EOD-Clinical Extension--Prostate: In the SEER EOD manual, there is a list of terms to distinguish apparent from inapparent tumor for prostate primaries. If a physician uses a term not currently on the list or if a physician uses a list in the "maybe" category, should we assume the tumor to be clinically inapparent or clinically apparent tumor?
For cases diagnosed 1998-2003:
If the physician used a term not on the clinically apparent/inapparent list, ignore that term and use the best information available from other sources to code the EOD-Extension field.
If clarifying stage information is missing and the term is in the maybe category or the term is not on the list, then code EOD-Extension as 30 [localized, NOS] for cases that appear localized.
MP/H/Multiple primaries--Urinary: In Aug 2008 Patient was diagnosed with Noninvasive Bladder Cancer. In Oct 2013 Patient was diagnosed with Transitional Cell Carcinoma of Right Ureter involving lamina propria, Noninvasive Transitional Cell Carcinoma Left Ureter and Invasive Transitional Cell Carcinoma of Prostatic Urethra. Is this a new primary and what is the primary site?
Rule M7 applies when comparing the 2008 diagnosis to the 2013 diagnosis: multiple primaries.
Rule M8 applies to the tumors identified in 2013: single primary.
Based on the information provided, code the primary site for 2013 to C689 because there is no indication of the site of origin among the involved sites.
Reportability--Brain and CNS: Is benign neural tissue compatible with a glioneuronal hamartoma of the cerebellopontine angle reportable?
No. A glioneuronal hamartoma is not neoplastic and not reportable. See page 2 of the 2004 SEER Program Coding and Staging manual for the list of reportable brain/CNS tumors. There is no ICD-O-3 code for hamartoma.
Multiple Primaries/Histology--Lymphoma/Leukemia: How many primaries and what histologies are coded when a path diagnosis for a cervical/neck mass demonstrates classical Hodgkin's lymphoma on a background of chronic lymphocytic leukemia?
For cases diagnosed prior to 1/1/2010:Hodgkin disease and chronic lymphocytic leukemia are separate primaries according to our current instructions. Abstract and code them separately.
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.
No. Per Appendix F, erythrocytosis of an unknown cause is not reportable.
The diagnosis must state "erythrocytosis megalosplenic" to be reportable (9950/3).
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--Hematopoietic, NOS: If a solitary plasmacytoma originates in the right tonsil and extends to the left tonsil, vallecula and hypopharynx, is extension still coded to 10 [localized disease, solitary plasmacytoma only]?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 10 [localized disease, solitary plasmacytoma only] for all cases of solitary plasmacytoma.
Reportability--Breast: Is an inflammatory myofibroblastic tumor of the breast with metastasis to the lung reportable?
Inflammatory myofibroblastic tumor of the breast with metastasis to the lung is reportable. Metastasis to the lung from the breast tumor indicates that the breast tumor is malignant. All malignant neoplasms are reportable.
Histology (Pre-2007)--Ovary: What codes are used to represent "mixed papillary serous and clear cell carcinoma" and "papillary serous carcinoma with focal clear cell features" of the ovary?
For tumors diagnosed prior to 2007:
Assign code 8323 [Mixed cell adenocarcinoma] to "mixed papillary serous and clear cell carcinoma." This is histology coding rule 3 in the 2004 SEER manual under single tumor (page 86). There is no other code for this mixture.
Example 1: 8323
Example 2: 8461 (clear cell is not coded according to Rule 6, page 87, because it is not the majority of the tumor).
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.
Primary Site--Heme & Lymphoid Neoplasms: How is the primary site coded for a B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma when a biopsy of the paraspinal muscle and epidural tissue is positive, but there is no indication of lymph node involvement in the chart?
Code the primary site to soft tissue of the back, NOS [C496] per Rule PH24 and the Abstractor Notes in the Heme DB for B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma.
Code the primary site to the organ when lymphoma is present only in an organ. The lesion is described as epidural (tissue surrounding the dura) and involving paraspinal muscle, NOS. Both are connective or other soft tissues of the trunk, NOS [C496].
B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma is a synonym for DLBCL 9680/3. When there is no primary site listed in the Heme DB, go to the Abstractor Notes. In the Abstractor Notes section it states that patients present with lymphadenopathy OR mass lesions in extranodal sites.
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.
Reportability/Histology--Colon: Is tubular adenoma with high grade dysplasia and focal invasion from a pathology report of a colon biopsy reportable?; if so, what is the histology code?
Tubular adenoma with high grade dysplasia and focal invasion is reportable. Assign the histology code and behavior as 8210/3 (Adenocarcinoma in tubular adenoma).
NAACCR Guidelines for ICD-O-3 Implementation discuss the term high grade dysplasia (without invasion). High grade dysplasia and related terms are under review and study for consideration as a reportable neoplasm. Registries should check with their state reporting legislation to see if included in the reporting requirements.
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