| Report | Question ID | Question | Discussion | Answer | Year |
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20021011 | Reportability/Histology (Pre-2007)/Behavior Code/Primary Site: How would you code these fields for a case in which an infant presents with a skin rash, enlarged spleen, palpable abdominal mass, inconclusive bone marrow biopsy and a skin biopsy that was positive for "Langerhans cell histiocytosis"? See discussion. | The pathologist states, "I would consider this case a malignancy, although it does not always behave as such. Lesions in babies often act in a malignant manner." | For tumors diagnosed prior to 2007:
If the pathologist states this is a malignancy, the case is reportable. Code the Histology field to 9751/3 [Langerhans cell histiocytosis, NOS] and change the Behavior Code from 1 to 3. Code the Primary Site field to skin [C44._].
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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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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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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20021156 | Primary Site/Histology (Pre-2007): What codes are used to represent site and histology for BSO specimen with a diagnosis, "Left and right adnexa: poorly differentiated serous carcinoma. Comment: The carcinoma occurs as multiple nodules within adnexal soft tissues. Direct involvement of ovaries is not seen, supporting an extraovarian origin." See discussion. | Per our pathologist consultant, the site should be pelvic peritoneum [C481] and the histology is primary serous papillary carcinoma of peritoneum [8461/3]. Does SEER agree? | For tumors diagnosed prior to 2007:
Code the Primary Site to C481 [Specified parts of peritoneum] and the Histology field to 8461/3 [primary serous papillary carcinoma of peritoneum].
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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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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20021197 | Scope of Regional Lymph Node Surgery--Breast: How should this field be coded when a mastectomy that removed 3 sentinel lymph nodes is later followed by an axillary lymph node dissection that removed 17 lymph nodes? Should all of the lymph node information be coded to this field, even though the Number of Regional Lymph Nodes Examined field will be coded to the number of lymph nodes from the most definitive surgery (17)? | For cases diagnosed 1/1/2003 and after: Yes, all of the lymph node information should be coded to the Scope of Regional Lymph Node Surgery field using code 7 [Sentinel node biopsy and code 3, 4, or 5 at different times].
The Number of Regional Lymph Nodes Examined field no longer exists for this time frame. |
2002 | |
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20020030 | EOD-Size of Primary Tumor: 1) Can we add "Imaging studies" to those EOD schemes that currently do not include this on their priority list for coding size? 2) When an EOD scheme already lists specific types of imaging studies, are we limited to only those types of procedures or can any imaging study be used to code size? See discussion. | How do we determine where to add "imaging studies" to the priority listing? Currently the hierarchy differs for primaries that currently include imaging studies on their EOD schemes. For example, on the breast EOD imaging ranks lower than the physical exam while on the thyroid EOD imaging ranks higher than the physical exam. | For cases diagnosed 1998-2003:
1) You may add "Imaging" to the size priority list for all EOD schemes that currently do not include it. Prioritize it just above the physical exam for these sites.
2) You may use the information from any imaging technique to code tumor size, even for those sites such as breast and bladder where specific imaging tests are mentioned. |
2002 |
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20021143 | Multiple Primaries (Pre-2007)--Breast: Should just one primary be reported when only ductal carcinoma in situ is diagnosed initially but the mastectomy performed as part of the first course of cancer-directed therapy, but more than 2 months after diagnosis, contains a diagnosis of invasive ductal carcinoma? See discussion. | How do we code this case in light of the EOD guideline that states we include all information collected within 4 months of diagnosis or through the completion of first surgery in the absence of disease progression when coding. | For tumors diagnosed 1998-2003:
Report this case as one invasive primary, unless stated to be two primaries by the clinician. This appears to be a single primary with different behaviors, rather than separate tumors.
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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20021047 | Surgery of Primary Site--Bladder: Do we code "random bladder biopsies" as an excisional biopsy (27) or as no cancer directed surgery (00) even if the only involvement mentioned on the pathology reports is "focal carcinoma in situ"? | Code the Surgery of Primary Site field to 00 [None; no surgery of primary site] when only random biopsy procedures are performed on the bladder. | 2002 |
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