Report | Question ID | Question | Discussion | Answer | Year |
---|---|---|---|---|---|
|
20091011 | MP/H Rules/Histology--Breast: What histology is coded for a tumor diagnosed as "intraductal papillary carcinoma (neuroendocrine differentiation)"? See Discussion. | Final diagnosis states: Right breast, excisional bx with findings most consistent with intraductal papillary carcinoma (neuroendocrine DCIS). The path micro states: the morphologic features are those of a neuroendrocrine-type tumor & IHC stains confirm neuroendocrine differentiation. | For cases diagnosed 2007 or later, assign code 8503/2 [Intraductal papillary carcinoma] using Breast rule H2. Code the histology from the final diagnosis. There is no code for neuroendocrine DCIS in ICD-O-3. |
2009 |
|
20091045 | CS Tumor Size/CS Site Specific Factor--Breast: When tumor size is unknown, but it is known that both in situ and invasive components are present, how should CS Tumor Size and SSF6 be coded? See Discussion. | We coded CS Tumor Size 990 and SSF 6 to 060 for a case in which no tumor size was mentioned and the breast core biopsy identified microinvasive infiltrating lobular carcinoma and lobular carcinoma insitu. The lumpectomy identified no residual tumor. SEER edit 218 states we must have CS Tumor Size as 999 if the CS SSF 6 is 060. Yet the tumor size code of 990 (Microinvasion; microscopic focus or foci only, no size given; described as less than 1 mm) would more accurately reflect this case. Even in a situation where there was microinvasion described as less than 1mm, the edit will not allow one to code CS Tumor Size to 990 with the CS SSF 6 as 060. Should these types of cases have CS Tumor Size coded 999 or should the edit be adjusted to allow for this combination? | 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 CS tumor size 990 [Microinvasion; microscopic focus or foci only, no size given; described as less than 1 mm] and CS SSF6 050 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated AND proportions of in situ and invasive not known].
This combination of codes captures the information available for this case. |
2009 |
|
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 |
|
20091066 | Multiplicity Counter--Lung: How is this field coded when there is no evidence of the primary tumor? See Discussion. | Patient presented with large mediastinal mass. CT showed no intraparenchymal lung tumor. Biopsy of mediastinal mass revealed adenocarcinoma consistent with lung primary. | Code Multiplicity Counter to code 99 [Unknown]. | 2009 |
|
20091102 | MP/H Rules/Histology--Thyroid: How should histology be coded for a diagnosis of "papillary sclerosing carcinoma" with an additional description of the tumor being "nonencapsulated"? See Discussion. | Pathology report reads, "Papillary sclerosing carcinoma." In one case, the results are in CAP protocol format and next to 'Encapsulation of tumor' it says 'No.' In the other case, it is not in CAP format, but the microscopic description says, 'encapsulation of tumor - no.' Is the correct code 8350? | For cases diagnosed 2007 or later, code 8350 [Nonencapsulated sclerosing carcinoma] per MP/H Other Sites Rule H11. The definition for 8350 in the Morphology section of ICD-O-3 includes nonencapsulated as well as diffuse sclerosing papillary carcinoma. When the pathologist states 'No' for encapsulated, that means nonencapsulated. | 2009 |
|
20091111 | Grade--Breast: How is this field coded for an "invasive ductal carcinoma, well differentiated, low nuclear grade"? | Assign code 1 [Grade 1, well differentiated]. Use the table in the 2007 SEER Manual on page C-607. Both "low grade" and "well differentiated" are coded 1 in the grade field. | 2009 | |
|
20091052 | Multiple Primaries--Lymphoma: How many primaries should be reported when a left tonsil biopsy is diagnosed with marginal zone lymphoma (9699) and a cervical lymph node biopsy is diagnosed with marginal zone lymphoma and grade 3 follicular lymphoma (9699 and 9698)? | For cases diagnosed prior to 1/1/2010: Abstract two primaries: The first is a marginal zone lymphoma of tonsil and the second is a follicular lymphoma of cervical lymph node. According to the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases (the tri-fold chart), marginal zone lymphoma (9699) and follicular lymphoma (9698) are different primaries.
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 | |
|
20091058 | MP/H Rules/Histology--Kidney: How is histology coded when it is described in the pathology report as "Histologic type: Clear cell (conventional) renal cell carcinoma. Percent of sarcomatoid component: 10%"? See Discussion. | MP/H rules for kidney, Table 1 lists both clear cell and sarcomatoid as specific types of renal cell carcinoma. The MP/H terms and definitions for kidney state that clear cell is architecturally diverse. For this case, does the sarcomatoid component represent a subtype of clear cell that has not been assigned an ICD-O code, and thus histology should be coded to 8310? Or does the sarcomatoid component represent a specific type of renal cell carcinoma for which rule H6 would apply? Should histology be coded 8255 for this case? | For cases diagnosed 2007 or later, assign code 8310 [clear cell adenocarcinoma] according to rule H5. Renal cell, clear cell and sarcomatoid are mentioned in the diagnosis. Sarcomatoid is referred to as a component. Component is not one of the terms listed in rule H5 that indicate a more specific type. Ignore sarcomatoid in this case. Use table 1 to identify clear cell as a specific renal cell type. Code the specific type (clear cell) according to rule H5. | 2009 |
|
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 |
|
20091089 | Histology--Hematopoietic: How is histology coded for a "chronic lymphocytic leukemia with plasmacytic differentiation"? | For cases diagnosed prior to 1/1/2010:Assign histology code 9823/3 [Chronic lymphocytic leukemia]. Plasmacytic differentiation does not indicate a plasma cell or plasmacytic leukemia. 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 |