| Report | Question ID | Question | Discussion | Answer | Year |
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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 | |
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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 |
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20021087 | Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are represented when a1998 invasive squamous cell carcinoma of the true vocal cord is followed by a 1999 diagnosis of in situ squamous cell carcinoma of the true vocal cord (called "recurrent" by the clinician), and in 2001 there is another invasive squamous cell carcinoma of the true vocal cord (no statement of recurrence)? Would your answer be any different if no statement of "recurrent" had been made in 1999? | For tumors diagnosed prior to 2007:
Code this case as two primaries, an invasive true vocal cord primary in 1998 and another invasive true vocal cord primary in 2001.
If there had been no statement of recurrence for the 1999 in situ diagnosis and the 1999 diagnosis was more than two months following the 1998 diagnosis, this case would be coded as three primaries.
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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20021124 | Multiple Primaries (Pre-2007)/Primary Site/EOD-Extension--Lung: Should lung cases be counted as more than one primary when nodules removed from separate lobes of the same lung have either the same histology or they are different immunophenotypes of the same main histologic classification (e.g., adenocarcinoma)? See discussion. |
1. Path report: "Two nodules (RLL, RUL) of primary pulmonary demonstrate adenocarcinoma with different histologic appearances and different immunophenotypes consistent with synchronous lung adenocarcinomas." Per ICC interpretation, two lung primaries are favored. 2. Path report: "Two peripheral nodules (LLL, LUL) demonstrate similar P.D. non-small cell carcinoma with features of large cell undifferentiated carcinoma." |
For tumors diagnosed prior to 2007: According to current SEER rules, both examples represent one primary because both tumors are in one lung and of a single histologic type. Code the Primary Site field to C34.9 [Lung, NOS] for both examples and the EOD-Extension field to 77 [Separate tumor nodules in different lobe]. This will capture the fact that there are multiple tumors within the lung for each of these examples. Differences in immunophenotypes confirm independent de novo cancers and rule out metastasis. Immunophenotype differences do not equate to different histologies. In the first example described, there are different histologic features; however, the main classification 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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20021016 | Histology (Pre-2007)/Behavior Code: What code is used to represent the histology "foci of well differentiated intramucosal carcinoma [carcinoma in situ] arising on the surface of a tubular adenoma"? The pathologist referred to this colon biopsy as "in situ". | For tumors diagnosed prior to 2007:
Assign histology code 8210 [adenocarcinoma in a tubular adenoma] and behavior code 2 [in situ]. "In situ" is specified by the pathologist.
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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20021031 | Primary Site--Meninges: Should the primary site for a meningioma of the right frontal lobe be coded to C71.1 or C70.0? See discussion. | In the opinion of some neurologists it is more important to capture the lobe in which the meningioma is located rather than code the primary site to meninges. Should a meningioma always be coded to meninges for primary site? | Code the Primary Site field to C70.0 [cerebral meninges], the suggested site code for most meningiomas. Meningiomas arise from the meninges, not the brain (although they can invade brain). ICD-O-3 does not differentiate the specific location of the brain that the meninges cover. The information of interest to neurologists would have to be captured in an optional or user-defined field. | 2002 |
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20020003 | EOD-Size of Primary Tumor: Can you code the tumor size if you have the aggregate size given for two or more tumor masses? | For cases diagnosed 1998-2003:
No. Never code the aggregate size in the Size of Primary Tumor field when the pieces removed come from TWO OR MORE tumors. If there is a clinical statement regarding the size of two or more tumors, code this field to the size of the largest tumor.
The aggregate size can only be used to code the Size of Primary Tumor field when the PATHOLOGIST estimates the size of the tumor from the pieces of ONE tumor removed by the surgeon. |
2002 | |
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20021034 | Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma in a tubulovillous adenoma with a mucinous component, the mucinous component is less than 50%"? See discussion. | For mucinous only, the tumor must contain at least 50% mucinous to be coded to the specific histology. | For tumors diagnosed prior to 2007:
Code the Histology field to 8263/3 [adenocarcinoma in a tubulovillous adenoma]. Because the mucinous component involves less than 50% of the tumor, the histology is not coded to mucinous. For mucinous only, the tumor must be at least 50% mucinous, mucin producing, to be coded to the specific 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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20021046 | Behavior Code/EOD-Extension--Bladder: If an in situ lesion of the urinary bladder involves the von Brunn nests, is it still in situ? See discussion. | Von Brunn nests: Compact, rounded aggregates of urothelial (transitional) cells in the lamina propria, with or without connection to the surface epithelium. Urothelial (transitional cell) carcinoma in situ...may involve von Brunn nests... Histologic Typing of Urinary Bladder Tumours, Second Edition, WHO, pp 12 & 21 |
For cases diagnosed 1998-2003:
Code the Behavior Code and the EOD-Extension field according to the pathology report.
If the pathology report states the tumor to be noninvasive or in situ, whether or not von Brunn nests are involved, code behavior as 2 [in situ] and extension as in situ.
If the tumor is described as invasive and involves the von Brunn nests, code the EOD-Extension field to 15 [invasive tumor confined to subepithelial connective tissue] because code 15 includes extension to the lamina propria and von Brunn nests are within the lamina propria. |
2002 |
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20021118 | Grade, Differentiation--Lymphoma/Leukemia: Should the term "Pre-T" be added to code 5 [T-cell] in the ICD-O-3 Table 22, 6th Digit Code for Immunophenotype Designation for Lymphoma and Leukemia? | For cases diagnosed prior to 1/1/2010:Code the Grade, Differentiation field to 5 [T-cell] in the 6th digit of the ICD-O-3 morphology field when the terms "pre-T cell" or "T-precursor" are used. However, this is not an official change to ICD-O-3. 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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