 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. |
2002 |
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20021194 | Grade/Histology (Pre-2007)--All Sites: What code is used to represent these fields for the histology "High grade dysplasia (adenocarcinoma in situ)" or "AIN III/High grade AIN"? |
For tumors diagnosed prior to 2007: Code the Histology field for the first example to 8140/2 [Adenocarcinoma, NOS, in situ] and for the second example to 8077/2 [AIN, grade III]. For both of the cases code the Grade, Differentiation field to 9 [Cell type not determined not stated or not applicable]. The 6th digit (grade code) of ICD-O-3 describes how much or how little a malignant tumor resembles the normal tissue from which it arose. In contrast, "grade" is used in the examples above to describe the degree of dysplasia, from mild dysplasia (low grade) to severe dysplasia (high grade). Do not record the degree of dysplasia in the 6th digit grade field. For tumors diagnosed 2007 or later, refer to the MP/H rules for histology coding instructions. 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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20021010 | Histology (Pre-2007): What code is used to represent the histology adenocarcinoma with "areas of" papillary architecture and "foci of" squamous differentiation? Even though "areas of" and "foci" are non-majority terms, should histology be coded to the combination code of adenocarcinoma with mixed subtypes [8255/3]? |
For tumors diagnosed prior to 2007: Code the Histology field to the majority of the tumor, which is 8140/3 [adenocarcinoma, NOS]. The terms "areas of" and "foci of" should be ignored because they are not terms that reflect the majority of the tumor. Therefore, we cannot use rule A on page 2 of Coding Complex Morphologic Diagnoses because this diagnosis does not represent a complex morphology. 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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20021149 | EOD-Extension--Head & Neck: In the absence of a clear surgical or pathologic description of how the salivary gland involvement relates to the head and neck primary, do we code the involvement as direct extension, further extension or metastasis? See discussion. | A composite resection of tonsillar mass and a modified radical neck dissection is performed. According to the pathology report: Squamous cell carcinoma involvement of tonsil with invasion of skeletal muscle. A separate specimen labeled "tumor" indicates a salivary gland is also involved with tumor. Neck dissection: 1 lymph node with metastasis. | For cases diagnosed 1998-2003:
In the absence of a clear statement that the gland was involved by direct extension, code the EOD-Extension field to 85 [Metastasis]. In this case, the salivary gland tumor was described as a "separate specimen" that contained the salivary gland. The extension does not appear to be contiguous for this case.
If the salivary gland involvement had been by direct extension, which would be assumed if there had been contiguous involvement of the gland with the primary site, then code the EOD-Extension field to 80 [Further extension]. If there had been direct extension, the surgeon probably would not have dissected through the tumor. The resection specimens would have been contiguous. |
2002 |
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20021027 | EOD-Size of Primary Tumor: Should a 2.0 cm ulcerated mass be coded to 020 or 999 for tumor size? See discussion. |
With regard to tumor size, how would SEER interpret "2.0 cm ulcerated mass"? Should this be interpreted as an ulcer, or is it a gross description of the appearance of a mass and therefore acceptable to code tumor size to it? | For cases diagnosed 1998-2003:
If this ulcerated mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field to 020 [2.0 cm] based on the size of this mass in the absence of a more precise tumor size description. |
2002 |
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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 | |
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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 |
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20021127 | Histology (Pre-2007)/Behavior Code--Thyroid: What code is used to represent the histology "micropapillary carcinoma" of the thyroid? See discussion. | The ICD-O-3 includes "micropapillary intraductal (C50._)" [8507/2], "micropapillary serous (C56.9)" [8460/3] and "micropapillary transitional cell (C67._) [8131/3] but does not seem to include a micropapillary code for a thyroid primary. | For tumors diagnosed prior to 2007:
Code the Histology field to 8507/3 [micropapillary carcinoma]. According to rule H, the topography code listed in the ICD-O is disregarded if the tumor is known to arise in another site. In this case, the site is thyroid [C73.9] so the topography code of breast [C50._] can be disregarded for this histology. Apply the matrix principle to change the Behavior Code from 2 to 3.
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 |