Report | Question ID | Question | Discussion | Answer | Year |
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20071071 | MP/H Rules/Multiple Primaries--Lung: If the biopsy for a lung primary is actually taken from a pleural mass, can the default rule "when there are several lung masses and only one lesion is biopsied, consider this a single primary" apply? See Discussion. |
Scenario: A parenchymal lesion in each lung. One lung also has a pleural lesion. MD biopsies the pleural mass only and it is positive for cancer. |
For cases diagnosed 2007 or later: Do not assume the biopsy of the pleural mass is a biopsy of the lung. Apply the 2007 MP/H Lung rules to the lung tumors only. For this case, the pleural lesion would be a metastasis (outside the lung). The 2007 MP/H rules do not apply to metastatic lesions. The 2007 MP/H Lung rules do not apply to pleura as a primary site. If the pleural lesion is primary, it should be abstracted as a separate primary. |
2007 |
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20081005 | Histology/Behavior--Brain and CNS: How are these fields coded for an "anaplastic glioneuronal neoplasm with spongioblastic architecture"? See Discussion. |
Scenario: Addendum from Mayo Clinic review, IHC and consultation made dx of "anaplastic glioneuronal neoplasm with spongioblastic architecture". The original micro states 'high grade glial neoplasm w/o characteristic features of glioblastoma multiforme in that it lacks areas of significant necrosis, no nuclear palisading nor endothelial vascular proliferation...." |
The best code available according to our pathologist consultant is 9505/3 [Ganglioglioma, anaplastic]. According to our consultant, while ganglioglioma is traditionally a benign tumor, anaplastic ganglioglioma is classified as malignant by WHO (page 103), and comes as close to fitting the description of this tumor as any other term. |
2008 |
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20210022 | Solid Tumor Rules (2018/2021)/Multiple primaries--Prostate: Is basal cell carcinoma with focal squamous differentiation and a small focus of infiltrating prostatic adenocarcinoma one or two primaries and if one, is the histology 8147/3? See Discussion. |
Scenario: Patient had a transurethral resection of the prostate on 8-29-19, positive for basal cell carcinoma with focal squamous differentiation involving approximately 50% of tissue (determined not to be mets by consult). On 11-14-19, the patient had a prostatectomy positive for residual basal cell carcinoma and a small focus of infiltrating prostatic adenocarcinoma. According to AJCC, 8th edition, page 724, basal cell carcinoma of the prostate is 8147/3 and we ignored the small focus of adenocarcinoma. The above scenario was reported as two primaries (8090/3 and 8140/3), but we are thinking it is one. |
Abstract a single primary and code as 8147/3 using Rule M18 and Rule H17 of the 2018 Other Sites Solid Tumor Rules. This is based on the findings of basal cell carcinoma of the prostate (8147/3) and adenocarcinoma (8140/3). We consulted with the Subject Matter Expert who advises that basal cell carcinoma and basal cell adenocarcinoma can be used interchangeably. This updates previous consultation regarding this histology. The Other Sites rules will be updated for 2022 and include this information in the prostate histology table. |
2021 |
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20100041 | Reportability--Heme & Lymphoid Neoplasms: Are "anemia of chronic disorders" or "hemolytic anemia" reportable given that a search of the Hematopoietic Database returns many different reportable conditions but no exact terminology match for either diagnosis? See Discussion. |
Searching the Heme Database for the term ANEMIA OF CHRONIC DISORDERS yields 71 results. However, none of the results match the terminology entered, yet all 71 "matched terms" are reportable. Is this diagnosis reportable?
Another example is HEMOLYTIC ANEMIA. The search results showed 28 "matched terms" which are all reportable, but none are exact matches.
Please clarify how we should interpret the results of these searches when using the Heme Database. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Neither diagnosis is reportable. Anemia of chronic disorder or disease is seen when a patient has a chronic immune disorder or a malignancy; the anemia itself is not a malignancy. Hemolytic anemia can be caused by many conditions, but is not malignant.
The problem you are having using the Heme DB is that you are searching for the entire term such as "anemia of chronic disorder." The DB search engine is not the same as those used in Google or other widely used internet search engines. The words lymphoma, leukemia, etc. are so common in the DB that the traditional search is not effective.
In order to make your search easier, search on a unique word. For example, for "anemia of chronic disorder" search on the words (use the quotes) "anemia of" and for the term hemolytic anemia, search on "hemolytic" By using the unique word search you will cut down on the number of terms displayed. If you do get several terms, click on "Name" in the header and all of the results will be alphabetized for quick identification. You may also use the "diseases matching any term" or the "disease match all terms" options to narrow down the results when searching the whole term phrase.
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. |
2010 |
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20230053 | Reportability/Histology--Ovary/Testis: Is serous borderline tumor-micropapillary variant (8460/2) of the ovary or testis reportable? If so, what dates are applicable to the reportability changes? See Discussion. |
Serous borderline tumor–micropapillary variant (8460/2, C569) was included in the ICD-O-3 Behavior Code/term updates effective 1/1/2018 but marked as Not Reportable for 2018. There have been multiple additional updates to the ICD-O but no further clarification as to the reportability of this histology. ICD-O-3.2 currently lists serous borderline tumor, micropapillary variant (C569) as 8460/2 with no mention of reportability and no information provided in Includes/Excludes. SINQ 20220032 instructs capturing this histology as reportable when diagnosed 1/1/2021 or later and occurring in the testis. The answer indicates this is reportable due to the /2 behavior code in ICD-O-3.2, but it does not specify that it is limited to specific sites. Is serous borderline tumor, micropapillary variant reportable for ovary? If so, what dates apply? Is serous borderline tumor, micropapillary variant of the testis diagnosed after 1/1/2021 reportable? |
Do not report serous borderline tumor–micropapillary variant of the ovary (8460/2, C569) as borderline ovarian tumors are not reportable. This applies to cases 2018 and later. Do report serous borderline tumor–micropapillary variant of the testis as stated in SINQ 20220032. It is reportable for cases diagnosed Jan 1, 2021 and later. |
2023 |
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20000449 | EOD-Extension/EOD-Lymph Nodes--Lung: Is "subcarinal extension" with no mention of lymph nodes coded in the EOD extension field or in the EOD lymph node involvement field? See discussion. | Should "subcarinal extension" with no mention of lymph nodes be assumed to be direct contiguous extension of the primary tumor or does it represent lymph node involvement? If it is direct extension, should we code it as 70 in the extension field? If not, should we code it as 2 in the lymph node involvement field? |
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 70 [mediastinum, direct extension]. |
2000 |
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20240008 | Solid Tumor Rules/Histology--Brain and CNS: Should the term “diffuse” be added to Note 2 in the Non-Malignant Central Nervous System (CNS) Solid Tumor Rules, Table 6: Specific Histologies, NOS, and Subtypes/Variants, for the papillary glioneuronal tumor 9509/1? See Discussion. |
Should Note 2 state, "Beginning with cases diagnosed 1/1/2023 forward, diffuse leptomeningeal glioneuronal tumor is coded 9509/3? See the Malignant CNS rules." Currently the Note only states, "leptomeningeal glioneuronal tumor," but the histology that changed behavior is listed in both Table 6, Column 1 (Non-Malignant CNS) and Table 3 (Malignant CNS) as, "Diffuse leptomeningeal glioneuronal tumor." |
The correct term is diffuse leptomeningeal glioneuronal tumor listed as a synonym in Column 2. We will add the term diffuse in Note 2, Column 1 with the 2025 updates. In the meantime, you can add "diffuse" to your pdf version until the update is published. |
2024 |
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20200085 | Solid Tumor Rules (2018)/Histology--Head and Neck: What is the histology of paraganglioma, NOS arising outside of the adrenal gland (for example, in the bladder) for cases diagnosed 1/1/2021 and later? See Discussion. |
Should histology be coded as paraganglioma, NOS (8680/3) or as extra-adrenal paraganglioma, NOS (8693/3) for a diagnosis of paraganglioma in the bladder? Does the pathologist have to specifically diagnose the tumor as extra-adrenal paraganglioma, NOS to use histology code 8693/3? Or, does any diagnosis of paraganglioma (NOS) arising outside of the adrenal gland, carotid body, middle ear, or aortic body (the specified sites for other types of paragangliomas) qualify as an extra-adrenal paraganglioma, NOS? The ICD-O-3.2 Implementation Guidelines (Tables 6 and 7) provide an associated site of C755 for histology 8680/3 (paraganglioma, NOS), but no associated site code is provided for histology 8693/3 (extra-adrenal paraganglioma, NOS). If the preferred site for paraganglioma, NOS is the paraganglia, would a paraganglioma in the bladder be an extra-adrenal paraganglioma? This question was prompted from preparing SEER*Educate coding exercises. We will use the answer as a reference in the rationales. |
Code the histology stated by the pathologist: paraganglioma, NOS 8680/3. |
2020 |
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20150015 | Primary Site--Testis: What is the prmary site for a 38 y/o male diagnosed with testicular cancer in a formerly undescended testis that was treated with orchiopexy at age 10-11? See discussion. |
Should it be coded to where the testis was physically at the time of diagnosis (C621), or should it be coded to C620 to reflect the increased risk for developing malignancy in an undescended testis? |
Code the primary site C621 (descended testis). The primary site of this neoplasm is a scrotal (descended) testis. The history of orchiopexy can be noted in a text field, but does not change the primary site in this case. |
2015 |
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20110043 | MP/H Rules/Histology--Breast: Which specimen should be used to code histology when a core biopsy revealed an unknown sized DCIS, comedo type and the partial mastectomy specimen showed only a 2mm focus of DCIS, solid pattern? See Discussion. | Should the histology be coded from the needle core biopsy or the partial mastectomy specimen? Patient had a needle core biopsy that revealed DCIS, comedo type, cribriform pattern, no tumor size given. Subsequently, the patient had a partial mastectomy which revealed DCIS, noncomedo type, solid pattern, largest focus of DCIS was 0.2cm.
Should the histology code be 8501/2 or 8230/2? The microscopic description on the partial mastectomy says that the previous core needle biopsy site revealed several foci of DCIS. |
Code the histology from the most representative specimen (the specimen with the MOST tumor tissue). Compare the size of tumor in the two specimens. If the tumor size is not available for both procedural specimens, code histology from the mastectomy specimen rather than the needle biopsy specimen. | 2011 |