Report | Question ID | Question | Discussion | Answer | Year |
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20130205 | MP/H Rules/Multiple primaries--Breast: How many primaries are reported and what is the histology for each in a case of infiltrating duct and lobular carcinoma of the breast (8522) with Paget disease of the same breast? | Abstract as two primaries according to rule M12. We interpret this as one tumor with infiltrating duct and lobular carcinoma (8522) and a second tumor with Paget disease (8540). | 2013 | |
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20130193 | Sex: How is sex coded for a transsexual diagnosed with a testicular primary? See Discussion. | The Physical Exam states patient is male. There is a note that the patient is transsexual. There is no indication that the orchiectomy was part of gender reassignment surgery. | Code sex to 1 [male]. When the natal sex is known, code that over transsexual. | 2013 |
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20130199 | MP/H Rules/Multiple primaries--Breast: Does breast Rule M10, 'Tumors that are lobular (8520) and intraductal or duct are a single primary" apply if you have two tumors in the same breast, one ductal and the other tubulolobular (8524) or are they separate primaries per Rule M12? |
Apply Rule M10 to this case. Tubulolobular is now classified as a variant of lobular. Code to lobular, NOS (8520) because Tubulolobular does not have a specific ICD-O-3 code. |
2013 | |
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20130138 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2010 diagnosis of a preleukemic condition is subsequently diagnosed in 2012 with a specific leukemia that is not listed as a transformation? See Discussion. |
10/02/10 bone marrow biopsy showed myelodysplastic syndrome, unclassified [9989/3]. 6/19/12 bone marrow biopsy showed chronic myelomonocytic leukemia (CMML-2) [9945/3]. CMML-2 is not listed as an acute neoplasm for MDS. Is this the same disease? Per the pre-2010 rules, this would be the same disease. The current Heme DB indicates these are separate primaries. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case should be accessioned as two primaries, myelodysplastic syndrome (MDS) [9989/3] diagnosed 10/2/10 and chronic myelomonocytic leukemia (CMML-2) [9945/3] diagnosed 6/19/12 per Rule M15. Per Rule M15, use the Multiple Primaries Calculator when rules M1-M14 do not apply. When myelodysplastic syndrome (MDS) became reportable, the rules in effect at that time resulted in MDS often being the only diagnosis reported when both MDS and a leukemia were diagnosed. Statistics for some leukemias were impacted. Now we report both the MDS and the leukemia for greater accuracy. 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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20130190 | Reportability: Is a thymoma, type B3 malignant and, therefore, reportable? See Discussion. |
Recent information received from a registrar/pathologist states the WHO classifies well-differentiated thymic carcinoma [8585/3] as a synonym for type B3 thymoma. |
For cases diagnosed prior to 2021 Thymoma, type B3 [8585/1] is not reportable. Well-differentiated thymic carcinoma [8585/3] is reportable. WHO lists well-differentiated thymic carcinoma as a synonym for type B3 thymoma, but indicates the behavior code differs as indicated above. See the applicable SEER manual for cases diagnosed 2021 and later. |
2013 |
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20130078 | Ambiguous terminology/Reportability--Heme & Lymphoid Neoplasms: Is a physician diagnosis of "appears to be a myeloproliferative disorder" reportable if the patient has no treatment and the physician elects to follow the patient with CBC's?. |
Yes. This is a reportable diagnosis and should be accessioned with the histology coded to 9975/3 [myelodysplastic/myeloproliferative neoplasm, unclassifiable]. The word is a reportable ambiguous term per the Hematopoietic Coding Manual (Case Reportability Instructions, Rule 4). Myeloproliferative disorder is synonymous with myeloproliferative disease. Myeloproliferative disease is listed as an alternate name for myelodysplastic/myeloproliferative neoplasm, unclassifiable. |
2013 | |
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20130222 | MP/H Rules/Histology--Bladder: How is the histology coded for a single bladder tumor showing invasive urothelial carcinoma with extensive divergent differentiation including small cell carcinoma, micropapillary carcinoma, and squamous cell carcinoma features? See Discussion. | MP/H rules seem to lead to Rule H8 which indicates that one use the numerically higher ICD-O-3 code. If one applies Rule H8, the histology is coded to 8131/3 [micropapillary urothelial carcinoma]. That would ignore the small cell carcinoma, which seems prognostically more significant. | Code the histology to 8045/3 [mixed small cell carcinoma], a combination of small cell with other types of carcinoma. There is currently no rule in the urinary site MP/H Rules for this combination of histologies. This will be included in the next revision of the MP/H Rules. | 2013 |
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20130101 | Reportability--Heme & Lymphoid Neoplasms: Is plasma cell dyscrasia, favor MGUS vs. smoldering myeloma reportable? See Discussion. | The pathology report states, "plasma cell dyscrasia, favor MGUS vs. smoldering myeloma." The patient then died of a heart attack and no further information is available. If this is reportable, what histology code applies? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case is not reportable. Neither plasma cell dyscrasia nor MGUS are reportable. Smoldering myeloma was given as a possible diagnosis, but never confirmed.
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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20130106 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2009 diagnosed Hodgkin lymphoma, nodular sclerosis type is treated and subsequently presents in 2010 with the same diagnosis? See Discussion. | 2009 diagnosis of Hodgkin lymphoma, nodular sclerosis type involved the superior mediastinal nodes, AP window nodes, bilateral axillary nodes and pulmonary nodules. The patient received chemotherapy and went into remission.
Patient presents in 2010 with Hodgkin lymphoma, nodular sclerosing type in the superior mediastinum.
Does timing play any part in determining if this reported as one or two primaries? There is no timing rule in the Heme Manual. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Accession a single primary, Hodgkin lymphoma, nodular sclerosis type [9663/3] diagnosed in 2009 per Rule M2.
Accession a single primary when there is a single histology. Note 2 for Rule M2 indicates timing is not relevant. This is disease progression or recurrence and not a new 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 |
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20130140 | Reportability/Ambiguous terminology--Heme & Lymphoid Neoplasms: Is a peripheral blood sample with an immunophenotype that is "characteristic of B-cell chronic lymphocytic leukemia" reportable? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This is a reportable diagnosis of chronic lymphocytic leukemia [9823/3]. The physician is using the terms "characteristic of" in the same manner as he/she would use the terms "diagnostic of."
This case fits with the usual diagnosis of CLL. The peripheral blood is diagnostic for leukemias. There was a specific leukemia noted, B-cell chronic lymphocytic leukemia. CLL (B-cell is the phenotype) is usually diagnosed incidentally by a peripheral smear because it is asymptomatic. However, we recommend looking for further work-up, such as a bone marrow biopsy.
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 |