System Guide
Back to Search Results

Search Results

Display Options
Display Options
Select Fields
Export Results to CSV Create Report 0
+ Add all results to report

Report Produced: 09/08/2024 19:19 PM

Report Question ID Question Discussion Answer Year
20130121 Reportability--Heme & Lymphoid Neoplasms: Is "early essential thrombocythemia" reportable? See Discussion. The bone marrow biopsy diagnosis was, "Combined bone marrow morphologic, flow cytometric, immunohistochemical, molecular and cytogenetic findings are most consistent with early or evolving essential thrombocythemia with low level JAK2 V617F mutation documented on molecular testing." The physician is calling this a benign process. Is this reportable as essential thrombocythemia? Are the terms early or evolving ignored? Does the presence of a JAK2 mutation make this reportable? Without JAK2 testing is this case reportable?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Yes, this is a reportable case. The histology is coded to 9962/3 [essential thrombocythemia]. The positive JAK2 mutation testing and bone marrow biopsy results taken together support the diagnosis of essential thrombocythemia in this case.

In the Abstractor Notes section of the Heme DB, it indicates that only 50-60 percent of patients with essential thrombocythemia will have a positive JAK2 mutation. A diagnosis of essential thrombocythemia can still be made in the absence of a JAK2 mutation. For example, if the bone marrow biopsy final diagnosis or a physician's clinical diagnosis is essential thrombocythemia, despite a negative JAK2 mutation test, the neoplasm is still reportable.

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
20130210

Primary site--Heme & Lymphoid Neoplasms: Does Rule PH27 apply meaning that primary site is coded to C809 or would it be more appropriate to code to C269 GI Tract NOS since all disease involves the GI tract and this is more specific?

Extranodal lymphoma first diagnosed in the stomach (fundus and antrum) which upon further investigation also involved the small bowel (MALT Lymphoma) in the absence of lymph node findings. MD staged this IIE. Initial thought was Gastric, but PET/CT indicated abnormal uptake involving loop of distended small bowel in the pelvis.

Assign C269 for Gastrointestinal tract, NOS. Apply Rule PH24, code to the organ when only an organ is involved. This rule can be used for NOS sites such as GI tract, NOS.

Based on the information provided, this lymphoma is confined to the GI tract -- stomach and small bowel.

2013
20130105

Primary Site--Heme & Lymphoid Neoplasms: How is the primary site coded for a B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma when a biopsy of the paraspinal muscle and epidural tissue is positive, but there is no indication of lymph node involvement in the chart?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the primary site to soft tissue of the back, NOS [C496] per Rule PH24 and the Abstractor Notes in the Heme DB for B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma.

Code the primary site to the organ when lymphoma is present only in an organ. The lesion is described as epidural (tissue surrounding the dura) and involving paraspinal muscle, NOS. Both are connective or other soft tissues of the trunk, NOS [C496].

B-cell lymphoma intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma is a synonym for DLBCL 9680/3. When there is no primary site listed in the Heme DB, go to the Abstractor Notes. In the Abstractor Notes section it states that patients present with lymphadenopathy OR mass lesions in extranodal sites.

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
20130150

MP/H Rules/Histology--Bladder: What is the histology code histology code for a bladder TUR that demonstrates mixed invasive urothelial and small cell carcinoma? See Discussion.

SINQ 20041104 (prior to 2007 MP/H rules) states to code histology to 8045. The MP/H rules do not address this combination of urothelial and small cell carcinoma. The current MP/H rule that applies is Rule H8, code the higher histology (8120/3). However, if the histology is coded to 8120/3, the fact that small cell carcinoma exists will be lost. If the small cell carcinoma drives the treatment plan/prognosis, shouldn't this situation be reflected in the rules for coding histology?

Code the histology to 8045/3 [mixed small cell carcinoma]. The presence of small cell carcinoma drives the treatment decisions for this case.

This issue will be addressed in the next revision of the MP/H rules.

2013
20130067 Histology--Heme & Lymphoid Neoplasms: How is histology coded for a pathology report final diagnosis of diffuse large B-cell lymphoma (50%) and follicular lymphoma, 3A (50%)?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the histology to diffuse large B-cell lymphoma [9680/3] per Rule PH11.

Code the histology to 9680/3 [diffuse large B-cell lymphoma] when DLBCL and any other non-Hodgkin lymphoma (follicular lymphoma, grade 3 in this case) are present in the same anatomic location. DLBCL is coded because it is the more aggressive histology.

NOTE: This answer assumes these two histologies are present simultaneously in the same anatomic location. Per Rule M4, this is a single primary.

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
20130096 Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded for a mantle cell lymphoma found in the sigmoid colon on colonoscopy with biopsy?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the primary site to the sigmoid colon [C187] per Rule PH24. Code the primary site to the organ when lymphoma is present only in an organ. Based on the information provided, the lymphoma is present only in the sigmoid colon.

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
20130142

Multiple primaries/Histology--Heme & Lymphoid Neoplasms: How many primaries are reported if a 2010 inguinal lymph node biopsy diagnosis of follicular lymphoma, grade 1 is subsequently diagnosed in 2012 with a 50% follicular, grade 3 and 50% diffuse large B-cell via a biopsy of an axillary mass?

In 2010 a left inguinal lymph node biopsy revealed follicular lymphoma, grade 1. There were no other suspicious lymph nodes in the body.

In 2012 a biopsy of a large axillary mass revealed a a 50% follicular, grade 3 and 50% diffuse large B-cell.

According to the rules, the transformation to a B-cell is new primary. Is the mixed cell neoplasm a single primary?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

There are two reportable primaries for this case -- follicular lymphoma in 2010 and DLBCL in 2012.

First determine the histologies needed to to determine the number of primaries to report. We determined the histologies are follicular lymphoma, grade 1 for 2010 and DLBCL for 2012 as follows:

  •  
  • Rule M4, a mix of DBLCL and follicular lymphoma, grade 3 is a single primary when two or more types of non-Hodgkin lymphoma are simultaneously present in the same anatomic location(s), such as the same lymph node or lymph node region(s), the same organ(s), and/or the same tissue(s). Additionally, the instruction per Rule PH11 indicates one is to code the histology to diffuse large B-cell lymphoma (DLBCL) (9680/3) when DLBCL and any other non-Hodgkin lymphoma (i.e., follicular lymphoma, grade 3) are present in the same lymph node(s), lymph node region(s), organ(s), tissue(s) or bone marrow.

Per the Hematopoietic database, follicular lymphoma (all types are chronic) transforms to DLBCL (acute). Per Rule M 10 instructions, "Abstract as multiple primaries when a neoplasm is as a neoplasm there is a of an neoplasm after the chronic diagnosis." Therefore, abstract the DLBCL as a second primary.

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
20130088 Grade--Heme & Lymphoid Neoplasms: Should Grade be coded to 5 [T-cell] or 9 [cell type not determined, not stated, not applicable] for anaplastic large cell lymphoma, NOS [9714/3]? See Discussion.

Under the Grade section in the Heme DB for anaplastic large cell lymphoma, NOS it indicates the following:

"Grade - Code grade specified by pathologist. If no grade specified, code 9."

There is no reference in the Grade section that we should look at the Abstractor Notes or a specific Module in the Heme DB for additional information. However, in the Abstractor Notes section it states, "Grade is T-cell (5) unless pathologist specifically designates as a B-cell (see G2 rule)." These two statements are conflicting. Which is the correct grade?

Assign code 5 [T-cell] for anaplastic large cell lymphoma [9714/3] unless the pathologist specifies that the histology is a B-cell disease process. See Grade rule G2, Note 2.

In the Heme DB, there is a default value in the Grade field for histologies that do not have a grade specified. However, this particular histology does not default to code 9. There was an error in the Grade section of the 2010 and 2012 versions of Heme DB that has now been corrected in the latest release.

2013
20130219 Date of diagnosis/Ambiguous terminology--Breast: Can a mammogram BIRADS 4 or 5 assessment be used to assess reportability and can the date of the mammogram be used to code the date of diagnosis? See Discussion.

  1. Assessment: BIRADS category 4-suspicious. Findings are considered suspicious/indeterminate for malignancy

  • Assessment: BIRADS 5- highly suspicious. Findings are highly suggestive of malignancy.

  • Assessment: BIRADS 4- suspicious abnormality consider biopsy

    • Can the BIRADS number be used to assess reportability? Can a BIRADS assessment of "suspicious" be used to code the date of diagnosis?

    		BIRADS category 4 and category 5 mammograms are not to be interpreted as a reportable "malignancy" for cancer registry purposes nor are they to be used to code the date of diagnosis should the patient subsequently have a malignancy confirmed. 2013
    		20130191 Systemic/Surgery Sequence--Bladder: How is the systemic treatment/surgery sequence field coded for a 2013 case if the patient has a TURBT followed by multi-agent chemotherapy, and then a cystoprostatectomy followed by post-operative multi-agent chemotherapy? For cases diagnosed in 2012 and later, code 7 (surgery both before and after systemic therapy) seems like the most appropriate answer. However, previous SINQ entries 20091055 and 20071102 have conflicting answers regarding surgery before and after systemic therapy. Do these SINQ entries apply to a 2013 diagnosis? Would the systemic treatment/surgery sequence be coded 7 because this patient had surgery then chemotherapy followed by more surgery? Should the post-operative systemic treatment be ignored in coding the sequence in this case?

    Code the Systemic/Surgery Sequence to 7 [surgery both before and after systemic therapy] for this case.

    The answers to SINQ 20091055 and 20071102 do not apply to a case diagnosed in 2013. These answers were posted prior to code 7 becoming effective in 2012.

    		2013