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Report Produced: 02/22/2026 12:37 PM

Report Question ID Question Discussion Answer Year
20021013 Histology (Pre-2007)--Breast: What code is used for histology "tubular carcinoma with lobular carcinoma in situ"?

For tumors diagnosed prior to 2007:

Assign code 8211/3 [Tubular carcinoma]. According to histology rule #2 for a single tumor on page 86 of the 2004 SEER manual, code the invasive histology when both invasive and in situ tumor are present.

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
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
20021053 EOD-Extension--Pancreas: How would you code extension for the following non-surgically treated pancreas primaries? None of these cases has TNM staging to assist with classifying the extent of disease. See discussion.

1) CT scan: Cystic lesion in body of pancreas. Discharge dx: pancreas ca.

2) Discharge dx: CBD obstruction due to probable early ca in head of pancreas.

3) CT scan: mass involves the head and body of the pancreas. No evidence of abdominal mets. Discharge dx: Locally advanced pancreatic ca.

4) H&P: Pt with splenomegaly probably secondary to splenic vein thrombosis and a large ca of the tail of pancreas. Imp: Advanced pancreatic ca of the tail of pancreas. Would you code extension to splenic vein [56]?

5) H&P: Pancreatic ca with extension or mets into porta hepatis. (Would you assume direct extension or mets?)

6) CT scan: Pancreas ca. Significant peritoneal implants. (Would you assume the implants to be related to the pancreas primary and code as involvement?)

For cases diagnosed 1998-2003:

The information provided for these pancreatic primary examples is very limited. Additional information should be sought. If not available, code the EOD-Extension field to:

1) 10

2) 10

3) 10

4) 99

5) Assuming primary in head, body or tail of pancreas, 76

6) 85

 2002
20021200 Date of Diagnosis: How do you code this field when the pathologic confirmation is delayed for 2 months because the clinician decides to "watch and see what happens" to a CT identified mass thought to be either a "metastasis from a previously diagnosed malignancy or a new primary"? Code the Date of Diagnosis field to the date of the scan. This is the earliest date that a recognized medical practitioner said the patient had cancer. The diagnosis on the CT scan was a malignancy. The only question was whether the mass on the scan was metastatic or a primary. 2002
20021072 EOD-Size of Primary Tumor--Breast: The path report provides a size for both the Paget disease and the underlying intraductal component in the breast. Should we assume the Paget disease to be invasive and code the size of the primary tumor to that invasive component? See discussion. For example, path diagnosis for resection gave the size of the Paget disease as 1 mm and the size of the underlying intraductal tumor as 4 cm. Should size for this breast case be coded to 040 or 003, less than 3 mm.

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 040 [4 cm], the size of the larger underlying intraductal tumor. Paget disease is classified according to the size of the underlying in situ or invasive tumor. Paget with an underlying in situ tumor is staged as in situ to match the AJCC classification of this disease process.

 2002
20021121 Multiple Primaries (Pre-2007)--Kidney: How many primaries are reportable in a patient treated with a bilateral nephrectomy that revealed multiple tumors within each kidney and the histology in both the left and the right kidney was "renal cell carcinoma, indeterminate type: multiple histologically identical tumors" and the clinical discharge diagnosis was "bilateral renal cell carcinoma, probably surgically cured"? See discussion. The SEER manual states "If only one histologic type is reported and if both sides of a paired site are involved within two months of diagnosis, a determination must be made as to whether the patient has one or two independent primaries." Frequently, the only statement we have is that "bilateral organs are involved." Additional guidelines for determining number of primaries would be helpful.

For tumors diagnosed prior to 2007:

Report this case as two primaries, left and right kidneys. According to our pathologist consultant, "The description sounds like bilateral multiple primaries. Multicentricity in the same kidney occurs in about 4% of all cases, and bilaterality in 0.5 to 3% (Atlas of Tumor Pathology, Tumors of the Kidney, Bladder, and Related Urinary Structures)."

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
20021059 Surgery of Primary Site--Soft Tissue: What code is used to represent this field when an excisional biopsy of a soft tissue sarcoma is followed two weeks later with a wide excision (re-excision)? For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 26 [partial resection]. According to the CoC, "Excision" in the surgery codes refers to the lesion and "partial resection" refers to the organ. The biopsy is a local excision (code 25). The wide resection is code 26, presuming that more than just the remaining lesion was removed. 2002
20020057 Histology (Pre-2007)--Melanoma: What code is used to represent the histology "radial growth phase: melanoma, superficial spreading type; vertical growth phase: epithelioid type"? See discussion. Can the "growth phase" be used to code histology? If so, would the histology be epithelioid cell melanoma (8771/3)?

For tumors diagnosed prior to 2007:

Code the Histology field to 8771/3 [epithelioid cell melanoma]. The "growth phase" information in this case describes the horizontal spread and the "invasive" or vertical growth through the layers of skin.

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
20021205 EOD-Extension--Melanoma: Is "erosion" synonymous with "ulceration" for melanoma cases?

For cases diagnosed 1998-2003:

No, do not interpret the term "erosion" as a synonym for "ulceration" when coding the EOD-Extension field for melanoma. According to AJCC's melanoma curator, erosion is not necessarily the same as ulceration.

 2002
20021208 Reason for No Cancer-Directed Surgery: Could you explain why this field would be coded to 1 [Cancer-directed surgery was not recommended] or 2 [Contraindicated due to other conditions] for a case that presents with distant metastasis at diagnosis?

For cases diagnosed 1998-2002:

Code the Reason for No Cancer-Directed Surgery field to 1 [Cancer-directed surgery was not recommended] for patients who present with either a primary site or histology for which surgery is not a standard treatment. Also use code 1 for those patients who present with distant disease for a primary site that is typically treated surgically. Patients with distant metastasis typically do not have surgery performed as part of first course of treatment.

Code 2 [Contraindicated due to other conditions] is used when surgery would normally be recommended for the site (given the current stage of the tumor) but other medical conditions pose too much of a risk for the patient to undergo surgery.

 2002