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Report Produced: 03/01/2026 15:59 PM

Report Question ID Question Discussion Answer Year
20010094

Reportability/Ambiguous Terminology--Breast: Should the American College of Radiology (ACR) BI-RADS assessment categories 4 [Suspicious Abnormality--biopsy should be considered] and 5 [Highly Suggestive of malignancy-appropriate action should be taken], impressions for mammograms and sonograms, be used as the sole basis for reportability? See discussion.

ACR website:

Category 4: Lesions that do not have the characteristic morphologies of breast cancer but have a definite probability of being malignant.

Category 5: lesions have a high probability of being cancer.

Updated Answer

Please refer to Appendix E of the SEER Program Coding Manual for the most up-to-date information, https://seer.cancer.gov/manuals/2018/SPCSM_2018_AppendixE.pdf

 2001
20010050 Chemotherapy--Hematopoietic, NOS: What treatment code is used to represent the drug "Gleevec" being used to treat chronic myelogenous leukemia? For cases diagnosed 1/1/2003 and after: Code the Chemotherapy field to 02 [Single-agent chemotherapy administered as first course therapy]. It should be classified as a chemotherapy agent, albeit a unique one. Gleevec seems to work the same way many other chemo drugs do. It disrupts cell division for malignant cells containing the BCR-ABL protein only, rather than for normal and abnormal cells together. When the cells can't divide and create a new generation, they simply die. This meets the definition of an antineoplastic chemotherapy agent. 2001
20010029 Grade, Differentiation--All Sites: Can "Fuhrman nuclear grade" be coded if it is the only grade given for a kidney primary, or is breast the only site for which we can use a nuclear grade in coding the Grade, Differentiation field? See discussion.

Our pathologist consultant disagrees with coding nuclear grade for any site because it is only a component of the grade, in most cases, and is not adequate to use by itself.

If the Fuhrman nuclear grade system can be used by coders, will a conversion table for the system be added to the coding documentation by SEER in the future?

 For cases diagnosed 2004 and later: Fuhrman grade can be used to code the Grade, Differentiation field. 2001
20010027 Histology (Pre-2007)--Prostate: What code is used to represent the histology "adenocarcinoma, cribriform type"?

For tumors diagnosed prior to 2007:

Code the Histology field to 8201/3 [cribriform carcinoma]. The word "type" is a term that indicates majority of the tumor. The term "cribriform" would be a term used to determine the histology code.

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.

 2001
20010145 EOD-Extension: There is a one to many relationship between T values in TNM staging and SEER EOD-Extension values (one T value can be coded to many extension values). For most situations, we can typically code EOD-Extension to the lowest value in the range available for that T value per the SEER guidelines. But, what happens if another tumor feature, such as tumor size, was involved in the assignment of a T value? See discussion. Example: Physician stages lung tumor as T2. The lowest extension code, 20, doesn't precisely fit the guidelines for a T2 tumor because the T2 stage may be based on the size of the tumor, which doesn't have anything to do with the EOD-Extension field. Should EOD-Extension be coded to 30 rather than 20?

The criteria for AJCC stage T2 consists of both size and tumor extension values. Size of tumor is recorded in the EOD-Size of Primary Tumor field. If you determine that size is the physician's sole criteria for assigning a T2 value, code an EOD-Extension value that reflects more specific information than 30 [localized, NOS]. Code to 10 or 25, depending on the case.

If the tumor size is not provided, and there is only a clinician statement that describes the lung tumor as a stage T2, code EOD-Extension to 20, the numerically lowest equivalent EOD-Extension code for the lung T2 category.

 2001
20010099 EOD-Extension--Pancreas: How do you code extension when CT scan shows a mass in the head of the pancreas "encompassing" the hepatic branch of the celiac artery? See discussion. We do not code the term "encompasses" as involvement. However, should we code this case as extension to the peripancreatic tissue, NOS or as unknown?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 40 [Extension to peripancreatic tissue, NOS]. There has to be extension to peripancreatic tissue if the mass encompasses the celiac artery.

 2001
20010103 Histology (Pre-2007)--Breast: Are diagnoses of "infiltrating duct and mucinous carcinoma" and "duct carcinoma, mucinous type" both coded to the histology code of 8523/3?

For tumors diagnosed prior to 2007:

Code "Infiltrating duct and mucinous carcinoma" to 8523/3 [Infiltrating duct mixed with other types of carcinoma] according to the instructions for coding a single tumor with complex histology in Appendix C of the 2004 SEER manual. Assign code 8523/3 when the diagnosis is duct carcinoma mixed with another type of carcinoma. Look for "and" or "mixed" in the diagnosis.

Code the Histology field for a "ductal carcinoma, mucinous type" to 8480/3 [Mucinous carcinoma].

The instructions for coding a single tumor with complex histology are to code the specific type if the diagnosis is "Duct carcinoma, _____ type."

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.

 2001
20010019

Reportability--Hematopoietic, NOS: Is the term "plasma cell dyscrasia" a synonym for multiple myeloma?

For cases diagnosed prior to 1/1/2010:

Plasma cell dyscrasia, NOS, is nonreportable. It is not a synonym for multiple myeloma. Plasma cell dyscrasia represents a broad spectrum of disease characterized by plasma cell proliferation that appears inappropriate or uncontrolled. Multiple myeloma is one disease type that falls into that classification. However, there are several other malignant and benign diseases also classified as such because of their immunoglobulin abnormalities. Reportability to SEER regarding a disease classified as a plasma cell dyscrasia is dependent on identifying the specific cell type associated with the disease in the 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.

2001
20010164 EOD-Size of Primary Tumor--Prostate: If you only have a biopsy and not a resection of the primary site, can you code the size of the prostate nodule demonstrated on digital rectal exam? See discussion.

Example 1: Digital rectal exam reveals 1 cm left side prostate nodule. TRUS-guided biopsy of left side of prostate shows adenocarcinoma. Right side biopsy is negative. Is size coded to 010 or 999?

Example 2: Digital rectal exam reveals 1 cm left side prostate nodule. Bone scan was positive for metastatic disease. Is size coded to 010 or 999?

For cases diagnosed 1998-2003:

You need path confirmation that a malignancy exists in the prostate before you can code the size of the nodule seen clinically.

Example 1: Code the EOD-Size of Primary Tumor to 010 [1 cm], because the nodule in the prostate is confirmed as cancer by needle biopsy.

Example 2: Code the EOD-Size of Primary Tumor to 999 because there was no pathologic confirmation of malignancy.

 2001
20010161 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Prostate: Radical prostatectomy reveals two distinct tumors. One is "adenocarcinoma with ductal differentiation" and the other is "adenocarcinoma with acinar differentiation." What code is used to represent the histology and how many primaries does the patient have?

For tumors diagnosed 2001-2006:

This is one primary. Code the Histology field to 8255/3 [adenocarcinoma with mixed subtypes] based on rule A of the Coding Complex Morphologic Diagnoses. This is code was added in the ICD-O-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.

 2001