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Report Produced: 11/06/2026 21:01 PM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20071130 Reportability--Brain and CNS: Are schwannomas of the spinal cord reportable when they are intradural? See Discussion. The CNS guidelines basically indicate that schwannomas must all come from peripheral nerves and thus are not reportable when they are on the spinal cord. However, the COC Inquiry 18174 & 18068 states that schwannomas occasionally will develop inside the dura (intradural) on the spinal cord and would be reportable.

According to an expert consultant, schwannomas must be derived from Schwann cells which are not a part of the CNS. All schwannomas come from peripheral nerves. Benign and borderline tumors of the peripheral nerves (C47_), including peripheral nerves along the spinal cord, are not reportable.

Please see http://www.cdc.gov/cancer/npcr/training/index.htm for more information.

 Brain and CNS N/A 2007
20031084 Histology (Pre-2007)--Colon: What code is used to represent the histology "Adenocarcinoma, intestinal type?" See Description. The code 8144/3 is not valid for colon primaries. Should we code these as 8140/3 [Adenocarcinoma, NOS] or over-ride the error message?

For tumors diagnosed prior to 2007:

Code adenocarcinoma, intestinal type of the colon 8140 [Adenocarcinoma, NOS]. Do not use code 8144 for intestinal type adenocarcinoma in the colon.

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.

 Colon Histology 2003
20031094 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How many primaries are coded and what code(s) is/are used to represent the histology "invasive ductal carcinoma with extensive spindle metaplastic change [metaplastic carcinoma] with a second, separate, tumor "invasive ductal carcinoma, moderately differentiated with extensive associated DCIS"? See Description. The comment on the pathology report states, "due to the associated DCIS this smaller lesion is felt to most likely represent a synchronous second primary." Is this two primaries, one coded 8575/33 and the other coded 8500/32 or is this a single primary with a combination code -- 8523/33?

For tumors diagnosed prior to 2007:

Abstract as two breast primaries. Code to 8575/33 (metaplastic carcinoma) and 8500/32 (infiltrating duct carcinoma). There are two lesions with different histologic types.

Do not use code 8523 to combine separate tumors with different histologies.

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 2003
20031089 Primary Site/Histology (Pre-2007)--Bone: How are these fields coded for a squamous cell carcinoma in bone? See Description. The consult path report says "I believe that there is definitely high grade malignant tumor in this amputation specimen, and that this tumor represents an invasive squamous cell carcinoma, which is extending into the bone and permeating in between the bone trabeculae. ... The fact that squamous cell carcinoma can arise from the sinuses of chronic osteomyelitis is well recognized."

For tumors diagnosed prior to 2007:

Based on the information provided, code the primary site as C40._ or C41._ [bone] because the tumor originated in the sinuses of chronic osteomyelitis. Code to the site in which the tumor arises. Override the SEER site/histology edits to allow this rare combination of bone and squamous 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.

 N/A Histology, Primary site 2003
20071101 Multiplicity Counter/CS Tumor Size: The Multiplicity Counter rule 6c states "Use code 99 when the tumor is described as diffuse". Is code 99 used in all circumstances when tumor size is coded to 998? See Discussion. The CS manual lists esophagus, stomach, familila/familial polyposis (colon), lung, and breast as the only circumstances when code 998 is valid. If this is correct, then if TS is coded to 998, then Multiplicity Counter must be 99. If the number of tumors is known, code the number in Multiplicity Counter. If the number of tumors is not known, assign code 99. If "diffuse" is the only information available to describe the tumor, assign code 99. N/A N/A 2007
20100012 Date of diagnosis--Breast: How is the date of diagnosis coded when a mammogram describes only "suspicious calcifications" with a BIRADS category of 4 assigned and the suspicious calcifications are subsequently proven to be malignant on biopsy? See Discussion. The date of diagnosis is the date when cancer was first diagnosed by a recognized medical practitioner, whether clinically or microscopically confirmed. Ambiguous terminology used to determine reportability is listed in part I of FORDS pages 3-4. No BIRADS categories are included and, therefore, should not be used by the registrar to determine the earliest date of diagnosis. In addition, the term "suspicious for calcification" is not reportable, because calcification is benign condition, unless the physician describes it as malignant. Reference 46637, 12/29/2009 FORDS - In the last paragraph there is a statement that no BIRAD categories are listed...cannot be used to determine earliest date of diagnosis. Does the SEER Program follow this guideline? The date of diagnosis for this case is the date of the biopsy. There is no reportable diagnosis on the mammogram. Breast Date of diagnosis 2010
20010002 EOD-Size of Primary Tumor: How do you code tumor size for lesions described as "at least 2 cm"? See discussion. The expression "at least 2 cm" seems to be different from "greater than 2 cm." Stating "at least" seems to indicate that if the tumor is larger than 2 cm, it is difficult to ascertain the exact tumor size. Should we accept 2 cm as the best info we have, or default to 999 because of the lack of specificity?

For cases diagnosed between 1998-2003:

Code the EOD-Size of Primary Tumor field to 020 [2 cm], using the rule "code what you know."

 N/A N/A 2001
20110132 Reportability/Histology--Heme & Lymphoid Neoplasms: Is a diagnosis of "small B-cell non-Hodgkin lymphoproliferative disorder" reportable? If so, how is the histology to be coded? See Discussion. The final diagnosis of a bone marrow biopsy dated 10/99/2010 was "small B-cell non-Hodgkin lymphoproliferative disorder." The differential diagnosis includes atypical small lymphocytic lymphoma/chronic lymphocytic leukemia and marginal zone lymphoma. Mantle cell lymphoma is very unlikely based on BCL1 negativity. Lymphoplasmacytic lymphoma is also excluded due to the absence of a plasma cell component (CD138 negative).

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

Yes. The term "small B-cell non-Hodgkin lymphoproliferative disorder" is reportable. Code the histology to 9591/3 [non-Hodgkin lymphoma, NOS] per Rule PH28. When there is a diagnosis of lymphoproliferative disorder and any lymphoma, code the lymphoma histology.

The information in the discussion is reflective of the difficulty in diagnosing hematopoietic and lymphoid neoplasms. The differential diagnosis indicates that a number of possible specific lymphoma/leukemia diagnoses that have been ruled out, which explains why the final diagnosis is non-Hodgkin, NOS.

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.

Heme & Lymphoid Neoplasms Histology 2011
20081017 Ambiguous terminology/Reportability--Leukemia: Is a 'suspicious peripheral blood smear' the same as a suspicious cytology? See Discussion. The final diagnosis on the path report for a peripheral blood smear is stated to be "suspicious for malignancy." The microscopic description states that the "lymphoid population raises the concern of chronic lymphocytic leukemia." Nothing further was done. Is this a reportable case? If so, should it be coded as a leukemia or a malignancy NOS?

For cases diagnosed prior to 1/1/2010:Do not accession a leukemia case based only on a "suspicious" peripheral blood smear. If a confirmed diagnosis, clinical confirmation or further information becomes available later, accession the case at that time.

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.

 N/A N/A 2008
20021098 Histology (Pre-2007)--All Sites: What code is used to represent the histology with a final diagnosis of adenocarcinoma, signet ring type when the comment suggests a "mixed histologic pattern"? See discussion. The following is the comment from the pathology report: "The histologic features reveal a tumor with a mixed histologic pattern. A diffuse infiltrate of signet ring cells and a second pattern of amphophilic polygonal cells. The latter elements suggest neuroendocrine differentiation, but IHC stains fail to reveal endocrine attributes in these cells."

For tumors diagnosed prior to 2007:

Code the Histology field to 8490/3 [Signet ring cell adenocarcinoma]. Code the specific subtype when the diagnosis says "generic carcinoma, something type." Neuroendocrine differentiation was suspected, but not supported by the IHC stains. A combination code is not appropriate for this example.

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.

 N/A Histology 2002