Report | Question ID | Question | Discussion | Answer | Year |
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20130066 | Multiple primaries--Heme & Lymphoid Neoplasms (Lymphoma): How many primaries are accessioned when a patient is diagnosed in 2003 with diffuse large B-cell lymphoma on an inguinal lymph node biopsy followed by a 2012 diagnosis of diffuse large B-cell lymphoma on a cervical lymph node biopsy? See Discussion. |
The only documentation in the record is that there is a history of DLBCL. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. Accession a single primary, diffuse large B-cell lymphoma [9680/3] diagnosed in 2003 per Rule M2. Abstract a single primary when there is a single histology. Per Rule M2, Note 2, a recurrence of the same histology is always a single primary (timing is not relevant). SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |
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20130058 | Reportability--Heme & Lymphoid Neoplasms: Is EBV-positive hemophagocytic lymphohistiocytosis (HLH) reportable when diagnosed in a 5 year old child and resulted in death in less than two months? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Hemophagocytic lymphohistiocytosis (HLH) is not a reportable disease because it is not listed in the Heme DB.
Per our expert pathologist consultant, "HLH is a lymphocyte driven hemophagocytic syndrome which may be either genetically based or caused by over-activated lymphoid cells, often in response to a viral infection. It is an abnormal immune response and is not considered a malignant disease, and is, therefore, not reportable. It is not synonymous with EBV-positive T-cell lymphoproliferative disease of childhood (9724/3)."
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 | |
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20130065 | Histology--Heme & Lymphoid Neoplasms: Should the higher histology code associated with grade 1 follicular lymphoma [9695/3] be used rather than grade 2 follicular lymphoma [9691/3] in cases of follicular lymphoma grade 1-2? | Code histology to 9691/3 [follicular lymphoma, grade 2], histology. For follicular lymphoma, when there is a grade such as 1-2 indicated, take the histology associated with the higher grade disease process, even though the lower grade histology code is higher. | 2013 | |
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20130125 | Reportability--Heme & Lymphoid Neoplasms: Is self-healing Langerhans cell histiocytosis (LCH) of the skin reportable? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This is a reportable primary. Langerhans cell histiocytosis (LCH) [9751/3] is a reportable neoplasm.
The term "self-healing" means that the neoplasm regressed without treatment. This is a known phenomenon.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 | |
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20130187 | Reportability: Is a clinically diagnosed Stage III malignant thymoma reportable when the post-neoadjuvant resection showed spindle cell thymoma? See Discussion. | A thymoma is described by the medical oncologist at the time of the initial diagnosis as a malignant thymoma, Stage III. The patient had neoadjuvant CAP chemotherapy followed by a resection. Following the resection, the pathologist stated the diagnosis was spindle cell thymoma. | A malignant thymoma is reportable. Based on the information provided, a reportable diagnosis (malignant thymoma) was made by a physician and the patient was treated for this diagnosis. Because there is no mention of the initial diagnosis being amended based on the resection specimen's pathology report, assume the initial diagnosis is still valid. | 2013 |
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20130186 | Grade: Can the FIGO grade be used to code the morphologic grade? See discussion. |
FIGO Grade is coded in CS SSF 7 in the Corpus Uteri schema. The SEER Manual does not address using FIGO grade for coding grade in morphology. |
Do not use FIGO grade to code the grade field. See the sentence below the table in Instruction #6 in the Grade Coding Instructions for cases diagnosed 2014 and later, http://seer.cancer.gov/tools/grade/ |
2013 |
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20130054 | MP/H Rules/Multiple primaries--Lung: How many primaries are accessioned if a lobectomy has two tumors that are both stated to be adenocarcinoma but the pathologist states they are synchronous primaries? See Discussion. | Left upper lung lobectomy: Adenocarcinoma, poorly-differentiated (grade 3), tumor size 1.2 cm, confined to lung. Second primary lung tumor: adenocarcinoma, well-differentiated (grade 1), tumor size 0.9 cm, confined to lung. Diagnosis COMMENT: The two tumors, although both adenocarcinoma, show markedly different histologies and thus are classified as synchronous primaries. Multiple synchronous primaries are staged separately according to the 7th edition of AJCC.
The AJCC Staging Manual 7th ed states, "Multiple tumors may be considered to be synchronous primaries if they are of different histological cell types. When multiple tumors are of the same cell type, they should only be considered to be synchronous primary tumors if, in the opinion of the pathologist, based on features such as ..., they represent different subtypes of the same histologic cell type..."
In this case, the pathologist insists these are two synchronous primaries, although different subtypes are not given, because the tumors have different grades and look completely different under the microscope. The MP/H rules indicate this is a single primary. How many primaries are accessioned? |
For cases diagnosed 2007 or later, accession a single primary, adenocarcinoma [8140/3] of the left upper lobe lung [C341]. The steps used to arrive at this decision are:
Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Lung MP rules because site specific rules exist for this primary.
Start at the MULTIPLE TUMORS module, rule M3. The rules are intended to be reviewed in consecutive order within a module. The patient has two tumors in the same lung with the same histology.
Do not use the AJCC Manual to make multiple primary decisions. Use the MP/H Rules to determine the number of primaries to accession. |
2013 |
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20130062 | Date of diagnosis--Heme & Lymphoid Neoplasms: Should the diagnosis date be coded to the date of the flow cytometry on the peripheral blood or the date of the bone marrow biopsy for a diagnosis of chronic lymphocytic leukemia/low grade B-cell lymphoma? See Discussion. | Is a flow cytometry on peripheral blood alone diagnostic of a hematopoietic malignancy (CLL)? If not, when the diagnosis is verified by a subsequent histologic diagnosis (bone marrow biopsy) would the diagnosis date be the date of the peripheral blood flow cytometry or the date of the bone marrow biopsy? The Class of Case depends on this diagnosis date. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the diagnosis date to the date of the peripheral blood flow cytometry because this is a procedure used to diagnose CLL. Per both the Abstractor Notes and the Definitive Diagnostic Methods sections in the Heme DB, CLL is diagnosed by flow cytometry (immunophenotyping).
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |
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20130124 | Reportability--Heme & Lymphoid Neoplasms: Is Rosai-Dorfman's syndrome (histiocytosis) a reportable malignant condition? | Rosai-Dorfman disease is not reportable. Rosai-Dorfman disease is a rare non-neoplastic disease. This disease can mimic lymphoma and extranodal involvement is frequent. | 2013 | |
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20130109 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2004 diagnosis of acute myeloid leukemia is followed by a 2013 diagnosis of myeloid sarcoma? See Discussion. |
Patient was diagnosed in 2004 with acute myeloid leukemia [9861/3] and treated with chemotherapy and transplant. Now the patient has a biopsy of an umbilical mass that is positive for myeloid sarcoma (granulocytic sarcoma) [9930/3]. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Accession a single primary, acute myeloid leukemia [9861/3] diagnosed in 2004 per Rule M3.
When there is a myeloid sarcoma diagnosed simultaneously or after a leukemia of the same lineage, it is a single primary. The myeloid sarcoma is actually caused by the AML progressing. The myeloid cells in the bone marrow or blood literally "seep out" and implant in the tissue.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |