Report | Question ID | Question | Discussion | Answer | Year |
---|---|---|---|---|---|
|
20021146 | Primary Site--Lymphoma: Is the primary site likely to be extranodal for a lymphoma that presents in an extranodal site and lymph nodes which are regional for that site? Is the primary site also likely to be extranodal if an extranodal site and lymph nodes are excised? See discussion. | Example: Work-up included a negative CXR. A CT showed multiple dilated loops of small bowel consistent with obstruction and nodular prominence at the base of bladder. Laparotomy with resection of small bowel and multiple biopsies of enlarged mesentric lymph nodes performed. Final path diagnosis: Lymphoma in a "mesenteric mass" and in "small bowel." There was no mention of lymph nodes in the final diagnosis and the detailed micro described the mesenteric mass as just adipose tissue replaced by lymphoma. However, the gross for that specimen states 4 lymph nodes were found in the fat. The small bowel micro described an ulcerated lesion of the small bowel extending into muscularis. | For cases diagnosed prior to 1/1/2010:Code the Primary Site field to C17.9 [small bowel] for the example. When an extranodal organ and that organ's regional nodes are involved, the extranodal site is most likely the primary, unless there is extension from the regional nodes to the organ. If the primary site cannot be determined for a lymphoma diagnosed in both a nodal and extranodal site, code to C77.9 [lymph nodes NOS]. 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 |
|
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 |
|
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 | |
|
20021185 | Surgery of Primary Site--Major salivary gland: How do you code Surgery of Primary Site for a submandibular gland primary when the operative report refers only to an excision of the submandibular "tumor" while the pathology report states the submandibular "gland" was removed? See discussion. | The gross description on the pathology report indicates that the specimen consists of a "submandibular gland." A further description on the pathology report included, "the specimen was sectioned exposing a focally cystic mass that nearly replaces the entire specimen." | For cases diagnosed on 1/1/2003 or after: Code the Surgery of Primary Site field to 40 [Total parotidectomy, NOS; total removal of major salivary gland, NOS], per the pathology report's gross description of the specimen unless the operative report description of procedure indicates that the removal was less than total. | 2002 |
|
20021168 | Histology (Pre-2007)--Corpus Uteri: What code is used to represent the histology "endometrioid carcinoma with squamous differentiation" for an endometrium primary? | For cases diagnosed 2004-2006:
Endometrioid adenocarcinoma with squamous differentiation is coded 8570 [Adenocarcinoma with squamous metaplasia].
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 | |
|
20020054 | Multiple Primaries (Pre-2007)--Ovary: Are mucinous cystic tumors of low malignant potential diagnosed in the left ovary in 12/2000 and in the right ovary in 7/2001 reportable as two primaries? See discussion. |
Page 14 of the SEER Program Code Manual, 3rd Edition, states that bilateral retinoblastomas and bilateral Wilms tumor are always single primaries whether simultaneous or not. Does this apply to bilateral ovarian tumors as well? |
For cases diagnosed 2001-2006: Borderline tumors are not reportable to SEER as of 2001. If you are collecting them in your registry, use the following procedure: Exception 1 in the SEER Program Code Manual, 3rd Edition, responds to the issue of processing ovarian tumors. Simultaneously occurring ovarian tumors with a single histology are coded as one primary. In the case you cite, the right ovary primary occurred 7 months after the left ovary primary. This is not simultaneous, so it would be counted as a second primary. 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 |
|
20021026 | Surgery of Primary Site--Skin: Should Mohs surgery be code to 27 [Excisional biopsy] or 31 [Shave biopsy followed by a gross excision of the lesion]? See discussion. | Under surgery coding in the 5/22/01 SEER Abstractor/Coder Workshop book, page 20, it states that Mohs surgery should be coded as an excisional biopsy. The ACoS I&R dated 6/6/2001 states that it should be coded to 31. | For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 34 [Mohs surgery, NOS], 35 [Mohs with 1-cm margin or less] or 36 [Mohs with more than 1-cm margin]. | 2002 |
|
20020063 | EOD-Extension--Breast: How do we interpret "dermal lymphovascular space invasion" and "dermal lymphovascular invasion" for extension? See discussion. | A breast path report states tumor invades dermal lymphovascular spaces. Also, pathologists sometimes state "dermal lymphovascular invasion". Are both these terms synonymous with dermal lymphatic invasion? | For cases diagnosed 1998-2003:
Dermal lymphovascular invasion and tumor in dermal lymphatics would both be coded as dermal lymphatic invasion. |
2002 |
|
20021174 | Histology (Pre-2007)/Grade, Differentiation--All Sites: When the original pathology reports diagnosis indicates a grade and the review of slides (ROS) pathology report does not give a grade, can you code the histologic type from the ROS and the grade from the original pathology report? See discussion. | For example, if the original diagnosis is "poorly differentiated carcinoma" and the ROS diagnosis is "squamous cell carcinoma," would the morphology code be 8070/33? | For tumors diagnosed prior to 2007:
Yes. Code the Histology and Grade, Differentiation fields to 8070/33 [poorly differentiated squamous cell carcinoma]. Code the higher grade when different grades are specified for the same specimen and code the more specific morphology (i.e., squamous cell carcinoma rather than carcinoma, NOS).
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 |
|
20020020 | Multiple Primaries (Pre-2007)--Breast: When two breast tumors with two different histologies, such as duct and mucinous are diagnosed in the same breast at the same time, are they reportable as two primaries? See discussion. |
Our rule is that multiple lesions of different histologic types are separate primaries. However, for separate tumors of duct and lobular, we report as a single primary. Since we now have a combination code for duct and other types of ca, do we report as a single primary or continue to report as separate primaries? |
For tumors diagnosed prior to 2007: When there are two breast tumors, one mucinous, the other duct carcinoma, report as two primaries when the pathologist's opinion clearly states that there are separate primaries. If there is no such information from the pathologist, the two tumors must be separate with clear (negative) margins to be reported as two primaries. Otherwise, report as one primary. The ICD-O-3 combination codes are not intended to combine tumors of different histologic types. 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 |