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Report Produced: 12/19/2025 03:48 AM

Report Question ID Question Discussion Answer Year
20010110 Grade, Differentiation--All Sites: Should we take the grade from a TNM staging form over a grade stated in a pathology report when the grade mentioned on the TNM staging form is a higher grade (e.g., Pathology report diagnosis is moderately differentiated adenocarcinoma, Gleason's 3+3=6, but the physician checked "poorly differentiated" on the TNM form)? Code the Grade, Differentiation field to 2 [moderatley differentiated]. Code from the pathology report over the TNM staging form. If you do not have access to the path report, use the grade from the TNM form. 2001
20010073 EOD-Extension--Bladder: Both papillary transitional cell ca in situ and sessile (flat) transitional cell ca in situ are diagnosed simultaneously in the bladder. We code the higher histology (8130/2). For extension, do we use the code that corresponds to the histology (01), or to the higher extension code (06)?

For cases diagnosed between 1998-2003:

Code the EOD-Extension field to 06 [sessile (flat) (solid) carcinoma in situ], the higher extension code.

 2001
20010117 Grade, Differentiation--Prostate: Has SEER officially changed the conversion code for Gleason score 7 to poorly differentiated [grade 3]?

For cases diagnosed prior to 2003, there has been no change in SEER standards for converting a Gleason score to a grade. As described in the SEER Program Code Manual, Gleason score 7 is converted to moderately differentiated [grade 2]. ONLY if the pathology report lists moderately poorly differentiated IN ADDITION to the Gleason's score 7, would you code the case as 3.

For cases diagnosed in 2003 and later, please see question number 20031123.

 2001
20010022 Grade, Differentiation--Bladder: Some pathologists use a two component grade system for bladder carcinomas - either low grade or high grade. Should we continue to code these per SEER rules as grades 2 [low grade] and 4 [high grade]? See discussion. The AFIP website states that this low grade classification corresponds to grade 1/3, while the high grade corresponds to both grade 2/3 and grade 3/3. Using the 3-grade conversion, this would also classify the low grade as grade 2, but would leave the high grade as a toss-up between grade 3 and grade 4. Continue to code Grade, Differentiation as specified in the SEER Program Code Manual: "Low grade" is coded to 2 and "high grade" is coded to 4. 2001
20010128 Multiple Primaries (Pre-2007)--Bladder/Prostatic Urethra: When invasive TCC of the bladder and TCC in-situ of the prostatic urethra are diagnosed at the same time, are they reportable as two primaries? See discussion. There is no direct extension of tumor from the bladder to the urethra. According to the SEER rules for determining separate primaries, bladder (C67) and urethra (C68) are separate sites. However, it seems that TCC in the bladder and urethra should be reported as a single primary.

For tumors diagnosed prior to 2007:

This is one primary. Mucosal spread of in situ cancer from a hollow organ (bladder) into another hollow organ (prostatic urethra) is coded as a single primary.

This type of mucosal spread of tumor is sometimes referred to as "intramucosal extension" or " in situ component extending to." Mucosal spread can also be expressed as a statement of an invasive component in one organ with adjacent or associated in situ carcinoma in a contiguous organ with the same type of epithelium.

This case represents an invasive bladder tumor with in situ extension to the prostatic urethra. A tumor that is breaking down can be invasive in the center with in situ cancer at its margins. Occasionally, the in situ margin can move into a contiguous organ with the same type of epithelium.

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.

 2001
20010124 First Course Treatment: What code is used to represent each treatment modality field when there is no indication that a particular modality of treatment was recommended or started? Code the individual treatment fields to 0 or 00 [None] when the modality is not addressed in the treatment plan (or when a treatment plan is lacking) and there is no indication that a particular modality of treatment was recommended or started. 2001
20010097 Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma with abundant mucin production"? See discussion.

If the diagnosis is adenocarcinoma with a mucinous focus, we code as 8140/3. However, when there is abundant mucin production, do we use 8480/3?

See SINQ #20010075: "The tumor must contain at least 50% mucinous, mucin producing, or signet ring to be coded to the specific histology. "

For tumors diagnosed prior to 2007:

Code the Histology field to 8481/3 [mucin-producing adenocarcinoma] if the diagnosis states "adenoca with abundant mucin production". Assume that the term "abundant" represents a term that implies > 50% of the tumor is mucin producing.

When a pathologist makes a diagnosis of mucin-producing adenocarcinoma, the pathologist has determined that more than 50% of the tumor is mucin-producing, so it is unnecessary for the abstractor/coder to look for additional supporting documentation.

If the pathologist states adenocarcinoma "with mucin production," look for a statement about the percentage or amount of mucin production, such as "abundant" or other wording indicating extensive mucin production. If such a statement or wording is present, code 8481/3 [mucin-producing adenocarcinoma]. If not present, code 8140/3 [adenocarcinoma, NOS].

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.

2001
20010135 Histology--CLL/SLL: If a tissue diagnosis of "small lymphocytic lymphoma" is made six months after an initial blood diagnosis of "chronic lymphocytic leukemia" should the histology be updated from 9823/3 to 9670/3?

For cases diagnosed prior to 1/1/2010:Do not change the histology to small lymphocytic lymphoma (9670/3). The chronic lymphocytic leukemia has advanced/progressed and disseminated into other tissues from the blood during the last six months. If the patient presents with disease in the blood and/or bone marrow only, code to CLL. If a lymph node or other solid tissue is involved initially, code to SLL. For the case cited, the tissue involvement occurred six months after the initial diagnosis and the histology code is not changed to reflect the progression of disease.

For cases diagnosed 2010 forward, 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.

 2001
20010116 EOD-Size of Primary Tumor--Corpus Uteri: If both the width and depth of the tumor are provided, do we code the largest dimension in the tumor size field? If the width dimension is not provided, can we code the depth of the tumor in the tumor size field? See discussion. Example: An endometrial primary is described as having, "a soft lobulated tumor diffusely involving the entire endometrium, extending 2.0 cm into the myometrium."

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 999 [unknown] for this case because this field is supposed to reflect the dimension for tumor width and not tumor depth. Tumor depth is coded in the EOD-Extension field.

 2001
20010161 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Prostate: Radical prostatectomy reveals two distinct tumors. One is "adenocarcinoma with ductal differentiation" and the other is "adenocarcinoma with acinar differentiation." What code is used to represent the histology and how many primaries does the patient have?

For tumors diagnosed 2001-2006:

This is one primary. Code the Histology field to 8255/3 [adenocarcinoma with mixed subtypes] based on rule A of the Coding Complex Morphologic Diagnoses. This is code was added in the ICD-O-3.

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.

 2001