SEER Inquiry System - Search

2023

Bosniak 4 is defined as  "clearly malignant cystic mass." The case is reportable as of the first date it is diagnosed as a Bosniak 4 lesion unless further workup (especially biopsy or resection) disproves the CT findings.

https://radiopaedia.org/articles/bosniak-classification-system-of-renal-cystic-masses?lang=us

Abstract one primary per Rule M7. Follow the Lung Solid Tumor Rules to determine the number of primaries. The AJCC TNM manual is used for staging. Do not apply AJCC instructions to determine the number of primaries.

Segments 2, 3, and 4 correspond to the left lobe of the liver. Segments 5, 6, 7 and 8 correspond to the right lobe of the liver. Segment 1 is the caudate lobe, which has completely different drainage and vascularization, is separate from the larger right and left lobes.

For cases diagnosed 1998-2003: Since segments 5 and 7 are both in the right lobe, assign EOD-extension code 30 for the case above, unless there is mention of vascular invasion. Be sure to record the size of the largest primary tumor.

Tumor size and vascular invasion are the most important factors for AJCC 6th edition staging.

For tumors diagnosed 1998-2003:

Based on the information provided:

The topography code for this lymphoma is C772 [Intra-abdominal lymph nodes].

Code SEER Summary Stage 2000 to 5 [Regional NOS].

Code EOD Extension to 20. More than one lymph node region below the diaphragm is involved (retroperitoneal and peritoneal). The organs mentioned are not involved by the lymphoma. The bulk of the masses is causing obstruction by displacing and/or encasing organs.

A physician description of "bulky disease" would not change the EOD for this case.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the histology to 9695/3 [follicular lymphoma, grade 1] per PH29.

Under the Alternate Names section of the Heme DB, B-cell non-Hodgkin lymphoma is synonym for non-Hodgkin lymphoma, NOS and B-cell lymphoma, NOS.

Per PH29, one codes the histology when there is one non-specific histology (NHL, NOS) and one specific histology (FL, grade 1). You are also required to confirm the specific and the non-specific (NOS) histology represent the same primary using the Multiple Primaries Calculator. The calculator indicates these are the same primary.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the oncologist's clinical diagnosis of peripheral T-cell lymphoma.

The definition for this neoplasm is "A large group of lymphomas which we collectively refer to as peripheral T-cell lymphomas with the optional addition of "unspecified" to emphasize that these cases do not belong to any better defined entities. Attempts to distinguish between them on morphological basis have met with poor reproducibility."

Per the Abstractor Notes in the Heme DB: Patients present with peripheral LN involvement. The diagnosis of PTCL, NOS is made ONLY when other specific entities have been explored.

This fits your case; attempts to find a more specific disease (flow cytometry; BM biopsy) were negative and gave no further information that could be used to assign a more specific classification.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

Contact the physician for clarification of the term "pancreatobiliary." If no further information can be obtained for this case, assign code C249 [Biliary tract, NOS] based on the CT findings for the specific case in this question.

When the primary is described as "pancreatobiliary" with NO FURTHER INFORMATION, assign C269.

Assign histology code 8246/3 and assign code 9 for grade.

Since the primary is unknown and the type of NEC is not definitively stated, code neuroendocrine carcinoma, NOS based on the diagnosis.

Code grade from primary tumor only. Assign grade code 9 when the primary site is unknown. See instruction 2.b. in the Grade Coding Instructions for 2014+.

SINQ 20170033 and SINQ 20160023 provide instructions for coding the grade/differentiation field. Using these SINQ questions to code histology could lead to errors.

For tumors diagnosed prior to 2007:

For example 1, code histology to 8582 [Thymoma, type AB]. This code is only applicable to "Type AB thymoma [mixed]" in the WHO classification. Use 8582 only for thymomas with type A and type B features. Spindle cell is a type A feature and epithelial is a type B3 feature.

For example 2, code histology to 8585 [Thymoma, type B3]. Lymphocytic is a B1 feature (8583) and epithelial is a B3 feature (8585). There is no type A component. Code the histology based on ICD-O-3 rule K on page 34.

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.

Assign code 40, Pull through WITH sphincter preservation (colo-anal anastomosis).  The National Cancer Institute Dictionary of Cancer Terms defines coloanal anastomosis as a surgical procedure in which the colon is attached to the anus after the rectum has been removed. It is also called coloanal pull-through.