| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20091048 | Surgery of Primary Site--Lymphoma/Soft Tissue: How is this field coded for an excision of a neck mass that found lymphoma in soft tissue (C49.0)? See Discussion. | CT scan showed soft tissue mass in the retropharynx. 9/23/2008 Laryngoscopy with biopsy taken of left tonsil and left base of tongue and random biopsies of nasopharynx; FNA of left neck. Path stated left tonsil, squamous papilloma. Left base of tongue, no significant histopathology. Nasopharynx biopsies, compatible with tonsillar tissue. Pretracheal lymph node biopsies, mild reactive lymphoid hyperplasia. 9/30/2008 Excision of left neck mass with limited deep jugular chain lymph node dissection. Path stated lymph node left jugular biopsy, no tumor seen. Soft tissue, left neck biopsy, malignant B cell lymphoma with plasmacytoid differentiation. Addendum from consult: favor a diagnosis of a marginal zone lymphoma. Per the gross description, the specimen was fibrofatty connective tissue in which there is a tumor infiltrate. | Updated May 2026 For cases diagnosed prior to 2023: Assign code 26 [partial resection]. Use the surgery codes that apply to the primary site, C490-C499. For cases diagnosed 2023+, see code A260. |
Head & Neck, Lymphoma | Surgery of Primary Site | 2009 |
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20000485 | EOD-Extension--Lung: Should the phrase "some pleural fluid in both posterior gutters" be interpreted as pleural effusion for lung primaries? See discussion. | CT scan: "3 cm mass left upper lobe of lung. Some pleural fluid in both posterior gutters. Large matted hilar lymph nodes, left. Some narrowing left upper bronchus by this adenopathy. Squamous cell ca lung with mets to left hilar lymph nodes, most likely possibility." Would you code extension to 72 [malignant pleural effusion; pleural effusion, NOS]? | For cases diagnosed 1998-2003:
Yes. Code the EOD-Extension field to 72 [malignant pleural effusion, pleural effusion, NOS]. Pleural effusion is mentioned as being present. |
Lung | N/A | 2000 |
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20021090 | Primary Site--Ovary/Peritoneum: How should the Primary Site field be coded when no resection is done and it is uncertain whether the primary site is in the ovary or the peritoneum? See discussion. | CT: ascites, omental cake and peritoneal studding. H&P impression: probable ovarian or peritoneal primary. Repeat CT: no enlarged adnexal mass seen to suggest ca of ovary, but possibility couldn't be ruled out. Omental bx: Metastatic ca. Comment: "IHC stains have been performed and are not typical of ovarian ca, although do not exclude an ovarian primary." After the bx, there were two clinical diagnoses written a month apart with no evidence of further work-up between those dates. The first diagnosis was "ovarian ca". The second was "Peritoneal carcinomatosis 2 month ago; Primary is unknown, possibly ovarian." | Use the best information available to identify the primary site. In this case, it is the physician's clinical assessment. Code the Primary Site to C56.9 [Ovary] for this example because the ovary is indicated to be the primary site according to the physicians involved.
When there is no surgical procedure involving the removal of the ovaries, code the Primary Site based on the clinical assessment of the disease location. If the disease is only noted to be in the peritoneum, code site to peritoneum, NOS. If the disease is seen clinically in both the ovary and the peritoneum, code site to ovary. |
Ovary | Primary site | 2002 |
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20071020 | Histology--CLL/SLL: What is the correct histology code for a lymph node described in the pathology report comment section as "phenotypically consistent with chronic lymphocytic leukemia"? See Discussion. | Current rules instruct us to select the lymphoma code for lymph node and/or tissue with the dual diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma. We have a cervical lymph node biopsy with that dual diagnosis, however, the pathology comment states that after immunohistochemistry testing, the lymph node is "phenotypically consistent with chronic lymphocytic leukemia." No bone marrow or blood work-up is performed. | For cases diagnosed prior to 1/1/2010:Code Small Lymphocytic Lymphoma. The current rules have not changed. Code to lymphoma because the diagnosis was made on a lymph node. "Phenotypically consistent" means the lymph node contains CLL/SLL, not some other hematopoietic or metastatic disease. For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
CLL/SLL | Histology | 2007 |
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20071007 | MP/H Rules/Histology: In the absence of a tissue diagnosis, should the histology field be coded based on the findings of a suspicious cytology or a CT scan that clinically confirmed the diagnosis? See Discussion. | Cytology (brushings at ERCP) which are highly suspicious of adenocarcinoma. A CT of the abdomen performed the next day shows a mass, most likely Klatskin tumor. Can the histology be coded to Klatskin tumor [8162/3] based on the CT findings? | For cases diagnosed 2007 or later, code the histology to 8162/3 [Klatskin tumor] using the histology from the CT. This case is confirmed clinically based on the CT. It cannot be accessioned based on suspicious cytology.
Rule H8 in the 2007 Histology Coding Rules for Other Sites provides instructions for coding histology when the pathology report and cytology report are not available. |
N/A | Histology | 2007 |
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20091079 | Primary site--Bladder: What is the correct subsite for "interureteric ridge"? See Discussion. | Description: 4 mm nodule at base of bladder near interureteric ridge. | For this case, assign code C670 [Trigone of bladder]. The description for this case states that the tumor location is the base of the bladder. Base is a synonym for trigone. The interureteric ridge (or interureteric crest, or interureteric fold) is a fold of mucous membrane extending accross the bladder between the two ureteric orifices. The trigone is located below the interureteric ridge. |
Bladder | Primary site | 2009 |
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20081083 | Multiple primaries--Lymphoma: Is mediastinal large B-cell lymphoma followed by classical Hodgkin lymphoma reportable as one or two primaries? See Discussion. | Diagnosed 06/06/2006 with mediastinal large B-cell lymphoma, 9679/36. On 05/10/2007, another mediastinal lymph node biopsy done and the diagnosis was recurrent malignant lymphoma, classical Hodgkin's. A Hematopatholgy Consultant states, "it appears likely that the preceding mediastinal diffuse large B-cell lymphoma and the current classical Hodgkin's lymphoma are clonally related and represent different manifestations of the same entity. One might also place this in the spectrum of 'mediastinal gray zone lymphoma' described by Dr. Jaffee and colleagues." | For cases diagnosed prior to 1/1/2010:Report this case as two primaries. Report non-Hodgkin lymphoma followed by Hodgkin lymphoma as separate primaries. According to the Table of Single and Subsequent Primaries for Hematologic Malignancies, mediastinal large B-cell lymphoma and Hodgkin disease are "D" - Different disease processes. For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
Lymphoma | N/A | 2008 |
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20081004 | First course treatment/Histology--Lymphoma: What treatment, if any, is coded for a patient with methotrexate induced lymphoma when the treatment plan is to take the patient off methotrexate? Also, is there a specific histology for drug induced lymphoma? See Discussion. | Diffuse Large B-cell Lymphoma of soft palate & nasal septum, methotrexate induced, in 5/07. Patient was taken off methotrexate with complete resolution of disease. No other treatment was given. Patient was on methotrexate for treatment of rheumatoid arthritis. | For cases diagnosed prior to 1/1/2010:Treatment: Code the treatment fields to 00 [not done] in this case. Document the discontinuation of methotrexate for rheumatoid arthritis in a text field. Histology: Assign code 9680/36 [Malignant lymphoma, large B-cell, diffuse, NOS]. There is no specific histology code for therapy-related lymphoma. For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
Lymphoma | First course treatment | 2008 |
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20010132 | Histology (Pre-2007)--Kidney: What code is used to represent the histology "renal cell carcinoma with granular cell morphology"? Kidney primary with diagnosis of renal cell CA with granular cell morphology. Do we code as granular cell carcinoma? Is the term "morphology" synonymous with "type"? See discussion. | Do we code this type of tumor as a granular cell carcinoma [8580/3]? | For tumors diagnosed prior to 2007:
Code the Histology field to 8320/3 [granular cell carcinoma]. Renal cell carcinoma is a non-specific term that has several specific cellular subtypes, one of which is granular cell [8320/3].
Note: Do not code to granular cell tumor [9580/3], which is not a histology related to renal cell carcinoma.
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. |
Kidney, renal pelvis | Histology | 2001 |
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20010129 | Histology (Pre-2007)--Breast: What code is used to represent the histology "duct carcinoma, colloid type"? See discussion. | Do we use 8480/3 [colloid carcinoma] or 8523/3 [duct carcinoma] mixed with other types of carcinomas? | For tumors diagnosed prior to 2007:
Code the Histology field to 8480/3 [colloid carcinoma] per Rule 4. The lesion is colloid type of ductal carcinoma, not ductal carcinoma mixed with colloid carcinoma.
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. |
Breast | Histology | 2001 |
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