Report | Question ID | Question | Discussion | Answer | Year |
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20130140 | Reportability/Ambiguous terminology--Heme & Lymphoid Neoplasms: Is a peripheral blood sample with an immunophenotype that is "characteristic of B-cell chronic lymphocytic leukemia" reportable? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This is a reportable diagnosis of chronic lymphocytic leukemia [9823/3]. The physician is using the terms "characteristic of" in the same manner as he/she would use the terms "diagnostic of."
This case fits with the usual diagnosis of CLL. The peripheral blood is diagnostic for leukemias. There was a specific leukemia noted, B-cell chronic lymphocytic leukemia. CLL (B-cell is the phenotype) is usually diagnosed incidentally by a peripheral smear because it is asymptomatic. However, we recommend looking for further work-up, such as a bone marrow biopsy.
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. |
2013 | |
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20160020 | Reportability--Gallbladder: Is high grade biliary intraepithelial neoplasia of the gallbladder reportable? |
High grade biliary intraepithelial neoplasia of the gallbladder is reportable. Assign code 8148/2. It is also known as biliary intraepithelial neoplasia grade 3, or BilIN-3. |
2016 | |
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20120009 | Histology--Heme & Lymphoid Neoplasms: How is the histology coded when the pathology report states the morphologic features and immunophenotype of a low grade B-cell lymphoma are most compatible with lymphoplasmacytic lymphoma or marginal zone lymphoma? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the histology to 9591/3 [B-cell lymphoma, NOS] per Rule PH28 which states that one is to code the histology when the diagnosis is
There is only one non-specific histology code mentioned, low grade B-cell lymphoma. This term is synonymous with B-cell lymphoma, NOS.
Per the Multiple Primaries Calculator, when comparing the histology 9591/3 [B-cell lymphoma, NOS] and 9671/3 [lymphoplasmacytic lymphoma], it is the same primary. When comparing the histology 9591/3 [B-cell lymphoma, NOS] and 9699/3 [marginal zone lymphoma], it is the same 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. |
2012 | |
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20071125 | Radiation Therapy--Prostate: Is the regional treatment modality XRT best coded to 50 (brachytherapy, NOS), 53 (LDR) or 54 (HDR) when the documentation indicates only "I-125 seeds" to the prostate? | Assign code 53 [Brachytherapy, interstitial, LDR] for seeds to the prostate. Seeds are always low dose because they are left in place and the radioactivity decays over time. | 2007 | |
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20140021 | 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. | 2014 | |
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20010119 | Scope of Regional Lymph Node Surgery/EOD Fields: When a patient has two simultaneously diagnosed primaries, and a regional lymph node dissection intended for one of the primaries removes nodes that are also regional for the other primary, is the information from the lymph node dissection coded for both primaries? | For cases diagnosed 1998-2003:
If the lymph nodes are negative, the status of nodes that are regional for both sites would be used to code the EOD and Site-Specific Surgery fields for both sites.
If any of the lymph nodes are positive use the histology from the lymph nodes to determine how the EOD and Site-Specific Surgery will be coded. For example: If prostate cancer is an incidental finding when a cystoprostatectomy and pelvic lymph node dissection are done to treat a bladder cancer, and all of the positive lymph nodes reflect the histology of the prostate primary (adenocarcinoma), code the nodes as positive for the prostate primary and negative for the bladder primary. |
2001 | |
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20120036 | Primary site--Heme & Lymphoid Neoplasms: Should the primary site be coded to C779 or C809 when a patient is diagnosed at another facility with mantle cell lymphoma and the staging bone marrow biopsy performed at this facility is negative? There is no available information concerning where the lymphoma originated. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Per PH Rule22, code the primary site to C779 [lymph nodes, NOS].
Rule PH22 is a default rule for lymphomas that is used when there is no other information regarding the primary site and the Heme DB does not indicate a primary site under its Primary Site(s) section. Rule PH27, code the primary site to unknown [C809], does not apply. Only use C809 [unknown] as the primary site when there is no evidence of lymphoma in lymph nodes AND the physician documents that the lymphoma originates in an organ(s).
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. |
2012 | |
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20031156 | Histology (Pre-2007)--Ovary: Should the histology "endometroid adenocarcinoma arising in a serous fibroadenoma" be coded to 8380 [Endometroid adenocarcinoma, NOS] or 9014 [Malignant serous fibroadenoma]? | For tumors diagnosed prior to 2007:
The best code is 8381/3 [Endometroid adenofibroma, malignant]. According to our pathologist consultant: "Serous 'fibroadenoma' is not exactly standard terminology. I would guess the pathologist is looking at an adenofibroma with more fibro and less adeno and thus has changed the terminology around. The combination of the benign serous and malignant edometrioid is also a bit unusual. Each of the proposed codes is defendable, but I prefer endometrioid adenofibroma, 8381/3, because it puts the tumor in the adenofibroma category (less common) yet still identifies the malignant element (endometrioid), even though it does lose the serous. But anyone wanting to look at malignant adenofibromas would find the case, and we would carry it under the appropriate malignant component."
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. |
2003 | |
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20110128 | Histology/Primary site--Heme & Lymphoid Neoplasms: How are these fields coded if a bone marrow biopsy demonstrates diffuse infiltration by B-cell lymphoma/leukemia which consists of medium-sized cells with Burkitt morphology and the flow cytometry has no evidence of leukemia or lymphoma? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case should be accessioned as one primary. Per Rule PH26, code the primary site to bone marrow (C421) when lymphoma is present only in the bone marrow. (We assumed all available physical exams, scans, and other work-up were negative for lymph node, tissue, or organ involvement.) Histology is coded to 9680/3 [Diffuse large B-cell lymphoma (DLBCL)]. Under the Alternate Names section of the Heme DB, a synonym for DLBCL is B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt 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. |
2011 | |
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20190016 | Update to current manual/SS2018--Breast: Should Code 3 of the Summary Stage 2018 (SS2018) for Breast designate the intramammary and infraclavicular lymph nodes as being ipsilateral? Similarly, should Code 7 designate infraclavicular lymph nodes as contralateral/bilateral? Laterality (ipsilateral, contralateral/bilateral) is included for axillary and internal mammary nodes in the respective codes. |
Based on your question, a review of the AJCC manual was done to clarify how these nodes would be coded. A review of Extent of Disease (EOD) Regional Nodes and EOD Mets was also done. That information is correct and in line with AJCC 8th edition. We apologize that SS2018 was not updated accordingly and thank you for bringing this issue to our attention. Per AJCC, infraclavicular and intramammary nodes are ipsilateral for the N category. Contralateral or bilateral involvement are included in the M category. The following will be applied to the planned 2020 update of the SS2018 manual. Code 3 Ipsilateral will be added to Infraclavicular and Intramammary Infraclavicular (subclavicular) (ipsilateral) Intramammary (ipsilateral) Code 7 The following will be added under Distant lymph nodes Infraclavicular (subclavicular) (contralateral or bilateral) Intramammary (contralateral or bilateral) |
2019 |