CS Mets at Dx/CS Mets Eval--Colon: Would the metastasis field be coded to 00 [No; none] and the evaluation field be coded to 1 [No path exam of metastatic tissue performed.] when the source of information is from the operative findings for the following 6 different cases? 1) Liver normal; 2) No evidence of metastatic disease; mesentery normal, 3) Small ascites; no liver metastasis, mass adherent to duodenum without obvious invasion, 4) No mets or local invasion, 5) No evidence of carcinomatosis, peritoneal studding or malignant effusion and 6) Tumor adherent to lateral sidewall (path negative); no evidence of metastatic implants.
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.
The CS Mets Eval code refers to the method used to evaluate the site farthest from the primary site. The correct code may not be the highest eval code. For example 1 above, if the liver is the site farthest from the colon primary that was evaluated for distant mets, code the CS Mets Eval code to the method used to evaluate liver. Code surgical evaluation as 1.
Assuming this is all of the information about possible distant metastatic sites for the examples above, code CS Mets at DX as 00, and CS Mets Eval as 1 for each.
Please note: imaging of farther sites should also be included when CS Mets at DX is coded. For example, if there was also a negative chest X-ray, the CS Mets at DX field would be 00 but the CS Mets Eval field would be 0 because the CXR documents that there are no mets beyond the immediate area of the tumor.
2004 SEER Manual Errata/CS Lymph Nodes--Head & Neck: On page C-353, in the supraglottic larynx schema, there is no mention of Level IV nodes in the CS Lymph Node codes.
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.The CS Steering Committee is aware of this issue and is working to resolve it.
CS Reg LN Pos/Exam--Colon: For a patient with both a prostate and colon primary, if the pathology report indicates that 2 of the 3 regional lymph nodes to the colon are positive for a prostate malignancy, how should these fields be coded for the colon primary?
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.For the colon primary, code Reg LN Pos 00 [all nodes negative]. Code Reg LN Exam 03 [three nodes examined].
Three lymph nodes were examined and found to be negative for metastatic colon cancer.
Primary Site--Breast: What subsite is to be coded for a case of invasive Paget disease of the nipple with an infiltrating ductal carcinoma of the lower inner quadrant?
Code C50.9 [Breast, NOS]. Code the last digit of the primary site to '9' for single primaries when multiple tumors arise in different subsites of the same anatomic site and the point of origin cannot be determined. Nipple [C50.0] and LIQ [C50.3] fit this rule. This is a single primary per MP/H Breast Rule M9.
Grade, Differentiation: Are anaplastic tumors always coded to grade 4, even for anaplastic brain primaries?
Yes. Always code the Grade, Differentiation field to for 4 [Grade IV] for "anaplastic" tumors. Anaplastic is synonymous with undifferentiated. Refer to the example in the SEER Program Code Manual, 3rd Ed.
CS Extension--Retinoblastoma: When the degree of extension differs between the retinas, how is extension coded for simultaneous bilateral retinoblastoma?
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 the CS extension code that corresponds to the greatest level of extension seen in either eye, excluding information from enucleation.
Record extension based on enucleation in Site Specific Factor 1.
Record bilateral disease under laterality. For retinoblastomas, bilaterality is not a component or consideration for staging.
Reportability/Behavior--Skin: Is an "atypical fibroxanthoma (superficial malignant fibrous histiocytoma)" with an ICDO-3 histology code of 8830 reportable with a behavior code of 3 or is it nonreportable with a behavior code of 1?
Yes, "atypical fibroxanthoma (superficial malignant fibrous histiocytoma)" is reportable. The information in parentheses provides more detail and confirms a reportable malignancy.
EOD-Extension/EOD-Lymph Nodes: Can the AJCC TNM/Stage be used to help code these fields when there is limited text information in the medical record that describes the tumor involvement?
For cases diagnosed 1998-2003:
Yes, this staging information can be used to help code the SEER EOD fields but only if a physician does the TNM/Stage at the time of diagnosis and there is limited text information that describes tumor involvement.
Multiple primaries--Heme & Lymphoid Neoplasms: Is this abstracted as one primary or two?
5/2/13 Bone Marrow biopsy: myelodysplastic syndrome with approaching to acute myeloid leukemia with del 5q and 7q deletions. FISH: deletion of chromosome 5q and deletion of chromosome 7q detected.
I checked the Heme DB manual and there is no term "With approaching to". I checked the Multiple Primary calculator and it says new primary. My interpretation is that the myelodysplastic syndrome is in the process of transforming to acute myeloid leukemia.
Abstract a single primary, myelodysplastic syndrome with del 5q and 7q deletions (9986/3). This neoplasm can transform to acute myeloid leukemia (AML); however, "with approaching to" cannot be used to report this AML.
Histology--Heme & Lymphoid Neoplasms: How is histology coded for a pathology report final diagnosis of diffuse large B-cell lymphoma (50%) and follicular lymphoma, 3A (50%)?
Code the histology to diffuse large B-cell lymphoma [9680/3] per Rule PH11.
Code the histology to 9680/3 [diffuse large B-cell lymphoma] when DLBCL and any other non-Hodgkin lymphoma (follicular lymphoma, grade 3 in this case) are present in the same anatomic location. DLBCL is coded because it is the more aggressive histology.
NOTE: This answer assumes these two histologies are present simultaneously in the same anatomic location. Per Rule M4, this is a single primary.
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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