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Report Produced: 09/15/2025 02:08 AM

Report Question ID Question Discussion Answer Year
20051040 Primary Site--Sarcoma: What is the correct topography code for a partial lung lobectomy with pathology diagnosis of "pulmonary sarcoma with smooth muscle differentiation"? See Discussion.

Operative report: palpable 2x2cm mass in the mediastinal surface of the rt middle lobe and the contiguous upper lobe together.

Path comment after partial lung lobectomy: In all likelihood this is a malignant process occurring in smooth muscle changes surrounding vessels within the lung versus an undifferentiated epithelial tumor.

ADDENDUM DX: low grade pulmonary sarcoma with smooth muscle differentiation.

Consultant's report concurs with that of the original pathologist's report of malignant neoplasm compatible with smooth muscle origin.

 This case is unique. Assign topography code C493 [Connective, subcutaneous and other soft tissue of thorax]. Based on the information provided, this sarcoma has smooth muscle differentiation and originated in the muscle. Code the primary site to muscle. 2005
20051119 CS Eval--Colon: When the surgical resection occurs after radiation or chemo, how is the tumor size/extension evaluation field coded when there is no mention of the tumor size or extension in the surgical resection pathology report? See Discussion. 6/30/04 CT Scan abd/pelvis: 7.5x7.2 cm large rectal mass with l cm nodular densities in perirectal region probably adenopathy; irregularity of perirectal soft tissue which could be due to tumor infiltration. 7/26/04 Patient has radiation therapy and 5FU. 10/19/04 LAR: MD Adenoca rectum with regional node mets (3/8).

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.Based on the information provided above, code CS Tumor Size and Extension from CT scan. Code CS TS/Ext eval 5 [Surgical resection performed with pre-surgical treatment...size based on clinical evidence].

Code CS lymph nodes using information from resection. Code CS Reg Nodes eval 6 [Regional LN removed...with pre-surgical treatment...based on pathologic evidence].

 2005
20051070 CS Lymph Nodes--Breast: Which category has priority when both apply, "Regional lymph nodes, NOS" or "Stated as N_, NOS"? See Discussion. Example: When there is a clinical diagnosis of axillary lymph node metastasis for a breast primary on a physical exam "Enlarged axillary lymph nodes suspicious for metastatic involvement", as well as a clinical N1 designation, do we code as 60 [Axillary LNS, NOS] or 26 [Stated as N1, NOS]?

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.For the example provided, assign code 25 [Movable axillary lymph node(s)...] for "Enlarged axillary lymph nodes suspicious for metastatic involvement." Code 60 [Axillary/regional lymph node(s), NOS] is the least specific and would not be used in this case because axillary nodes are defined in code 25. Code 26 is for cases in which "N1, NOS" documented by the physician is the only information available.

 2005
20051109 CS Site Specific Factor/Terminology--Breast: Does the term "focal areas" of in situ carcinoma qualify as "minimal" in situ component when coding SSF6 field (assessment of the invasive and in situ components present) in the CS breast scheme?

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 term "focal areas" of in situ carcinoma describes a minimal in situ component.

 2005
20051136 Surgery of Primary Site--Breast: How is the surgery field coded when an excisional biopsy that is originally stated to be negative is later determined to be positive on ROS and a mastectomy with negative findings is performed 2 years later? See Discussion.

Hospital 'A' performed a breast biopsy and found only atypia. Two years later Hospital 'B' re-read the first biopsy as multifocal ductal carcinoma in situ, cribriform type. A mastectomy at Hospital 'B' followed and all specimens from this were negative.

Do we report the procedure at Hospital 'A' an excisional biopsy, despite the negative findings at the time?

For hospital A, follow the instructions in the 2004 SEER Manual on page 5, #4. For hospital B, the case is not reportable.

The diagnosis date is the date of first excision. Code the breast excision from Hospital A as surgery, first course treatment. The mastectomy was not part of first course treatment.

 2005
20051069 CS Extension/CS Mets at Dx--Pineal Gland: In Collaborative Stage, how is positive cerebral spinal fluid coded?

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 CS Mets at DX code 40 [Distant metastases] for a pineal gland primary with positive cerebral spinal fluid.

 2005
20051135 2004 SEER Manual Errata/CS Tumor Size--Can the Determining Descriptive Tumor Size information, on page 6 in the SEER EOD Manual, January 1998, be used to code descriptive tumor size in Collaborative Stage?

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 instructions in the CS Manual, Appendix 1, page 62. This information will be added to the 2004 SEER manual in the next update.

Do not use the Determining Descriptive Tumor Size information from EOD for CS Tumor Size.

 2005
20051027 Grade, Differentiation--Bladder: If the only indication of grade for a bladder primary is "grade 2, NOS," and we do not know the grading system being used by the pathologist, is the numeric grade 2 coded?

See the General Coding Rules on page 92 of the 2004 SEER Manual for instructions about coding grade.

If the only information available is "Grade 2," assign code 2 [Grade II].

 2005
20051072 Primary Site/CS Extension--Lymphoma: Should CS Extension be coded to 22 [Involvement of spleen PLUS lymph node(s) BELOW the diaphragm] or 32 [Involvement of spleen PLUS lymph node(s) on both sides of the diaphragm] for the biopsy proven lymphoma in a retroperitoneal mass and a CT of the chest with nodes described as "indeterminate" or "calcified"? See Discussion.

It was diagnosed on CT-guided biopsy of retroperitoneal mass: obtained access to the posterior aspect of the lesion adjacent to the left side of the spinal column at approx the level of the kidney.

CT Abdomen/Pelvis: Large low attenuation & smooth walled regions in hilum of the spleen & into the splenic parenchyma w/assoc smaller lesions in the spleen. Associated adenopathy on left side of aorta between the superior mesenteric artery & renal vein.

Body of report: Soft tissue mass 4.4 x 4.8 x 7cm adjacent to the left side of the aorta & spanning the distance betw superior mesenteric vein inferiorly to level of left renal vein, appears to be matted adenopathy.

CT Chest: indeterminate nodes in pretracheal region w/calcified nodes in infracarinal region, right perihilar region & calcifications in pulmonary parenchyma of right lung. Calcified nodes & other structures suggest healed granulomatous process. However, with the infarct/mass lesion in the spleen & left periaortic adenopathy, extension of this process to the mediastinum can't be excluded.

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.Code the primary site C772 [Intra-abdominal lymph nodes]. Assign CS extension code 22 [Involvement of spleen plus lymph nodes below diaphragm]. The description from the chest CT is not sufficient to code lymph node involvement above the diaphragm.

 2005
20051108 Reportability--Brain and CNS: Which types of neurofibromatosis are reportable to SEER? See Discussion. Clin exam: probable neurofibromatosis, type I. On the trunk alone are >14 cafe au lait spots all at least 10mm. Both axillary regions have freckling. No palpable fibromas, spine is straight, no organomegaly. MRI of head: no abnormality. Neurofibromatosis type I (von Recklinghausen's disease, the Elephant Man disease) is primarily tumors of the subcutaneous tissues. By itself, NF1 is not reportable. NF2 is much more likely to develop acoustic neuromas. This syndrome is reportable only when acoustic neuroma(s) is present, because the acoustic neuroma is what is reportable. This case is not reportable because none of the symptoms affect the central nervous system. 2005