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Report Produced: 09/14/2025 10:56 AM

Report Question ID Question Discussion Answer Year
20041015 Primary Site--Lymphoma: How should this field be coded when a diffuse large B-cell lymphoma is found in the femur and in the soft tissue of the anterior chest wall but all CT scans are negative for lymphadenopathy?

For cases diagnosed prior to 1/1/2010:Code the Primary Site field to C809 [Unknown primary site]. The primary site of diffuse large B cell lymphoma can be either nodal or extranodal. The case described above is likely extranodal because there is no evidence of lymph node involvement. Because the extranodal site of origin is unknown, code the Primary Site to C809.

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.

 2004
20041074 Histology (Pre-2007)--Colon: Is the histology coded as adenocarcinoma arising in a polyp when the final diagnosis on the pathology report is adenocarcinoma but the colonoscopy report associated with the path states that the surgeon performed a polypectomy? See Discussion. Histology: 3/04 Colonoscopy with polypectomy of a sessile appearing polyp. Path report: Final Dx: Adenocarcinoma; Micro: Adenocarcinoma apparently arising from the mucosa...noted to invade the muscularis mucosa into the submucosa.

For tumors diagnosed prior to 2007

Code this case to adenocarcinoma [8140]. The best source for histology is the final diagnosis on the path report from the procedure that removed the most tumor tissue. When there is a conflict, the path diagnosis has higher priority than the colonoscopy diagnosis for coding histology.

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.

 2004
20051110 Other Therapy: Can herbal therapy be coded when used as a single therapy or when used in combination with conventional therapy as a complimentary treatment? See Discussion. Page 201 of the SPCM 2004, item #5, states "Assign code 6 for unconventional methods whether they are single therapy or given in combination with conventional therapy." This statement itself is ok but there is no guideline on the use of complementary therapy when it is given as the only treatment. The SPCM, 3rd editon, page 140 states: "Use code '6' for alternative and complementary therapies ONLY IF the patient receives no other type of treatment." There is no such statement in the SPCM 2004. Assign code 6 for unconventional methods whether they are single therapy (alternative medicine is the only treatment) or given in combination with conventional therapy (complementary medicine plus conventional). 2005
20051093 CS Lymph Nodes/Scope of Regional Lymph Node Surgery--Prostate: When prostate cancer is an incidental finding at cystoprostatectomy for bladder cancer, is the pelvic lymph node dissection coded for the prostate as well as the bladder?

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.

Yes, the pelvic lymph node dissection is coded as regional lymph node surgery for both primaries and the nodes are counted in collaborative staging for both primaries. The examination of the pelvic lymph nodes is relevant to both the bladder and the prostatic primaries.

 2005
20051102 CS Extension--Breast: What is the CS Extent for this 2004 breast cancer? See Discussion. A patient had lobular carcinoma of the left breast in 2000. At that time, she had bilateral simple mastectomies and the right breast was benign. In 2004, she notices a nodule in the right chest wall, which is excised and found to be invasive ductal ca and lobular ca in situ. So is this Sequence 2, C50.9, 8522/3. And what is the CS Extent - 40 chest wall? (The physician stages this as T2N0M0)

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.Residual breast tissue is present following a mastectomy. If the nodule is in the breast tissue (tissue above the ribs), assign CS extension code 10 [Confined to breast tissue...Localized, NOS]. If the nodule is in the chest wall (tissue below the ribs), assign code 40 [Invasion of chest wall].

 2005
20051133 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How are the number of primaries, histologies and CS extension fields coded for breast tissue that contains separate areas of invasive ductal carcinoma, intraductal carcinoma and Paget disease? See Discussion.

Excisional biopsy of a breast mass: 1.0 cm tumor that was infiltrating ductal carcinoma, high grade, with an associated intraductal component with comedonecrosis.

Pathology report for the mastectomy three weeks later: no residual tumor was found near the original biopsy site. In another portion of the same breast was found high-grade intraductal carcinoma involving the nipple ducts, with Paget Disease of the nipple. (No size was given for this.)

For tumors diagnosed prior to 2007:

This is a single primary. According to Exception 3 of Multiple Primary Rule 6 for multiple tumors, combinations of Paget disease and ductal carcinoma are a single primary. The histology code for this case is 8541 [Paget disease and infiltrating duct carcinoma]. Assign CS extension code 10 [confined to breast tissue] based on the information above.

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.

 2005
20051128 CS Lymph Nodes/CS Site Specific Factor 3--Breast: How are positive intramammary lymph nodes reflected in these fields? See Discussion. Patient with breast cancer underwent mastectomy. No axillary lymph nodes were positive, but 1 out of 2 intramammary lymph nodes were positive for mets (greater than 2 mm). CS Lymph node codes describe axillary and internal mammary nodes, but do not describe intramammary lymph nodes.

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.

Intramammary lymph nodes are coded as axillary lymph nodes for staging purposes. Intramammary node are nodes within the breast tissue. Both staging and treatment suggest these are equivalent to axillary nodes.

 2005
20051068 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.

 2005
20051112 Collaborative Staging--Hematopoietic, NOS: Which Collaborative Staging schema is used for a connective, subcutaneous and soft tissue primary of the pelvis [C495] with the morphology of Langerhans cell sarcoma [9756/39]? See Discussion. On page C-411 of the SEER manual for the connective, subcutaneous, and other soft tissues schema it lists exceptions for certain morphologies and the above is not listed as an exception. On the Hematopoietic scheme it lists the above morphology.

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.Use the hematopoietic schema on page C-709 of the 2004 SEER manual. The histologically defined schemas have priority over the site schemas when both apply. See page 115 of the 2004 SEER manual.

The morphology codes listed on page C-411 pertain to the SEER Site Specific Guidelines.

 2005
20051096 Primary Site--Peritoneum: During a second look staging lap following a diagnosis of serous carcinoma of the left ovary, did the physician correctly indicate a new peritoneum, NOS primary for disease described as an endometrioid adenocarcinoma in a "paracaval cyst" that appears to have arisen in endometriosis?

The primary site is C482 [Peritoneum, NOS]. "Paracaval" means alongside or near the vena cava.

Code the site in which the primary tumor originated.

 2005