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| Report | Question ID | Question | Discussion | Answer | Year |
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20000502 | EOD-Extension/EOD-Lymph Nodes: Can the AJCC TNM/Stage be used to help code these fields when there is limited text information in the medical record that describes the tumor involvement? | For cases diagnosed 1998-2003:
Yes, this staging information can be used to help code the SEER EOD fields but only if a physician does the TNM/Stage at the time of diagnosis and there is limited text information that describes tumor involvement. |
2000 | |
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20000419 | EOD-Extension--Corpus Uteri: How do you code myometrial involvement described as 1) "to the level of the middle one-third" or 2) "superficial"? | For cases diagnosed 1998-2003:
Evaluate each case carefully.
1. Code the EOD-Extension field to 12 [Myometrium-inner half] because the pathology report indicates involvement of the myometrium "to the level of." However, if you feel that you cannot make that determination with certainty and you cannot ask a pathologist for clarification, then code the EOD-Extension field to 14 [Myometrium, NOS].
2. Code the EOD-Extension field to 12 [Myometrium-inner half] for cases with "superficial" myometrial invasion. |
2000 | |
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20000514 | Histology (Pre-2007)--Skin: Are "atypical melanocytic hyperplasia" and "severe melanotic dysplasia" synonyms for melanoma in situ? |
For tumors diagnosed prior to 2007: No. SEER determines its reportable list from the ICD-O-3. The above terms are listed as tumor-like lesions and conditions, but are not in situ or malignant. 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. |
2000 | |
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20000248 | Date of Diagnosis: When doing follow-back at nursing homes on DCO cases, we find it difficult to code diagnosis date because the nursing home records are often vague or incomplete. Should the diagnosis date be coded as unknown (excluded from SEER database), the date of death, or the approximate date of diagnosis as reported on the death certificate? | If the nursing home record indicates that the patient had cancer, use the best approximation for date of diagnosis.
If the record says the patient had cancer when admitted, but it does not provide a date of diagnosis, use the date of admission as the date of diagnosis.
If there is no mention of cancer in the nursing home record and/or all work-up in the record is negative, assume the cancer was discovered at autopsy. Use the date of death as the date of diagnosis, and leave as a Death Certificate Only case. |
2000 | |
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20000491 | Terminology: Do focus, focal, foci and chips mean the same thing? | Focus, focal, and foci are variations of the same word. Focus (noun) describes an area or point of disease, either grossly or microscopically. Focal (adjective) relates to the area/focus of disease; an example is a prostate with focal adenocarcinoma. This means that the majority of the prostate is benign and the adenocarcinoma is confined to one small area/point. Foci (plural) describe more than one area/focus of disease. A prostate with foci of adenocarcinoma means the disease is multifocal (several areas/points of disease).
Chips are microscopic amounts of either tissue or tumor. A pathologist might examine several chips of prostate tissue, one of which contains a focus of adenocarcinoma. |
2000 | |
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20000436 | Histology (Pre-2007)--Colon: What code is used to represent the histology "adenocarcinoma arising in a papillary adenomatous polyp"? See discussion. |
Is "adenocarcinoma arising in a papillary adenomatous polyp" equivalent to adenocarcinoma in a villous adenoma [8261/3] or adenocarcinoma in an adenomatous polyp [8210/3]? |
For tumors diagnosed prior to 2007: Code the Histology field to 8261/3 [adenocarcinoma in a villous adenoma]. In describing colon polyps, papillary and villous are equivalent terms. 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. |
2000 |
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20000244 | Behavior Code--Bladder/Lymphoma: Should the "in situ" designation on a bladder primary's pathology report be ignored that states a diagnosis of "in situ lymphoma"? | Ignore the in situ designation. You cannot assign an in situ behavior code to a lymphoma primary. The term or designation of "in situ" is limited to solid tumors; carcinoma and/or cancer. | 2000 | |
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20000846 | EOD-Extension/EOD-Lymph Nodes--Bladder: Are "perivesical nodules" coded in the EOD-Lymph Nodes field or are they discontinuous extension and coded in the EOD-Extension field? |
For cases diagnosed 1998-2003: Code "perivesical nodules" in the EOD-Lymph Nodes field as involvement of regional lymph nodes. Each gross nodule of metastatic carcinoma in the fat surrounding an organ is counted as one positive regional lymph node. |
2000 | |
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20000487 | Primary Site--Kaposi Sarcoma: Would the following Kaposi primaries be examples of cases not coded to skin for primary site? See discussion. | 1. KS developed initially as a lesion in the oral cavity and followed by the appearance of skin lesions.
2. KS found in a resected parotid gland with metastasis to the parotid gland lymph node. No skin lesions identified.
3. KS discovered in a biopsied 3 cm axillary lymph node. Clinically, the patient had hepatosplenomegaly, ascites, and extensive mesenteric lymph nodes. (No mention of skin.) |
Code the Primary Site field as follows:
1. C44.9 [Skin, NOS] as the default value when lesions develop simultaneously in skin and non-skin areas. 2. C07.9 [Parotid gland] 3. C44.9 [Skin, NOS] as the default value when there is no mention of lesions in the skin or other primary site.
Edward Klatt states in Practical AIDS Pathology, "...Visceral Kaposi (involving one or more internal organ sites) is also present in three-fourths of cases, but may not be diagnosed prior to autopsy. Visceral involvement frequently includes the lung, lymph nodes and gastro-intestinal tract." |
2000 |
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20000535 | EOD-Pathologic Extension--Prostate: Is extracapsular extension implied by the following phrases: "case staged as C" and "case staged as T3a"? See discussion. | Example: A prostatectomy was done on 6/29. The physician staged the case as a "C" on 7/2 and as T3a on 8/6. It appears the physician is interpreting the following pathology information as unilateral extracapsular extension: "The tumor on the right extends to the inked surface of the gland. In this area the capsule appears absent." Should pathologic extension be coded to unilateral extracapsular extension [42]?
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For cases diagnosed 1998-2003:
Yes. Use the best information available to stage this case. In this case, the best information is the physician's statement that the case is stage T3a. Without any additional information, the EOD-Extension field is coded to 42 [Unilateral extracapsular extension (pT3a)] on the basis of the T3a stage by the MD. When there is a conflict between different staging systems, default to the AJCC stage. |
2000 |
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