The term "coagulable state" is not reportable. This is not a a neoplasm. The term means capable of coagulating or capable of becoming thick. There are neoplasms, such as polycythemia vera, in which the blood becomes thick; however, you must have an actual reportable diagnosis in order to accession the case.
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.
EOD-Extension--Lymphoma: Would a lymphoma involving mesenteric and retroperitoneal nodes (both site code C77.2) be coded to extension 10 [Involvement of a single lymph node region; Stage I], based on the fact that while more than one "chain" is involved only one "region" is involved?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 20 [Involvement of two or more lymph node regions on the same side of diaphram]. The AJCC lists mesenteric as a core nodal region, but does not list retroperitoneal lymph nodes as a part of this region, so retroperitoneal is a separate region.
The EOD staging scheme for lymphoma uses lymph node REGIONS as the criteria for assigning the extension code. Use the AJCC Cancer Staging Manual as the definitive source for classifying lymph node regions, not the ICD-O-3. If it is a separate LN region per the AJCC, it is coded in the EOD as a separate region.
According to the AJCC curator, the nodal regions are defined in Kaplan's book on Hodgkin disease. Bilateral cervical, or axillary, or hilar, or pelvic, or inguinal nodes count as two regions. Mediastinal and para-aortic lymph nodes count as one region regardless of laterality as they are centrally located. A large mediastinal mass constitutes one region involved regardless of the size.
Reportability--Head & Neck: Would this be reportable and if so what histology would be coded? Soft tissue mass left cheek excision reveals Carcinoma Ex Pleomorphic Adenoma Non-Invasive with focal vascular invasion. Margins clear.
Carcinoma ex pleomorphic adenoma (Ca-ex-PA) is reportable. Assign 8941/3. The WHO classification of head and neck tumors defines Ca-ex-PA as an epithelial malignancy arising in a benign pleomorphic adenoma. Most of these originate in the parotid gland but can also arise in other salivary glands.
MP/H/Histology--Breast: What MP/H Rule, histology, and behavior code for a breast primary apply to the following?
2 foci DCIS, solid, high grade (Grade 3) w/microca++
Apply the Multiple Primaries/Histology, Breast Rule H3: DCIS and a more specific in situ are coded to the more specific histology term which in this case is solid. Code the histology to ductal carcinoma in situ, solid type (8230/2). Based on the information provided, there is no invasive component. The term "microca ++" means micro-calcifications are present, not micro carcinoma.
MP/H Rules/Histology--Breast: How is histology coded for an "infiltrating papillary carcinoma" of the breast when there is no mention of ductal or adenocarcinoma in the pathology report?
For cases diagnosed 2007 or later, assign histology code 8503 [Papillary adenocarcinoma]. Rule H14 applies.
ICD-O-3 code 8050 does not apply in this case. Refer to the numeric listing in ICD-O-3. 8050 is a squamous cell neoplasm. Papillary carcinoma of the breast is NOT a squamous cell neoplasm. It is a neoplasm of the breast parenchyma - ducts, lobules or connective tissue. 8503 is the correct code in this case.
EOD-Extension--Corpus Uteri: What code is used to represent this field for a corpus primary (sounding 8 cm or less in length) treated with radiation prior to a hysterectomy that pathologically showed superficial myometrial invasion? Is it possible that the invasion could have been more extensive prior to the radiation treatment?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 12 [Myometrium, inner half] which represents the extension you know. In this particular case, there was no clinical evidence of extension outside the corpus. As long as the surgery was not performed because of disease progression, use information from the surgery to code EOD extension.
Histology--Lymphoma: How is "histiomonocytic lymphoma" coded?
For cases diagnosed prior to 1/1/2010:Assign code 9755 [Histiocytic sarcoma; True histiocytic lymphoma]. "Histiomonocytic" is not standard terminology, according to our expert consultant. However, 9755 is the best code to assign.
For cases diagnosed 2010 forward, 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.
Reportability--Melanoma: Please explain how a CTR is to interpret the guideline in the MP/H rules (Cutaneous Melanoma): Evolving melanoma (borderline evolving melanoma): Evolving melanoma are tumors of uncertain biologic behavior. Histological changes of borderline evolving melanoma are too subtle for a definitive diagnosis of melanoma in situ. Is this to mean that evolving melanoma in situ is not reportable? Or should we follow the guidelines in SEER Question 20130022 that states the reportability terms for melanoma and melanoma in situ.
Follow the guidelines in SINQ 20130022 for now. When the MP/H rules are revised, new instructions will be implemented.
MP/H Rules/Histology--Sarcoma: What would be the morphology code for a low grade myofibroblastic sarcoma of the left distal forearm? I tried several different combinations but the closest I could come up with is myosarcoma.
Assign code 8825/3. Apply the ICD-O-3 Matrix Concept, Rule F, page 29 of the hardcover ICD-O-3. The WHO Classification of Soft tissue and Bone, page 85, lists low grade myofibroblastic sarcoma, also called myofibrosarcoma, 8825/3.
Secondary polycythemia vera is not reportable. See Appendix F.
Primary polycythemia vera is a condition in which there is an overproduction of blood cells due to a neoplastic process. Secondary polycythemia vera is an over production of red blood cells caused by a co-morbidity, in this case, volume depletion.
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.
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