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Report Produced: 12/24/2024 13:03 PM

Report Question ID Question Discussion Answer Year
20000513 Multiple Primaries/Histology (Pre-2007)--Bladder: What code is used to represent the histology and how many primaries should be coded for a TURB specimen that demonstrates carcinoma in situ, Grade I to II papillary transitional cell carcinoma, and high grade transitional cell carcinoma? See discussion.

Pathology report:

A. Biopsy, bladder neck, @ 6:00: Carcinoma in situ

B. Biopsy, Bladder wall, lateral, left:

1. Papillary carcinoma (Grade I-II)

2. Loose fragments of high-grade transitional carcinoma

C. Biopsy, Bladder neck @ 5:00: Carcinoma in situ

D. Biopsy, Bladder neck @ 7:00: Cystitis Glandularis

E. Biospsy, Bladder wall, posterior: Papillary carcinoma (Grade I)

For tumors diagnosed prior to 2007:

Code this case as one primary and code the Histology and Grade, Differentiation fields to 8130/34 [papillary transitional cell carcinoma, high grade].

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.

 2000
20000851 Primary Site: What site code is used to classify a femur biopsy with pathologic diagnosis of "Ewing sarcoma/primitive neuroectodermal tumor (PNET)"? See discussion. ICD-O-3 lists PNET as being site specific to C71._. The pathology report states "some authors consider both Ewing sarcoma and PNET to be the same histologic entity given that they share the same translocation between chromosomes 11 and 23." Code the Primary Site field to C40.2 [femur] based on Rule H in the ICD-O-3 that states, "Use the topography code provided when a topographic site is not listed in the diagnosis. This topography code should be disregarded if the tumor is known to arise at another site." 2000
20000845 Primary Site: What code should be used to represent the site for an "extraovarian" papillary serous adenocarcinoma located in the "rectal muscle sheath"? See discussion. The location of the tumor in the rectus muscle sheath is unusual and suggests an origin within a preexisting mullerian. Code the Primary Site field to C49.4 [connective, subcutaneous and other soft tissues of the abdomen]. 2000
20000242 EOD-Size of Primary Tumor--Prostate: Should the size of tumor be recorded as 001 (focus) or the actual size when both are stated? See Discussion. The pathology report from a TURP identifies a 3-mm focus of adenocarcinoma. For cases diagnosed 1998-2003, code the EOD-Size of Primary Tumor field to 003 [3 mm]. The rule that says to code a focus or foci of tumor as 001 was developed for use when no tumor size is given. 2000
20000542 EOD-Lymph Nodes/TNM--Breast: Do we code these lymph nodes fields for a breast primary that describes ipsilateral axillary lymph node involvement as "extending through the lymph node capsule and into perinodal soft tissue/fat" as "fixed/matted"?

For cases diagnosed 1998-2003:

Code the EOD-Lymph Nodes field to 6 [Axillary regional lymph nodes, NOS], if the size of the metastasis within the lymph node is not known. "Extension into perinodal soft tissue" does not imply that the lymph nodes are fixed to one another or to other structures. AJCC stage for lymph nodes is coded to N1 [Metastasis to moveable ipsilateral axillary lymph nodes].

In order to code the EOD-Lymph Nodes field to 5 [Fixed/matted ipsilateral axillary nodes] which is the equivalent to AJCC equivalent N2, there must be some clinical or pathologic statement of fixation or matting. There can be extension through the capsule without fixation or matting. "Fixation" is a clinical term and "matting" can be either clinical or pathologic. A pathologist can recognize two or more lymph nodes stuck together by tumor.

 2000