CS Extension--Corpus uteri: Can a suspicious cytology be used to code extension? See Discussion.
Endometrial primary confirmed by biopsy on 10/26/06. Pelvic washing on 11/14/06 was 'suspicious for malignancy.' Resection path the same day stated the primary tumor invades the inner 1/3 of the myometrium.
Can we use the pelvic washing cytology & code CS extension 61 or should CS extension be coded 12?
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 extension code 61 [cancer cells in peritoneal washings] for the case described above.
"Suspicious" is listed as a term indicating involvement. There is no exception noted for cytology reports. See page 122 of the 2007 SEER manual.
MP/H Rules--Lung: Per rule M8, tumors of the same site (left lung), same histology (NSCC), greater than 3 yrs apart are separate primaries.
However, there was a recurrence to mediastinal LNs after 2 years. Would that make a difference as to whether the 2008 left lung carcinoma is reportable as a new primary or not? See Discussion.
Scenario: NSCC 2004 LLL with positive hilar/mediastinal LNs treated with LLL lobectomy, chemo and rad. 2006 per CT/PET recurrence in mediastinal LNs treated with chemoradiation. 2008 left lung nodule positive for NSCC stated by MD to be recurrence from 2004 (2008 path not compared to 2004 path).
For cases diagnosed 2007 or later:
The 2008 lung carcinoma is a separate primary according to rule M8. The 2006 diagnosis is metastases to the lymph nodes. Do not apply the MP/H rules to metastases.
MP/H Rules--Bladder: Is a TURBT in 4/07 that demonstrates papillary carcinoma (8130/3) followed two weeks later with biopsies that demonstrate high grade flat dysplasia/carcinoma in situ (8010/2) two primaries?
For cases diagnosed 2007 or later, rule M6 applies and this is a single primary.
Flat transitional cell carcinoma and carcinoma in situ of the bladder are synonymous. See the definition of "Flat Tumor (bladder)/Noninvasive flat TCC" in the Urinary Terms and Definitions section of the 2007 MP/H manual.
MPH Rules/Behavior--Breast: Would a positive right axillary node following DCIS of the right breast indicate the presence of a new primary? See Discussion.
How would you abstract the information from 2007? A patient with a strong family history of breast cancer had bilateral simple mastectomies in 2000, after a suspicious mammogram. Results showed DCIS in the rt breast; no malignancy in the left breast. Now in 2007, the patient has a right axillary lymph node removed - positive for carcinoma of breast origin. Comment says, "recurrent breast carcinoma in rt axillary node from patient's known history of DCIS." Is this a new primary? Is this a diagnosis date in 2007? Is the site C509 and laterality right side?
For cases diagnosed 2007 or later:
A metastasis was diagnosed in 2007. The 2007 MP/H rules do not apply to metastases.
Change the behavior code of the 2000 diagnosis. The breast cancer diagnosed in 2000 must have been invasive based on the metastasis in 2007.
Date Multiple Tumors--Prostate: For a prostate biopsy done 10/20/08, both lobes involved with tumor, unknown how many tumors, what would be coded in date of multiple tumors?
In this case, code the date of the biopsy in Date of Multiple Tumors [10202008]. When the number of tumors is unknown, code the date of diagnosis as the Date of Multiple Tumors. This is the date on which it was determined that there were an unknown number of tumors. This instruction will be added to next edition of the MP/H manual.
MP/H Rules/Histology--Colon: How do you use Rule H5 or H6 to code "moderately diff adenoca with mucinous component"?
For cases diagnosed 2007 or later, code the histology 8140 [Adenocarcinoma]. Rule H6 applies because the final diagnosis is not "mucinous adenocarcinoma" and the percentage of mucinous adenocarcinoma is not stated.
Rule H13 does not apply because "component" is not a term that indicates a specific histology.
Histology: Must every word in the ICD-O-3 code definition appear in the diagnosis in order to assign that ICD-O-3 code? See Discussion.
Is the diagnosis "Acute myeloid leukemia, M2" coded to Acute myeloid leukemia with maturation, FAB M2, NOS, (9874/3) or to Acute myeloid leukemia, NOS, (9861/3)?
For cases diagnosed prior to 1/1/2010:The general instructions for assigning histology codes are to code as precisely as possible. Acute myeloid leukemia with maturation is the definition of the FAB M2 category. A pathologist does not need to provide every word in the term associated with an ICD-O code; pathologists don't always talk that way. AML M2 is a very specific diagnosis and should be coded to 9874/3.
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.
MP/H Rules--Ovary: How do you code histology for a diagnosis of "clear cell CA, predominately cystic."
For cases diagnosed 2007 or later, assign histology code 8310 [Clear cell carcinoma]. Cystic describes the appearance of the tumor. Clear cell is the histologic type. Code clear cell carcinoma 8310/3. Rule H11 applies.
Reportability--Brain and CNS: For von Hippel Lindau disease with multiple hemagioblastomas, is each hemangioblastoma reportable as a new primary? See Discussion.
Diagnosis of von Hippel-Landau disease, multiple brain surgeries between 2002 and 2007 for recurring hemangioblastomas, 9161/1. This disease manifests as multiple (recurring) hemangioblastomas.
For cases diagnosed 2007-2014:
If the hemagioblastomas occur in sites with different ICD-O-3 topography codes, they are separate primaries.
Please note: Rule M4 in the Benign & Borderline Intracranial and CNS Tumors MP/H coding rules on the SEER website has been corrected to read:
Multiple primaries/Histology--Lymphoma: How many primaries should be abstracted and how should the histology field(s) be coded in this situation?
How would the bone marrow involvement by only NHL be handled? Composite lymphoma (9596) as defined by SEER and ICD-O is NHL and HD in one node which fits the final impression on the removed cervical node. See Discussion.
Patient presented with cervical, supraclavicular & superior mediastinal lymphadenopathy. A cervical node was excised for pathological review. The final impression on that node was Composite lymphoma characterized by (1) Nodular Lymphocyte Predominant Hodgkin Lymphoma [HD] (2) CLL/SLL [NHL]. Then, a bone marrow aspirate/bx was performed revealing CLL/SLL [NHL].
For cases diagnosed prior to 1/1/2010:This is a single primary. The histology code is 9596/3 [composite Hodgkin and non-Hodgkin lymphoma].
According to the Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table, 9596/3 followed by 9670/3 is one primary.
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.
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