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Report Produced: 02/21/2026 12:44 PM

Report Question ID Question Discussion Answer Year
20110075 Primary site--Heme & Lymphoid Neoplasms: How do you code primary site for a case of "leukemia cutis" when the bone marrow exam is negative for involvement with leukemia?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the primary site to C421 [bone marrow] per Rule PH30 which states to use the to determine the primary site and histology when rules PH1-PH29 do apply. Leukemia cutis is the term for a leukemic infiltration of the epidermis, the dermis or the subcutis. This infiltration is easily identified as cutaneous lesions, but the primary site is still bone marrow. This is a type of "metastasis" or spread of the leukemia cells. The "conventional" definition for leukemia cutis is the infiltration of skin from a bone marrow primary. See the Hematopoietic & Lymphoid Neoplasm Coding Manual Glossary.

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
20110106 Primary site--Heme & Lymphoid Neoplasms: How is the primary site to be coded for a 2010 diagnosis of follicular lymphoma involving the spleen and lymph nodes above and below the diaphragm?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Use Rule PH21 to code the primary site to C778 [lymph nodes of multiple regions]. The spleen is not listed under the Primary Site(s) section in the Heme DB for follicular lymphoma. Per Rule PH21 code the primary site to multiple lymph node regions, NOS (C778) when multiple lymph node regions, as defined by ICD-O-3, are involved and it is not possible to identify the lymph node region where the lymphoma originated. The spleen is a primary site for only a few lymphomas (noted in the Heme DB). Because the spleen filters blood, it is often reactive (splenomegaly) or frankly involved with the lymphoma. That reaction or involvement, however, does not affect the primary site coding. Only the involved nodes are used in coding primary site.

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
20110122 Histology--Heme & Lymphoid Neoplasms: Is histology coded to AML, NOS [9861/3] for a bone marrow biopsy with a diagnosis of acute myeloid leukemia evolving from myelodysplastic syndrome (MDS) if the cytogenetics revealed trisomy 13? See Discussion. This patient actually had no prior diagnosis of MDS. The bone marrow biopsy revealed AML evolving from MDS. Cytogenetics revealed trisomy 13 with no other abnormalities. Does the presence of a trisomy 13 change the histology to a more specific subtype of AML?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph..

This should be accessioned as a single primary per Rule M8 which states to abstract as a single primary and code the acute neoplasm when both a chronic (MDS) and an acute (AML) neoplasm are diagnosed simultaneously or within 21 days AND there is documentation of only one positive bone marrow biopsy, lymph node biopsy, or tissue biopsy. Code the histology to 9895/3 [acute myeloid leukemia with myelodysplasia-related changes].

NOTE: When you search with quotation marks around the phrase, the database will only return results with that exact wording. To only return results for the expression trisomy 13, enter in the Heme DB. In this case, a search for "trisomy 13" returns no results. Therefore, it does not impact the coding of histology for this 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.

2011
20110059

Histology: How do you code histology for "malignant myopericytoma"?

Report malignant myopericytoma as 8824/3 for cases diagnosed 2021 and later.

 2011
20110125 MP/H Rules/Histology--Lung: What would the histology code be for a wedge bx of the left lung, lower lobe, that was read out as well differentiated adenocarcinoma with micropapillary features? Code papillary adenocarcinoma 8260/3. The ICD-O-3 codes for micropapillary have specific associations such as ductal, serous or transitional. None of those associations fit lung primaries. 2011
20110048 First course treatment--Heme & Lymphoid Neoplasms: How is a "donor lymphocyte infusion" that is used in the treatment of CLL coded?

Donor lymphocyte infusion (DLI) is coded as immunotherapy. The lymphocytes are donated by the same person who donated the original stem cell transplant. The lymphocyte infusion creates an immune response in which the T-cells are activated to attack the cancer cells.

See "Treatments" for CLL/SLL (9823/3)

 2011
20110012 Reportability--Sarcoma: Is "atypical lipomatous tumor/well-differentiated liposarcoma" reportable? See Discussion.

The final diagnosis for a soft tissue excision is, "atypical lipomatous tumor/well-differentiated liposarcoma". The Comment section states, "Atypical lipomatous tumor/well differentiated liposarcoma has a significant risk for local recurrence, but no metastatic potential."

Per the 2010 SEER Manual, page 3, example 4: The pathologist makes the final decision about the behavior for a particular case. In this case, the pathologist uses both a reportable and a non-reportable term in the final diagnosis and in the comment section of the pathology report. Does the pathologist's comment impact the behavior and reportability of this tumor?

 For cases diagnosed 1/1/2014 and later: Atypical lipomatous tumor (8850/1) is not reportable. If the pathologist uses the term "well-differentiated liposarcoma" (8851/3) report the case. Use of this terminology indicates a less favorable prognosis. 2011
20110008 MP/H Rules/Histology--Vulva: How is histology coded for VIN III with focal invasion? See Discussion. Per SINQ 20000442, the histology for CIN III with microinvasion is coded to 8077 [squamous intraepithelial neoplasia, grade III] per the matrix system rules, with a behavior code of /3 [malignant]. Coding the histology to 8077/3 per the matrix principle causes IF25_3 and MorphICDO3_P1 edits to fail. Flagging the first error resolves any reporting issue. How is the MorphICDO3_P1 edit resolved? Assign 8076/3 [squamous cell carcinoma, microinvasive] for VIN III with focal invasion. This applies to all terminologies listed under 8077/2. The SINQ question from 2000 will be retired. 2011
20110123

Reportability--Heme & Lymphoid Neoplasms: Are the terms EBV positive B-cell lymphoproliferative disorder with or without the term "of the elderly" and iatrogenic EBV positive lymphoproliferative disorder reportable? See Discussion.

The only reportable term listed is "EBV positive B-cell lymphoproliferative disorder of the elderly." Are the following cases reportable?

  • Does the diagnosis of EBV positive B-cell lymphoproliferative disorder specifically have to include the expression "of the elderly" to be reportable? Is there an age range associated with the term "of the elderly"?
  • Is "iatrogenic EBV positive lymphoproliferative disorder" reportable?
  • Is a diagnosis of "EBV positive B-cell lymphoproliferative disorder" reportable when there is no further classification of the LPD as lymphoma?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

  1. EBV positive B-cell lymphoproliferative disorder is reportable. Code EBV positive lymphoproliferative disorder as DLBCL [9680/3], the term "of the elderly" does not have to be part of the diagnosis.
  • The term "iatrogenic" simply means that there is no known cause for the disease. Iatrogenic EBV positive lymphoproliferative disorder is reportable.
  • EBV positive B-cell lymphoproliferative disorder is a synonym for DLBCL [9680/3]. You do not need to have the lymphoma (DLBCL) diagnosis.

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
20110079 MP/H Rules/Histology: In the MP/H Manual, where is the documentation indicating "focal" is not a term that can be used to code histology? See Discussion. Example: neuroendocrine carcinoma with focal squamous differentiation. For the purposes of the MP/H rules, the term "focal" is not used to indicate a more specific histology. Terms that may be used to indicate a more specific histology are listed in the relevant histology rules. For example, see Breast histology rule H3. Notice the terms listed in the note for this rule are "type, subtype, predominantly, with features of, major, with ___ differentiation, architecture or pattern." The term "focal" is not included. This concept will be clarified in future revisions to MP/H rules. 2011