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: 05/01/2025 02:08 AM

Report Question ID Question Discussion Answer Year
20130212 Reportability--Heme & Lymphoid Neoplasms: Is a case reportable in which the pathology report is negative for plasmacytoma but a subsequent physician's clinical diagnosis is plasmacytoma?

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

This case is reportable if the patient was treated for plasmacytoma. When the physician calls the case plasmacytoma and treats the patient accordingly, report the case.

See Case Reportability Instructions #6: Report the case when there is a clinical diagnosis (physician's statement) of a reportable hematopoietic or lymphoid neoplasm.

Note 1: The clinical diagnosis may be a final diagnosis found within the medical record or recorded on a scan (CT, MRI for example)

Note 2: Report the case even if the diagnostic tests are equivocal. A number of hematopoietic neoplasms are "diagnoses of exclusion" in which the diagnostic tests are equivocal and the physician makes the clinical diagnosis based on the equivocal tests and the clinical picture. See the Heme DB for definitive diagnostic methods for the specific neoplasm being abstracted.

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
20130211 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are reported if a bone marrow shows low grade mature B cell lymphoma with IgM paraprotein - macroglobulinemia? See Discussion.

Physician note: Bone marrow shows 10% involvement with low grade lymphoma. Assessment: Low grade mature B cell lymphoma with IgM paraprotein - macroglobulinemia.

The multiple primaries calculator indicates two primaries are to be reported. However, the physician stated that Waldenstrom's macroglobulinemia is another name for this patient's lymphoma.

There were no enlarged lymph nodes seen on the CT scan. The proposed treatment for this patient is Rituxan for the macroglobulinemia.

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

Per Rule M2, this is a single primary because there is a single histology. The bone marrow initially showed a non-specific B-cell lymphoma. WM is a type of B-cell neoplasm. After immunophenotyping, a more specific histologic diagnosis of WM was made. In this case a single histology (WM) is diagnosed by the definitive diagnostic method (serum paraprotein demonstrating IgM), so it accessioned as a single primary.

Per PH16, code the histology to 9761/3 [Waldenstrom Macroglobulinemia (WM)] and the primary site to C420 [blood].

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
20130157

Primary Site--Heme & Lymphoid Neoplasms: What primary site code should be assigned and what rule justifies that code?

Scenario: Pleural effusion, underwent thoracentesis. Pleural fluid unexpectedly showed Large B-Cell Lymphoma. Extensive workup including CT & PET was done and all findings were within normal limits. No evidence of lymphoma was seen and no palpable adenopathy was found. The only indication of lymphoma was the malignant pleural effusion.

Code to pleura, C384.

Per the Hematopoietic database, Diffuse Large B-Cell Lymphoma can originate in the pleural cavity.

2013
20130015 Reportability--Heme & Lymphoid Neoplasms: Is essential thrombocytopenia reportable? See Discussion. Many times essential thrombocytopenia has been coded based on blood counts. Sometimes the discharge summary states thrombocytosis (NOS), and the case is coded to essential thrombocytopenia. Are these cases reportable?

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

The following are not alternative names for any reportable disease process:

  • Essential thrombocytopenia

  • Reactive thrombocytosis

  • Thrombocythemia

  • Thrombocytopenia

  • Thrombocytosis

    • The diagnosis of essential thrombocythemia is based on blood counts, but is usually a diagnosis made by excluding other myelodysplastic disorders. The following are reportable disease processes:

    • Essential thrombocythemia (9962/3)

  • Essential thrombocytosis (9962/3)

  • Refractory thrombocytopenia (9992/3)

    • 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
    		20130122 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when an excisional biopsy of a chest wall nodule shows diffuse large B-cell lymphoma (40%) and follicular lymphoma, grade 3A (60%)? See Discussion.

    The patient presented with a right chest wall nodule. The PET scan showed widespread disease: subcutaneous nodule/mass in the left scalp and right chest wall; large right paraspinal mass; soft tissue density likely a second early paraspinal mass at the right costovertebral junction; right paravertebral mass; and abnormal bony foci in the right humeral head, right iliac crest, right acetabulum and right femur. The physical exam showed 2 cm left supraclavicular lymphadenopathy and a firm 3 cm mass in the right chest wall. Lungs were clear. Abdomen showed no masses or ascites, and no palpable hepatosplenomegaly.

    Chest wall nodule excisional biopsy pathology: Lymph node and adjacent soft tissue: Malignant lymphoma with components: 1. Diffuse large B-cell lymphoma (40%). 2. Follicular lymphoma, grade 3A (60%). Pathology report note states the diffuse large cell lymphoma is probably arising from the follicular center cell lymphoma.

    Should this be a single primary? There is no mention of cutaneous lymphoma.

    Accession a single primary per Rule M4. Code histology to 9680/3 [diffuse large B-cell lymphoma] per Rule PH11.

    Per Rule M4, accession a single primary when two or more non-Hodgkin lymphomas are present in the same lymph node or organ.

    Per Rule PH11 code the histology to diffuse large B-cell lymphoma (DLBCL) (9680/3) when DLBCL and any other non-Hodgkin lymphoma are present in the same lymph node(s), lymph node region(s), organ(s), tissue(s) or bone marrow.

    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
    		20130003

    MP/H Rules/Histology--Head & Neck: How is the histology coded for a mammary analogue secretory carcinoma (MASC) of the parotid gland? See Discussion.

    There is no histology listed in the ICD-O-3 for a mammary analogue secretory carcinoma. The pathologist stated that, "MASC is a recently described salivary gland tumor type which, as the name implies, resembles secretory carcinoma of the breast." Should the histology be coded 8550/3 [acinar carcinoma] or 8502/3 [secretory carcinoma of breast]?

    Assign code 8502/3 [secretory carcinoma of breast].

    Acinar carcinoma [8550/3] describes a very typical type of salivary gland tumor only. This histology code does not adequately capture the histology in this case which describes a secretory carcinoma that is similar to mammary cancer. Both of these elements are reflected in the histology code 8502/3 [secretory carcinoma of breast].

    		 2013
    		20130182 Primary site--Head and Neck: How is primary site coded if a floor of mouth biopsy reveals microinvasive squamous cell carcinoma but the definitive resection of the tongue and floor of mouth unifocal lesion reveals only in situ squamous cell cancer? See Discussion.

    Patient with overlapping lesion of tongue and floor of mouth. Initial biopsy of floor of mouth reveals microinvasive squamous cell cancer. Definitive resection reveals in situ squamous cell cancer. Pathology report states unifocal tumor. The tumor site on pathology report is documented as involving the tongue and floor of mouth.

    Should the primary site be coded to floor of mouth because it is the site of invasive disease? Or is primary site C148 [overlapping sites of lip, oral cavity and pharynx] because invasion should not be used to determine primary site?

    		Code the primary site to C068 [overlapping lesion of other and unspecified parts of the mouth]. Based on the information provided, this is a tumor described as a "book-leaf" lesion a lesion that overlaps the floor of the mouth and the underside of the tongue. 2013
    		20130077 Reportability--Heme & Lymphoid Neoplasm: What is the histology code if a myeloproliferative disorder is reportable should a physician suspect this diagnosis and treats the patient? See Discussion. Physician suspects patient has a myeloproliferative disorder and treats her with a phlebotomy and Hydrea. Patient receives Hydrea during an inpatient stay, but does not see the Heme/Onc again. The patient is subsequently only seen by a Palliative Medicine physician who also states she has an underlying myeloproliferative disorder. The patient died while an inpatient.

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

    This is a reportable diagnosis and should be accessioned with the histology coded to 9975/3 [myelodysplastic/myeloproliferative neoplasm, unclassifiable].

    The term is a reportable ambiguous term per the Hematopoietic Coding Manual (Case Reportability Instructions, Rule 4). Also, the patient was treated for a myeloproliferative disorder, making this a reportable clinical diagnosis per the SEER Manual (Reportability, Pg 4, Exception 1).

    Myeloproliferative disorder is synonymous with myeloproliferative disease. Myeloproliferative disease is listed as an alternate name for myelodysplastic/myeloproliferative neoplasm, unclassifiable.

    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
    		20130092

    Reportability--Head & Neck: What are the correct site and histology codes if a glomus tympanicum tumor of the middle ear is reportable?

    Glomus tympanicum tumors of the middle ear are not reportable. The 2005 WHO Classification of Head and Neck Tumors classified these tumors as a borderline [/1] behavior and recorded them in the ICD-O-3 with histology code 8690 [glomus jugulare tumor, NOS].

    According to WHO, "the distinction between jugular and tympanic paragangliomas can easily be made in the patient by modern imaging methods ... the jugular neoplasm is identified as arising from the jugular bulb region ... while the tympanic neoplasm is confined to the middle ear." Benign and borderline neoplasms of the middle ear [C301] are not reportable. The middle ear is not a reportable CNS site for benign and borderline tumors.

    		 2013
    		20130155

    Diagnostic confirmation--Heme & Lymphoid Neoplasms: How do we code diagnostic confirmation if the pathology report states the diagnosis of a skin biopsy is "low-grade B cell lymphoma, most compatible with marginal zone lymphoma," genetic data includes positive rearrangement for immunoglobulin heavy chain gene favor a diagnosis of "B cell lymphoma," and the physician's clinical diagnosis is "cutaneous marginal zone lymphoma"?

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

    Code diagnostic confirmation to 3 [positive histology AND positive immunophenotyping studies (9590/3 - 9992/3)].

    Immunoglobulin heavy and light chain genes rearranged is listed under Genetics Data in the Heme DB for 9699/3 [extranodal marginal zone lymphoma]. Given the documentation of this positive genetic finding and the positive bone marrow, code diagnostic confirmation to 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