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Report Produced: 02/19/2026 06:19 AM

Report Question ID Question Discussion Answer Year
20020002 Date Therapy Initiated: What date should be entered in Date Therapy Initiated when treatment follows a surgical procedure that is not coded under Surgery of Primary Site? See discussion. If a patient has a surgical procedure that is not coded in the Surgery of Primary Site field and then the patient undergoes additional first course of treatment, such as radiation therapy, how should the Date Therapy Initiated field be coded? In this example, code the Date Therapy Initiated field to the date of the first surgical procedure. If a SEER edit is triggered, please notify us. 2002
20020052 EOD-Extension--Lung: How do you code extension for a lung tumor described on bronchoscopy as "obstructing the RUL and intruding into the right bronchus intermedius. Small tumor nodules distally in midline of anterior trachea wall"?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 85 [Metastasis] because the tumor nodules are discontinuous from the primary tumor.

 2002
20021003 Multiple Primaries (Pre-2007): Whenever two hollow organs are diagnosed simultaneously with the same histology, one being invasive and the other in situ, can one assume that mucosal spread has occurred and that this situation represents one primary? In the absence of a physician statement, how do you determine mucosal spread from one organ to another?

For tumors diagnosed prior to 2007:

Yes, this type of situation represents one primary. A tumor that is breaking down can be invasive in the center with in situ cancer at the margins. Occasionally the in situ margin can move into a contiguous organ with the same type of epithelium.

Physicians may describe mucosal spread in various manners. You will see the terms "intramucosal extension," "in situ component extending to," or statements of an invasive component in one organ, with adjacent/associated in situ carcinoma in a contiguous organ with the same type of epithelium. A frequent example of this process is bladder cancer extending into the prostatic urethra via mucosal spread.

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.

 2002
20021070 CS Extension/CS Lymph Nodes--Breast: How would you interpret the phrase "axillary lymph node tissue, not clearly a lymph node" or the phrase "satellite nodule of invasive tumor, left axillary lymph node or chest wall tissue"? See discussion. A lumpectomy with axillary lymph node dissection and removal of nodule in anterior axillary line revealed negative lymph nodes. The nodule specimen was labeled "axillary lymph tissue, not clearly a lymph node". The microscopic description for that specimen stated "Fibroadipose tissue. A fragment of a lymph node is incidentally sampled in block 4 and it is free of tumor". The final path dx stated "Satellite nodule of invasive tumor, left axillary lymph node, or chest wall tissue. Comment: If the tissue is considered chest wall this would be a stage IIIB. If it is considered an intramammary satellite nodule, this is a stage I". The clinician repeated what the comment said, and added "If lymph node mets, this is a stage II." Code the invasive tumor in the axillary area as a regional lymph node metastasis. According to the AJCC, cancerous nodules in the axillary fat adjacent to the breast, without histologic evidence of residual lymph node tissue, are classified as regional lymph node metastases. 2002
20031132 EOD-Lymph Nodes--Breast: Are micrometastases in the lymph nodes, found only on immunohistochemical staining, coded as positive lymph nodes?

For cases diagnosed 1998-2003: Do not code as positive lymph nodes that have micrometastases diagnosed ONLY on immunohistochemistry. By traditional diagnostic methods, these are still negative lymph nodes.

Summary Stage and EOD ignore the IHC positive micrometastases for cases diagnosed through 2003. The collaborative staging system that begins with 2004 cases and is based on the sixth edition of TNM addresses this issue.

 2003
20031078 EOD-Lymph Nodes--Colon: Are "multiple submucosal lymphoid collections infiltrated with tumor" or "lymphoid areas" coded as lymph node involvement, similar to the way nodules in the pericolic fat are coded? See Description. For an adenocarcinoma in the colon, under the "lymph node" section of the final path diagnosis it states "multiple submucosal lymphoid collections infiltrated with tumor" in addition to "one of two involved lymph nodes." The micro description states "There are multiple small lymphoid areas with tumor. A definite node excised from the mesentery shows...replacement of stroma and an additional very small node shows no tumor."

For cases diagnosed 1998-2003: No, do not code tumor infiltration of lymphoid collections or lymphoid areas as lymph node involvement.

However, code lymph node involvement for this case as 3 [mesenteric, NOS] because a mesenteric node is involved.

Regarding tumor infiltration of lymphoid collections or lymphoid areas from our pathologist consultant: Unless the anatomy of lymph node is evident (sinuses, trabeculae, primary and secondary follicles) these aren't lymph nodes and should not be coded as such. Unless there is evidence to the contrary in the path report, I would suggest that this be considered intramural spread, not lymph node spread.

 2003
20031162 Multiple Primaries/Histology--Hematopoietic, NOS/Lymphoma: How many primaries are represented and what are the histologies for "B-cell lymphoma with immunophenotypic findings consistent with hairy cell leukemia" found on a bone marrow biopsy? See Description. Pathologist completed AJCC lymphoma staging form indicating this case should be abstracted as a lymphoma.

For cases diagnosed prior to 1/1/2010:Abstract as one primary, 9591/3 [B-cell lymphoma, NOS]. The bone marrow diagnosis indicates that the main/definite diagnosis is B-cell lymphoma, with a lesser indication of hairy cell leukemia. Both of these are mature B-cell neoplasms according to the WHO histological classification.

For cases diagnosed 2010 forward, 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.

 2003
20031191 EOD-Clinical Extension--Prostate: How is this field coded when biopsies of the prostatic apex are positive and the physician clinically stages the case as T1c?

For cases diagnosed 1998-2003:

Code clinical extension to 33 [arising in the prostatic apex] when a biopsy of the prostatic apex is positive for malignancy, with no further evidence of involvement. If biopsies of both the apex and another site within the prostate (for example right lobe) are positive and there is no mention that the malignancy arose in the apex, code extension to 34 [extending into the prostatic apex].

 2003
20031017 Reason for No Surgery of Primary Site: Does code 2 [Contraindicated due to other conditions; autopsy only case] or code 1 [ Cancer-directed surgery not recommended] have priority when coding this field for extensive tumors not surgically treated because of existing comorbidities? See discussion.

Example:

Patient has Stage IVA carcinoma of the tongue. The physician states that patient is not felt to be a good surgical candidate secondary to multiple medical frailties. Patient is treated with beam radiation.

In this case, how do we code Reason for No Site Specific Surgery? Do we use code 2 because surgery was contraindicated due to co-existing medical conditions or do we use code 1 because the tumor is very extensive and surgery would probably not be done anyway?

SEER has not established a priority for assigning the Reason for No Surgery of Primary Site codes. Assign the code which best describes the reason surgery was not performed.

Example: Assign code 2, Contraindicated due to patient risk factors. According to the physician, this is the reason that surgery was not performed.

 2003
20031152 Ambiguous Terminology/Histology (Pre-2007): How do we code histology when there is a difference between the histology mentioned on a suspicious cytology and the clinical diagnosis by the treating physician? See Description. An FNA of pancreas is stated as "highly atypical cells present, suspicious for pancreatic ductal carcinoma." The attending physician states the patient has pancreatic carcinoma. Can histology be coded 8500/3 [infiltrating duct carcinoma, NOS] or should it be 8010/3 [carcinoma, NOS]?

For tumors diagnosed prior to 2007:

Code the histology from a suspicious cytology when this histology is supported by the clinical diagnosis.

Code the example above to 8010/3 [Carcinoma, NOS].

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