Report | Question ID | Question | Discussion | Answer | Year |
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20140047 | MP/H/Multiple primaries--Urinary: In Aug 2008 Patient was diagnosed with Noninvasive Bladder Cancer. In Oct 2013 Patient was diagnosed with Transitional Cell Carcinoma of Right Ureter involving lamina propria, Noninvasive Transitional Cell Carcinoma Left Ureter and Invasive Transitional Cell Carcinoma of Prostatic Urethra. Is this a new primary and what is the primary site? |
Rule M7 applies when comparing the 2008 diagnosis to the 2013 diagnosis: multiple primaries.
Rule M8 applies to the tumors identified in 2013: single primary.
Based on the information provided, code the primary site for 2013 to C689 because there is no indication of the site of origin among the involved sites. |
2014 | |
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20140048 | MP/H Rules/Histology--Sarcoma: Is 8811/3 the correct code for myxofibrosarcoma (myxoid malignant fibrous histiocytoma) high-grade (grade 3/3)? |
8811/3 is the correct code for myxofibrosarcoma. See Rule J on page 33 in ICD-O-3. Fibromyxosarcoma is equivalent to myxofibrosarcoma. |
2014 | |
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20140039 | Reportability--Heme & Lymphoid Neoplasms: Is a statement of "JAK-2 positive polycythemia" reportable? See discussion. |
Polycythemia, NOS is not reportable. However, there is a statement in the Heme Manual Glossary for JAK2 that states, "When JAK2 is positive, the MPN is definitely reportable." Does a positive JAK 2 always mean there is a reportable myeloproliferative disorder or must there also be an associated statement of a reportable neoplasm (e.g., myeloproliferative disorder, polycythemia vera, or essential thrombocythemia)? |
A positive JAK 2 does not always mean there is a reportable myeloproliferative disorder. There must also be an associated statement of a reportable neoplasm (e.g., myeloproliferative disorder, polycythemia vera, or essential thrombocythemia). The glossary entry will be clarified. |
2014 |
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20140067 | MP/H/Histology--Kidney, renal pelvis: What is the histology code for renal cell carcinoma translocation type? |
Code renal cell carcinoma translocation type as renal cell carcinoma, NOS, 8312. While WHO recognizes renal cell carcinomas with associated translocations, there is no specific ICD-O-3 code for this variant of renal cell carcinoma. |
2014 | |
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20140055 | Reportability--Heme & Lymphoid Neoplasms: Is this a reportable case and if so what codes would be used for the primary site and histology?
Lymph node flow cytometry and bone marrow biopsy revealed involvement by a low-grade B-cell lymphoproliferative disorder. Medical oncologist states monoclonal gammopathy, question marginal zone B cell lymphoma versus lymphoplasmacytic lymphoma/lymphoproliferative disorder. |
Based on the information provided, this case is not reportable. Low grade B-cell lymphoproliferative disorder is not reportable, nor is monoclonal gammopathy. There is no definitive diagnosis for marginal zone or lymphoplasmacytic lymphoma. The terminology used includes "question" and "versus" which are not acceptable ambiguous terms for reportability. If possible, follow up with the physician regarding the definitive diagnosis. |
2014 | |
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20140089 | Multiple primaries--Heme & Lymphoid Neoplasms: Should the 2014 diagnosis be abstracted as a new primary since it is not mantle cell lymphoma and all of the types listed in the differential diagnosis would be a new primary? See discussion. |
Mantle cell lymphoma diagnosed in 1997 which was treated with chemotherapy. Now in 2014 a 'relapse' of non-Hodgkin lymphoma. They do a biopsy of the pericardium, which is called low grade B cell non Hodgkin lymphoma. See comment. The comment says histochemical stains are reviewed and findings are consistent with involvement by a CD5 positive low grade B cell lymphoma. Lack of cyclin D1 and SOX-11 positivity as well as negative IGH-CCND1 FISH analysis essentially rule out mantle cell lymphoma. The morphologic and immunophenotypic features of this disorder are not specific for any lymphoma subtype. The differential includes CLL, marginal zone lymphoma, and lymphoplasmacytic lymphoma. If this is coded NHL, NOS (9591) it is the same primary as seq. 1 and would not be abstracted. |
This is the same primary, the mantle cell lymphoma.
Differential diagnoses cannot be used to assign histology. For the 2014 diagnosis, the only histology that can be assigned is 9591/3 for non-Hodgkin lymphoma, NOS. (CLL, mantle cell lymphoma and lymphoplasmacytic lymphoma are all NHL's.)
Compare the 1997 diganosis of mantle cell lymphoma with the 2014 diagnosis of non-Hodgkin lymphoma. Start with Rule M1. The first rule that applies is Rule M15, which instructs you to use the multiple primaries calculator. Enter 9673/3 and then 9591/3 and then calculate. The result is same primary.
If at a later time one of the differential diagnoses is confirmed, apply the rules again.
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2014 |
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20140021 | Reportability--Breast: Is an inflammatory myofibroblastic tumor of the breast with metastasis to the lung reportable? | Inflammatory myofibroblastic tumor of the breast with metastasis to the lung is reportable. Metastasis to the lung from the breast tumor indicates that the breast tumor is malignant. All malignant neoplasms are reportable. | 2014 | |
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20140088 | Reportability--GIST: The 2014 SEER Program Coding and Staging Manual and the answer to SINQ 20100014 appear to conflict with respect to reporting GIST cases. The manual states (p.5, exception 1) that we are to accession the case if the patient is treated for cancer. However, the patient in Example #7 in the SINQ discussion is receiving chemotherapy, but is deemed not reportable. This is a problematic issue in our area, as pathologists prefer using the NCCN “Risk Stratification of Primary GIST by Mitotic Index, Size and Site” table rather than stating whether the tumor is benign or malignant. Although they tell us that moderate or high risk should receive treatment, they will not characterize them as malignant. |
Determining reportability for GIST is problematic because of the reluctance of pathologists to use the term "malignant" for GIST cases. If you can document the pathologist's terminology and case characteristics (e.g. treatment) that correspond to "malignant" for your registry as part of the registry's policies and procedures, you can report those cases as malignant.
The exception cited above in the SEER manual pertains to a clinical diagnosis with a negative pathology report. Normally, the negative pathology report would override the clinical diagnosis and the case would not be reportable. However, if the patient is treated for a malignancy in spite of the negative pathology, report the case.
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2014 | |
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20140022 | MP/H Rules/Kidney, renal pelvis--How many primaries are there for this case? Should we stop at rule M8 making this all one primary (C689) even though there were right and left renal pelvis tumors? Rule M3, which contains laterality, does not apply because there is also a bladder tumor. See discussion. |
Kidney: originally diagnosed 12/21/2011 with right renal pelvis high grade papillary urothelial cancer. Status post right nephrectomy. Then on 01/10/2013 diagnosed with low grade papillary urothelial cancer of the bladder. 01/21/2013 diagnosed with left renal pelvis urothelial carcinoma iIn situ. Path report stated this may represent a hgh grade papillary urothelial cancer – unable to confirm due to specimen size. On 01/24/2013 left periaortic lymph node biopsy revealed poorly differentiated carcinoma consistent with prior diagnosed right renal pelvis high grade urothelial cancer. Neither the bladder nor the left renal pelvis tumor was compared to the previous right renal pelvis tumor. Also has bone mets. |
Abstract this case as a single primary.
First, apply the MP/H rules to compare the 2013 bladder tumor to the 2011 renal pelvis tumor. Rule M8 applies, this is a single primary. Next, apply the MP/H rules to compare the 2013 in situ renal pelvis tumor to the 2011 renal pelvis tumor. Rule M8 applies, this is a single primary. As you correctly pointed out, Rule M3 for bilateral renal pelvis tumors, does not apply because there is also a bladder tumor in this case. |
2014 |
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20140086 | MP/H Rules/Multiple primaries--Colon: Does rule M7 apply here (A frank malignant or in situ adenocarcinoma and an in situ or malignant tumor in a polyp are a single primary)? Can the frank malignant adenocarcinoma be any specific type of adenocarcinoma for this rule to apply?
A patient has 2 synchronous tumors in the ascending colon. The first is grade 3 adenocarcinoma with signet ring differentiation and focal mucinous features (8255/3). The second is grade 2-3 adenocarcinoma in a tubulovillous adenoma (8263/3). |
M7 applies to this case. The frank adenocarcinoma can be a specific type of adenocarcinoma. |
2014 |