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Report Produced: 12/13/2025 02:15 AM

Report Question ID Question Discussion Answer Year
20081099 MPH Rules/Behavior--Breast: Would a positive right axillary node following DCIS of the right breast indicate the presence of a new primary? See Discussion. How would you abstract the information from 2007? A patient with a strong family history of breast cancer had bilateral simple mastectomies in 2000, after a suspicious mammogram. Results showed DCIS in the rt breast; no malignancy in the left breast. Now in 2007, the patient has a right axillary lymph node removed - positive for carcinoma of breast origin. Comment says, "recurrent breast carcinoma in rt axillary node from patient's known history of DCIS." Is this a new primary? Is this a diagnosis date in 2007? Is the site C509 and laterality right side?

For cases diagnosed 2007 or later:

A metastasis was diagnosed in 2007. The 2007 MP/H rules do not apply to metastases.

Change the behavior code of the 2000 diagnosis. The breast cancer diagnosed in 2000 must have been invasive based on the metastasis in 2007.

 2008
20081045 MP/H Rules--Melanoma: How is histology coded for a regressing melanoma? See Discussion.

How is histology to be coded for the following tumors?

Example 1: Path showed malignant melanoma Histologic type: superficial spreading. Regression: present.

Example 2: Shave, mid back: malignant melanoma, lentigo melanoma type, level II, regression: present and prominent.

For cases diagnosed 2007-2014:

Apply MP/H Melanoma Histology Coding rule H5 and code the histologic type of the melanoma.

Code example 1 as 8743 [Superficial spreading melanoma].

Code example 2 as 8742 [Lentigo maligna melanoma].

 2008
20081040 Reportability/Histology--Hematopoietic: If a JAK2 positive myeloproliferative disorder is reportable, how should histology be coded?

Please discuss the significance of JAK2 point mutation.

Example: Bone marrow biopsy showed hypercellular marrow with increased megakaryocytes associated with JAK2 point mutation consistent with myeloproliferative syndrome. Path comment: While the morphologic changes would be compatible with a myeloproliferative syndrome, they are not specific for this as similar findings can be seen in reactive conditions. However, a molecular diagnostic test demonstrated a positive JAK2 point mutation which would support the diagnosis of myeloproliferative syndrome. In summary, the combined histologic and molecular diagnostic findings support a myeloproliferative syndrome. The differential diagnosis would be between polycythemia vera and essential thrombocythemia. Subsequent clinical diagnosis: polycythemia vera.

For cases diagnosed prior to 1/1/2010:Follow the instructions in the SEER manual on pages 1-4 to determine reportability.

Code the histology using all information available for the case. If the clinician reviews the case and states a particular histology based on his/her review, code that histology.

The clinician has access to all of the information available for this case. He/she uses his/her expertise to form a clinical diagnosis.

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
20081113

Reportability--Brain and CNS: Is a cavernoma reportable as a benign brain tumor? See Discussion.

Cavernous hemangiomas are typically described as vascular malformations in the brain. Per a search of the literature, cavernoma, cavernous hemangioma and cavernous malformation are all synonymous. There is some controversy as to whether cavernomas are vascular malformations or tumors. Cavernous hemangioma (9121/0) has been assigned a code in the ICD-O-3. The other terms are not even listed. Benign brain guidelines indicate that named tumors that have been assigned an ICD-O-3 code are reportable. Would we report a lesion that is labeled cavernous hemangioma but not one that is labeled carvernoma? Are cavernous malformations of the brain to be reported as benign brain tumors? The MP/H guidelines for benign brain tumors do not include blood vessel tumors in chart 1.

Are the following tumors reportable? If so, what is the primary site?

Example 1: Patient admitted for resection. Clinical diagnosis is left temporal cavernous hemangioma. Path diagnosis is cerebral cortex and white matter showing cavernoma.

Example 2: Patient admitted for resection with clinical diagnosis of parietal cavernous hemangioma. Path shows A-V malformation.

Example 3: Patient had T4 spinal tumor removed. Path showed cavernous angioma.

Reference: I&R 18109 and 23460

Cavernoma is a reportable benign brain tumor. According to our pathologist consultant, cavernoma is synonymous with cavernous hemangioma.

Examples

1. Reportable. Primary site - C710 [cerebrum]

2. Not reportable. Path dx disproves clinical diagnosis.

3. Not reportable. Not a brain tumor.

 2008
20081002 Primary site: What is the correct primary site code for angiosarcoma of the spleen with mets to bone marrow C42.2 vs C49x? See Discussion.

Robbins Pathology states the following about liver angiosarcomas: Hepatic angiosarcomas are rare but of interest because they are associated with distinct carcinogens, including arsenic (exposure to arsenical pesticides), Thorocast (a radioactive contrast medium previously widely used in radiology), and polyvinyl chloride (PVC) (widely used in plastics). The increased frequency of angiosarcomas among works in the PVC industry is one of the truly well-documented instances of chemical carcinogenesis in humans. With all these agents, there is a very long latent period of many years between exposure and the development of tumors.

Could the same apply to the spleen?

 Code C422 [Spleen] as the primary site for angiosarcoma of spleen with metastasis to bone marrow. 2008
20081028 Multiplicity Counter--Ill-defined sites: How is this field coded for Ill-Defined sites (C760-C768)? Code the number of tumors present if known. If the number of tumors present is not known, code 99 [unknown number of tumors, unknown if multiple tumors]. 2008
20081121

Multiple primaries/Histology--Lymphoma: How many primaries should be abstracted and how should the histology field(s) be coded in this situation?

How would the bone marrow involvement by only NHL be handled? Composite lymphoma (9596) as defined by SEER and ICD-O is NHL and HD in one node which fits the final impression on the removed cervical node. See Discussion.

 Patient presented with cervical, supraclavicular & superior mediastinal lymphadenopathy. A cervical node was excised for pathological review. The final impression on that node was Composite lymphoma characterized by (1) Nodular Lymphocyte Predominant Hodgkin Lymphoma [HD] (2) CLL/SLL [NHL]. Then, a bone marrow aspirate/bx was performed revealing CLL/SLL [NHL].

For cases diagnosed prior to 1/1/2010:This is a single primary. The histology code is 9596/3 [composite Hodgkin and non-Hodgkin lymphoma].

According to the Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table, 9596/3 followed by 9670/3 is one primary.

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
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
20081022 CS Extension/CS Mets at Dx--Wilm's Tumor: Is the fact that a Wilm's tumor case is bilateral captured in the CS Extension field or is the CS Mets at Dx field coded to 40?

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 laterality as bilateral, code the greatest extension from either side in CS extension.

Code CS Mets at diagnosis 00 [None] UNLESS true distant metastases were identified.

 2008
20081050 MP/H Rules--Fallopian Tube: How many primaries are to be abstracted for a case in which a bilateral fallopian tube primary is staged T1c by the pathologist? See Discussion.

A bilateral fallopian tube primary was coded to multiple primaries. However, the AJCC staging for T1b says, "tumor limited to both tubes"

and T1c "tumor limited to one or both tubes." The tumor is T1c according to the pathologist. Is this two T1c primaries or one?

For cases diagnosed 2007 or later, abstract as two primaries using Other Sites rule M8.

This issue will be reviewed during the next update to the MP/H rules.

 2008