CS Eval/Surgery of Primary Site--Colon: When the only procedure performed is a polypectomy, if there is NO tumor at the margins, should CS TS/EXT-Eval be coded as 3 and the surgery coded as a polypectomy?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign eval code 3. A polypectomy with no tumor at the margin meets the criteria for pathologic staging.
Code polypectomy in Surgery of Primary site in this case.
EOD-Extension--Stomach: What code is used to represent this field for a stomach primary described as linitis plastica?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 30 [Localized, NOS], unless more information is known about the extent of tumor involvement. Coding the Histology field to 8142/3 [Linitis plastica] and the Size of Primary Tumor field to 998 [Diffuse; widespread; 3/4 or more: Linitis plastica] identifies this diagnosis.
In the EOD-Extension field, the depth of invasion is the important characteristic to be coded. The 10 digit EOD corresponds to the AJCC Staging Manual in which the "T" is based on level of invasion. While a diagnosis of linitis plastica indicates a worse prognosis, it does not define the extent of infiltration. There is no luminal mass with linitis plastica. Instead, the entire gastric wall is thickened by tumor.
Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient is diagnosed with small lymphocytic lymphoma in 1996, received chemotherapy on and off for 15 years due to relapses, and was subsequently diagnosed with diffuse large B-cell lymphoma in 2012?
Per Rule M10, this case should be accessioned as two primaries. According to Rule M10, one is to abstract as multiple primaries when a neoplasm is originally diagnosed as a chronic neoplasm AND there is a second diagnosis of an acute neoplasm more than 21 days after the chronic diagnosis.
The histology for the 1996 chronic neoplasm is coded to 9670/3 [small lymphocytic lymphoma]. The histology for the 2012 acute neoplasm is 9680/3 [diffuse large B-cell lymphoma].
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.
Laterality: Why is a code 5 for laterality midline only allowed for certain sites of brain and skin? I have a nasal cavity tumor and the path report specifically says "Tumor laterality: midline". What is the correct laterality code here?
Assign laterality code 9 for midline nasal cavity tumor. We will investigate this issue further.
When coding the Covid testing results, does SEER have any guidance on whether or not at home tests fall within reportability? For instance, if a medical provider says pt tested positive on an at home test, do we record that?
When you have information about home COVID tests, record this information. For example, if the home test was positive record as follows: COVID-19 rapid viral antigen test POS 08/09/2022
Histology (Pre-2007)--Breast: What code is used to represent histology for "invasive ductal carcinoma with squamous differentiation"? Is "squamous differentiation" synonymous with "squamous metaplasia"?
For tumors diagnosed prior to 2007:
Code the Histology field to 8570/3 [Adenocarcinoma with squamous metaplasia]. Our pathology consultant agrees that squamous metaplasia is synonymous with squamous differentiation.
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.
SEER Manual/Reportability--Vulva: Is vulvar intraepithelial neoplasia (VIN II) alone reportable? An example is a final diagnosis from a pathology report that states only 'VIN II' with no additional details/wording.
Report VIN II. The 2024 SEER Manual lists this as a separate diagnosis in the Reportability section under Malignant Histologies 1.a.x.
2004 SEER Manual Errata/Surgery of Primary Site--Lymphoma: Item 9.a on page 178 is incorrect. Do not assign surgery code 98 to lymphoma, primary in lymph nodes. See Appendix C, page C-707 for Lymphoma (primary in lymph nodes) surgery codes.
Delete item 9. a. i. ii. and iii. on page 178 of the 2004 SEER Manual. This correction will be included in the next errata.
Histology (Pre-2007)--Colon: What code is used to represent histology when the surgeon describes a sessile polyp and the final path diagnosis is stated as: "Rectal sessile polyp: Invasive moderately differentiated adenocarcinoma" (pathologist does not state that it is "arising in a sessile polyp")?
For tumors diagnosed prior to 2007:
Code the Histology field to 8210/3 [adenocarcinoma arising in a polyp]. The structure in which this adenocarcinoma is arising, is a polyp.
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.
Histology--Pancreas: How is a "gastrin and somatostatin producing endocrine neoplasm" coded that has lymph node metastasis?
The best code available for this situation is 8153/3 [Gastrinoma, malignant].
Many pancreatic endocrine tumors produce more than one peptide, such as gastrin and somatostatin in this case. ICD-O-3 does not provide a code for pancreatic endocrine tumors which produce more than one peptide. According to the WHO Classification of Tumours of Endocrine Organs, there is a distinct hormonal syndrome associated with gastrin producing tumors, and not with many of the somatostatin producing tumors. Therefore, our pathologist consultant advises us to code to gastrinoma in this case.
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