Primary Site/Histology (Pre-2007)--Rectum: How are rectal biopsies with the histology of "poorly differentiated carcinoma with mixed basaloid and squamous features" coded if, per the SEER site/histology validation table, the histology 8094/3 [basosquamous carcinoma] histology cannot be coded to the rectum for the primary site?
For tumors diagnosed prior to 2007:
Code primary site C209 [rectum] and histology 8094/3 [basosquamous carcinoma]. As of 6/9/2003, this is no longer an impossible site/histology combination.
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.
MP/H Rules/Histology--Colon: What histology would be coded when the right colon demonstrates a combined adenocarcinoma and high grade small cell neuroendocrine carcinoma [forming the dominant component] arising in a villotubular adenoma and the liver biopsy demonstrates metastatic high grade small cell neuroendocrine carcinoma?
For cases diagnosed 2007 or later, start with rule H1 in the Single Tumor module. Stop at rule H4. Assign code 8263 [adenocarcinoma in tubulovillous adenoma].
Stop at the first rule that applies. Code histology based on a specimen from the primary site whenever available.
MP/H Rules/Histology--Bladder: Can the histology for a high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" be coded to sarcomatoid transitional cell carcinoma (8122/3)?
Example; TURBT, Final Diagnosis - Urothelial carcinoma, high grade. Type/grade comment: Extensive sarcomatoid dedifferentiation is present (40-50% of tumor volume).
Code high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" to sarcomatoid transitional cell carcinoma (8122/3).
MP/H/Histology--Breast: What MP/H Rule, histology, and behavior code for a breast primary apply to the following?
2 foci DCIS, solid, high grade (Grade 3) w/microca++
Apply the Multiple Primaries/Histology, Breast Rule H3: DCIS and a more specific in situ are coded to the more specific histology term which in this case is solid. Code the histology to ductal carcinoma in situ, solid type (8230/2). Based on the information provided, there is no invasive component. The term "microca ++" means micro-calcifications are present, not micro carcinoma.
Histology (Pre-2007): Is histology for an anorectal biopsy of "Cloacogenic carcinoma (squamous cell carcinoma with basaloid features)" coded to 8124/3 [Cloacogenic carcinoma] or 8083/3 [Basaloid squamous cell carcinoma]?
For tumors diagnosed prior to 2007:
Code histology to 8124/3 [Cloacogenic carcinoma]. These are squamous cell carcinomas of basaloid type that are found in the cloacogenic (transitional) zone of the anal canal.
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.
Reportability--Skin: Is atypical intradermal smooth muscle neoplasm (AISMN) of the skin reportable? The comment on the path report states: Atypical intradermal smooth muscle neoplasm (AISMN) was previously termed "cutaneous leiomyosarcoma."
Atypical intradermal smooth muscle neoplasm (AISMN), previously termed "cutaneous leiomyosarcoma," is not reportable. It is classified as a borderline, /1, neoplasm.
Reportability--Eye: Is conjunctival intraepithelial neoplasia (CIN III) from an excision of the left eye conjunctiva reportable?
Conjuctival intraepithelial neoplasia grade III (CIN III) is reportable. Intraepithelial neoplasia, grade III, is listed in ICD-O-3 as /2. It is reportable for sites other than skin.
Histology (Pre-2007)--Bladder: How is a "carcinoma with squamous, mucinous, and signet ring cell features" coded?
For tumors diagnosed prior to 2007:
Code histology to 8490 [Signet ring cell carcinoma]. Rule 7 on page 87 of the 2004 SEER Manual applies to this case.
Rule 7: Code the numerically higher ICD-O-3 code. This is the rule with the lowest priority and should be used infrequently.
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.
Marital Status: Is marital status coded to 2 [married] if the patient is legally married to a same-sex spouse (e.g., patient has a Canadian spouse and in Canada, same-sex marriages are legal)?
Code marital status for same-sex persons based on the legal status. For the case example above, assign code 2 [married].
Multiple primaries/Histology--Heme & Lymphoid Neoplasms: How many primaries should be reported for a bone marrow biopsy diagnosis of "lymphoproliferative disorder, small cell lymphocytic lymphoma/small cell lymphocytic leukemia consistent with marginal zone lymphoma"?
According to our hematopoietic/lymphoid neoplasm physician expert, abstract one primary with the histology code 9699/3 [marginal zone lymphoma]. The pathologist is using the expression "small lymphocytic lymphoma" in a descriptive manner (marginal zone lymphoma is comprised of small lymphocytes) rather than in a "diagnostic" manner.
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