MP/H Rules/Multiple primaries--Thyroid: How many primaries should be coded in a patient with a 4/5/08 left thyroid lobectomy diagnosis of follicular carcinoma followed by a 7/25/08 right thyroid lobectomy diagnosis of papillary carcinoma, follicular variant?
For cases diagnosed 2007 or later:
Rule M17 under Other Sites applies. These are separate primaries based on their ICD-O-3 histology codes. Follicular carcinoma is coded 8330. Papillary carcinoma, follicular variant is coded 8340. The histology codes are different at the third number. Rule M6 does not apply because these diagnoses are more than 60 days apart.
Reportability: When a biopsy is suspicious for cancer and re-biopsy is negative, is reportability based on the clinician's judgement (cancer vs NED)?
If the re-biopsy was done because the first biopsy was inconclusive, do not report this case. If the re-biopsy was more complete, or performed in an attempt to gain a wider margin, this case is reportable based on the first biopsy.
Grade--Breast: How is this field coded for an "invasive ductal carcinoma, well differentiated, low nuclear grade"?
Assign code 1 [Grade 1, well differentiated]. Use the table in the 2007 SEER Manual on page C-607. Both "low grade" and "well differentiated" are coded 1 in the grade field.
Common variable immunodeficiency (acquired hypogammaglobulinemia) is not a reportable condition.
Common variable immunodeficiency represents a group of approximately 150 primary immunodeficiencies that have a common set of symptoms but different underlying causes, both benign and malignant.
The case is not reportable unless this immunodeficiency diagnosis is accompanied by a diagnosis of a cancer or a reportable hematopoietic or lymphoid neoplasm.
See Appendix F: Non-Reportable List for Hematopoietic Diseases.
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.
Primary Site--Heme & Lymphoid Neoplasms: What primary site code should be assigned and what rule justifies that code?
Scenario: Pleural effusion, underwent thoracentesis. Pleural fluid unexpectedly showed Large B-Cell Lymphoma. Extensive workup including CT & PET was done and all findings were within normal limits. No evidence of lymphoma was seen and no palpable adenopathy was found. The only indication of lymphoma was the malignant pleural effusion.
Code to pleura, C384.
Per the Hematopoietic database, Diffuse Large B-Cell Lymphoma can originate in the pleural cavity.
CS Lymph Node Examined--Lung: How is this field coded when a mediastinoscopy and lobectomy are performed and the pathology report indicates multiple lymph node fragments were removed as biopsy specimens and the lobectomy specimen revealed 3 interlobar lymph nodes?
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.
Code the CS Lymph Node Examined field to 98 [number unknown] because the biopsy information is not clear and as a result you do not know how many lymph nodes were examined.
EOD-Pathologic Extension--Prostate/Lymphoma: How is this field coded for a prostatic lymphoma?
For cases diagnosed 1998-2003: Do not code the prostate pathologic extent of disease field for prostatic lymphoma. Leave the path extension for prostate field blank. Code the extent of disease using the lymphoma scheme. Use ONLY the lymphoma scheme - do NOT try to code both lymphoma and prostate extension fields for prostatic lymphoma.
Surgical Procedure of Other Site--Pancreas: Should an embolization of liver metastasis for a pancreas primary be coded as treatment?
Code "embolization" (or hepatic artery embolization, HAE) to a metastatic site in Surgical procedure of Other Site. Assign code 1 [nonprimary surgical procedure performed].
This procedure was previously coded as other therapy, experimental. Code as surgery as of July 2005.
EOD-Size of Primary Tumor: Pathologist states that the size of the tumor is difficult to measure but is greater than 3cm but less than 5cm. How would we code the tumor size?
For cases diagnosed 1998-2003:
Code the largest dimension mentioned, since that is the standard rule for coding tumor size. Keep in mind that tumor size is not used in analysis for certain sites such as stomach, colon & rectum, ovary, prostate, and urinary bladder. Tumor size is important for analysis for certain sites such as lung, bone, breast, and kidney.
EOD-Extension--Corpus uteri: How should EOD extension be coded when the pathology report shows adenocarcinoma arising in the endometrium with the statement "no invasive carcinoma identified?"
For cases diagnosed 1998-2003: Code endometrial cancer with no invasion to EOD extension code 11 [Confined to endometrium (stroma)]. "No invasion" most likely means no invasion of the myometrium.
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