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Report Produced: 05/06/2026 23:14 PM

Report Question ID Question Discussion Answer Year
20081096 Computed Ethnicity: Should the Name--Alias field be used when generating Computed Ethnicity? No, "Alias" is not used and should not be used to generate Computed Ethnicity. Computed Ethnicity records the ethnicity based on last name and/or maiden name using a computer algorithm. Alias is not part of the algorithm. 2008
20081139 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. 2008
20081128

MP/H Rules/Histology--Breast: What is the histology code for the following?

4/21/03 Left breast: infiltrating ductal carcinoma, grade 3 micropapillary type. Tumor size: 3.5 cms; deep margin negative. Skin, nipple & areola positive for invasive ductal carcinoma. Dermal lymphatic invasion by carcinoma breast. Extensive intraductal component absent. 6+/6. See Discussion.

 How should histology be coded for a 2003 diagnosis and also for the same diagnosis in 2007 or later?

For a case diagnosed in 2003, code 8507/3 [Duct micropapillary carcinoma]. See Coding Complex Morphologic Diagnoses, revised August 2002, 3rd example on page 5 and page 3, #4.

For cases diagnosed 2007 or later, code 8507/3 [Duct micropapillary carcinoma]. Use rule H12.

 2008
20081126

MP/H Rules--Brain and CNS: Are stigmata of neurofibromatosis in the brain reportable neurofibromatosis lesions? See Discussion.

Reference: SINQ 20051108; SINQ 20061018 Three year old patient with history of neurofibromatosis 1. 3/05 MRI of the brain showed right optic nerve glioma. It also showed heterogeneous high t2 signal in the middle cerebellar peduncles and near the genu of the internal capsules bilaterally are stigmata of neurofibromatosis type I. 3/08 MRI showed new mass suspicious for glioma in the hypothalamus. Clinical diagnosis is benign glioma secondary to diagnosis of neurofibromatosis. How many primaries are to be accessioned for this patient? Should the matrix principle be invoked for the second glioma? Should the behavior code for the glioma be 0?

For cases diagnosed 2007 through 2017

Accession NF (9540/1) when there is CNS tumor -- a glioma or some other intracranial/intraspinal tumor. Stigmata of NF are reportable when the stigmata themselves are reportable tumors. For example, glioma, or another intracranial/intraspinal tumor. Do not report sitgmata that are only termed "stigmata seen on MRI," for example, without other reportable terminology.

Do NOT accession NF (9540/1) when there is only peripheral nerve/nervous system involvement.

Accession the neurofibromatosis itself only once per patient. Accession any initial neoplasm in the CNS separately. Abstract and code any subsequent CNS neoplasms according to the multiple primary brain rules.

Accession three primaries for the case described above.

  1. Neurofibromatosis (C729 9540/1)
  • Optic nerve glioma (C723 9421/3)--> see below.
  • Hypothalamus glioma (C710 9380/0)

--> Optic nerve gliomas associated with NF are pilocytic astrocytomas. Code pilocytic astrocytoma as 9421/3 in North America.

For cases diagnosed 2018 or later

See the 2018 Solid Tumor Rules for Non-Malignant CNS tumors.

 2008
20081134

MP/H Rules--Breast: For tubulolobular carcinoma, do we use 8522? See Discussion.

Path comment: This mixed variant of ductal and lobular carcinoma has been called in the past tubulolobular carcinoma, however, more recently is a mixed pattern of ductal and lobular carcinoma and not a variant of lobular carcinoma.

For cases diagnosed 2007 or later, use rule H18 and assign code 8524 [lobular mixed with other types of carcinoma]. According to the MP/H rules, tubular is not a specific type of duct or lobular. This is based on the latest WHO classification of breast tumors.

The combination histology of tubular and lobular will be reviewed during the upcoming revision of the MP/H rules.

 2008
20081093

CS Extension: How is CS Ext coded for the following?

Rretroperitoneal primary

Cystic mucinous tumor with intraepithelial carcinoma

There is no CS Extension code for intraepithelial ca in the retroperitoneal 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.According to the American College of Surgeons I & R system, assign code 10 [confined to site of origin] for intraepithelial carcinoma of the retroperitoneum.

 2008
20081066 Multiplicity Counter/Type of Multiple Tumors--Breast: How should these fields be coded when path shows a 1.2 cm infiltrating carcinoma with lobular features and several foci of infiltrating lobular carcinoma [7 foci described as multifocal], 1 large focus, and numerous foci of LCIS and CIS with lobular and ductal features? Should we count the foci or separate tumor nodules, ignore them, or code unknown values for these fields? See Discussion.

Scenario: 10/17/07: Right axilla soft tissue bx - infiltrating mammary ca with lobular features arising within apparent breast tissue present within axilla. Tumor size 1.2 cm. 11/3/07: Right breast, reexcision lumpectomy - Several foci of infiltrating lobular CA. (2) foci & (5) foci within specimen (multifocal). (1) large focus also present. No lymphovascular invasion identified. Numerous foci LCIS. Pleomorphic LCIS & CIS with lobular and ductal features. Margins free of invasion however margins diffusely involved with LCIS.

When do you count foci or separate tumor nodules, when do you ignore them, and when do you code unknown values for these fields? Coding instruction 3b states, "When the tumor is multifocal or multicentric and the foci of tumor are not measured, code as 99." Instruction 4b states, "Use code 01 when there is a single tumor with separate foci of tumor." Finally, instruction 6b states, "Use code 99 when the tumor is described as multifocal or multicentric and the number of tumors is not given," which seems to imply that if we know the number of tumors, we would code that number.

Multiplicity Counter: Use instruction 4b. Since there is one measured tumor and the foci were not measured, code the multiplicity counter 01 [One tumor only].

Type of Multiple Tumors: Code Type of multiple tumors 00 [Single tumor].

 2008
20081136 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.

 2008
20081039 Diagnostic Confirmation/Histology--Hematopoietic: How are these fields coded when the final pathologic diagnosis for a bone marrow biopsy differs from the final clinical diagnosis of a hematopoietic disease? See Discussion.

Frequently, pathology reports describe hematopoietic diseases using ambiguous terms. Flow cytology and cytogenetics may be obtained. It appears that the clinician is the person who pulls all the information together for a diagnosis.

Example: Bone marrow biopsy is most compatible with chronic phase myeloproliferative disease. Path comment: Differential would include CML. Outside hematology report indicates an elevated peripheral WBC, primarily neutrophils. Flow cytometry showed 1.0 % of the white cells are myeloid blasts of abnormal phenotype, additionally finding 7.3 % basophils. Flow reported peripheral blasts at 1.2 % and peripheral basophilia. Cytogenetics report showed abnormality with trisomy of chromosomes 13 and 21. This finding is consistent with a clonal abnormality suggestive of acquired disease. Results were consistent with the absence of the t(9,22)(q34;q11) translocation or fusion product associated with CML. Subsequent clinical impression: Bone marrow evaluation most consistent with CML. Overall features most consistent with CML.

For cases diagnosed prior to 1/1/2010:Code the Diagnostic Confirmation field as 1 [positive histology]. Code the ICD-O-3 morphology based on the clinician's statement.

The code in Diagnostic Confirmation pertains to the best method used to confirm the presence of cancer over the entire course of the disease. Therefore, if a bone marrow report confirms cancer, code 1 [positive histology] in Diagnostic Confirmation.

Code the histology using all of the information available. The clinician has access to all of the information relating to this case. The pathologist had only the bone marrow. Code the histology recorded by the clinician.

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.

 2008
20081135

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.

 2008