Report | Question ID | Question | Discussion | Answer | Year |
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20091073 | Grade: Can FIGO grade be used to code Grade/Differentiation? See Discussion. | SINQ 20020059 says not to use FIGO grade to code differentiation. It also says SEER is evaluating whether the ICD-O-3 sixth digit differentiation codes accurately represent the FIGO grade. For the time being, do not code FIGO grade. What is the result of the evaluation? Any new information regarding FIGO grade? | 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.Do not code FIGO grade in the grade field. The conversion from a three-grade system to a four-grade system does not work for FIGO grade three. Since FIGO G3 includes both Poorly differentiated and undifferentiated, it cannot be converted. FIGO grade may be captured in a CS site specific factor in the future. |
2009 |
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20091031 | MP/H Rules/Histology--Thyroid: How is histology coded for a thyroid tumor described as "predominantly papillary carcinoma, tall cell variant, follicular type"? | For cases diagnosed 2007 or later, assign code 8340 [Papillary carcinoma, follicular variant] according to rule H15 for Other Sites. "Predominantly" and "type" indicate specific histologies. "Variant" does not. See rule H13. The histology in this case is papillary and follicular. Tall cell variant is ignored. |
2009 | |
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20091057 | CS Site Specific Factor--Lymphoma: Can the term "intermediate risk" be used to code IPI score? See Discussion. | Patient has Hodgkin disease. The physician states that the patient has bulky stage IIA intermediate risk disease. Is the term "risk" another way of stating IPI score? If so, how would intermediate risk be 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.Code SSF 3 for lymphoma based on the IPI score stated in the record. Do not attempt to interpret statements or terms in order to assign a code to SSF 3. If no further information is available for this case, code SSF 3 999 [Unknown]. |
2009 |
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20091042 | Multiple primaries--Hematopoietic, NOS: How many primaries should be coded when a patient has multiple occurrences of plasmacytoma followed by a diagnosis of multiple myeloma? See Discussion. | Example: Patient had a diagnosis on February 2003, plasmacytoma of the sinus; June 2003, plasmacytoma of the alveolar ridge; July 2003, plasmacytoma of the skin; and June 2004, multiple myeloma.
If this represents a transformation of plasmacytomas to multiple myeloma, will the information on multiple myeloma be available for statistical and research purposes? |
For cases diagnosed prior to 1/1/2010:Accession this case as plasmacytoma diagnosed in Feb. 2003. Each of the subsequent diagnoses are not abstracted as new primaries. They are the "same," one primary only, according to the Definition of Single and Subsequent Primaries for Hematologic Malignancies (the tri-fold heme table). The 2003 diagnosis is a classic example of extraosseous plasmacytoma (9734/3). Plasmacytoma and multiple myeloma would be two primaries in the new hematopoietic rules taking effect in 2010. 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. |
2009 |
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20091082 | Behavior--Breast: How is this field coded for a case in which the final diagnosis reports DCIS, but the CAP protocol or microscopic findings show microinvasion? See Discussion. | 1. Path report for breast cancer has final diagnosis as 'DCIS' but the CAP protocol in the body of the report says 'microinvasion seen, T1mic.' 2. Path report says 'DCIS' in the final diagnosis and microinvasion is identified in the microscopic portion of the report, but it is not in CAP protocol format and not stated in the final diagnosis. |
Code both scenarios /3 [malignant (invasive)]. Information regarding behavior is not limited to the final diagnosis or the CAP protocol. See page 84 in the 2007 SEER manual: Code the behavior as malignant /3 if any portion of the primary tumor is invasive no matter how limited; i.e. microinvasion. |
2009 |
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20091105 | Multiple Primaries--Hematopoietic: How many primaries and which histologies should be reported for a case presenting with a 2005 diagnosis of CLL/SLL, 2006 clinical diagnosis of MDS and a 2008 diagnosis of AML? See Discussion. |
2005 diagnosis of CLL/SLL (9670) with lymph node involvement, treated with FCR. 2006 clinical diagnosis of MDS secondary to chemo (9987) with CLL/SLL in remission. 2008 biopsy reveals AML (9861). Per Seer Hematopoietic Table, 9987 & 9861 are a single primary. In 6/2008 patient receives bone marrow transplant. 2009 status post BMT, BM biopsy reveals RAEB-1 (9983). Is this still the same disease process or a new primary (since status post BMT)? |
For cases diagnosed prior to 1/1/2010:Two primaries should be abstracted. Using the Definitions of Single and Subsequent Primaries for Hematologic Malignancies table, compare 9670 (SLL) in 2005 and 9987 (MDS secondary to chemo) in 2006. This is two primaries. MDS can transform to AML. On the Definitions of Single and Subsequent Primaries for Hematologic Malignancies table, 9987 (MDS) and 9861 (AML) are a single primary. The AML would be documented in follow-up. (While 9670/SLL and 9861/AML are two different primaries, the SLL has already been reported.) RAEB is a form of MDS. On the Definitions of Single and Subsequent Primaries for Hematologic Malignancies table, 9987 (MDS) and 9983 (RAEB) are a single primary. The RAEB would be documented in follow-up. (While 9670/SLL and 9983/RAEB are two different primaries, the SLL has already been reported.) 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. |
2009 |
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20091053 | Multiple Primaries--Breast: How many primaries should be reported when a lobular carcinoma with positive margins is followed 8 years later by a lobular carcinoma near the previous lumpectomy site? See Discussion. |
Left breast invasive lobular ca diagnosed 3/00 and treated with a lumpectomy, but with multiple positive margins; she received no post operative radiation or other medical treatment (unknown why). 10/08 core biopsy of "an area of distortion" near the scar site is positive for invasive lobular ca. The radiologist states "compatible with recurrence at her previous lumpectomy site" on an x-ray report. One thought is that this should not be a new primary because the patient was never disease free (multiple positive margins) and the patient received incomplete treatment. Or should this be a new primary because the tumors are diagnosed more that 5 years apart? |
Abstract the 10/08 diagnosis as a new primary, per Breast rule M5. In spite of the positive margins and apparently incomplete treatment in 3/00, there is no mention of the presence of disease between 3/00 and 10/08 according to the information provided. |
2009 |
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20091091 | Primary Site/CS Extension--Lymphoma: How should these fields be coded for a malignant lymphoma with spleen involvement, inguinal and iliac adenopathy, T12 lesion with bony destruction, and a paraspinal mass in lower lumbar region with extension into iliac fossa involving left psoas muscle and causing bony destruction? | For cases diagnosed prior to 1/1/2010, 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 C496 [Connective, subcutaneous and other soft tissue of trunk]. When lymphoma is present in an extranodal organ/site and in that organ/site's regional lymph nodes, code the extranodal organ/site as the primary site. In this case, there is a soft tissue paraspinal mass at T12 extending into iliac fossa, left psoas muscle and bone. Lymph nodes are also involved. Assign CS extension code 21 [Direct extension to adjacent organs or tissues].
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. |
2009 | |
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20091094 | Reportability--Anal canal: Are squamous cell carcinomas arising in a condyloma of the rectum reportable or should we assume that the site is skin of anus or perianal area and not reportable? | Squamous cell carcinoma arising in a rectal condyloma is reportable. Do not assume the site is skin of anus or perianal. | 2009 | |
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20091018 | MP/H Rules/Multiple Primaries/CS Extension: How many primaries are to be accessioned when tumors are present bilaterally in the pleura and fallopian tubes? See Discussion. | For both pleura and fallopian tube, the MP/H rules indicate that bilateral involvement of these sites should be coded as multiple primaries. However, both of these sites have CS extension codes that classify the contralateral disease as regional extension. Is a case described as a left sided pleural mesothelioma that has right sided pleural disease coded as one or two primaries? How is CS coded? |
For cases diagnosed 2007 or later: For a pleural or fallopian tube primary, if there is tumor(s) on the left and separate tumor(s) on the right and neither is stated to be metastatic from the other, abstract as multiple primaries according to rule M8 for other sites. If both sides are involved, but there is only one tumor, rule M2 for other sites applies and this is a single primary. Code each primary separately in CS. |
2009 |