Report | Question ID | Question | Discussion | Answer | Year |
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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 | |
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20130002 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned, and what is the year of diagnosis, when the patient was initially diagnosed with poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell [9591/3] in 1991, followed by multiple recurrences and transformations? See Discussion. |
5/1991 Left groin biopsy: Poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell [9591/3]. Subsequently, the patient had multiple recurrences. 7/1/08 Left axillary biopsy: Disease transformed to malignant lymphoma, large B-cell and a small focus of follicular lymphoma. Patient was followed until there was no evidence of disease. 4/22/10 Left axillary biopsy: Recurrence of follicular lymphoma, grade 1. No large cell component was found. The bone marrow biopsy was negative for lymphoma. The patient was on observation. 11/02/10 MD note indicates the disease progressed to follicular lymphoma, grade 3. No large cell component was identified. The patient clinically has no evidence of disease on maintenance Rituxan. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case should be accessioned as a single primary, non-Hodgkin lymphoma (previously called poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell) [9591/3] diagnosed in 1991. Determining the number of primaries is based on the rules in effect at the time of each diagnosis. The original lymphoma was diagnosed in 1991 and the first transformation to follicular lymphoma in 2008. The pre-2010 rules for coding histology and determining multiple primaries must be applied first because the rules changed for diagnoses occurring 2010 or later. Per the Single Versus Subsequent Primaries Table, poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell [9591/3] is the same primary as follicular lymphoma [9690]. The Heme DB and Manual are used to confirm that the 2010 recurrences of follicular lymphoma, grade 1 [9695/3], and follicular lymphoma, grade 3 [9698/3], are the same primary according to the Heme Calculator check required per Rule M15. Per the Heme DB page, the diagnoses follicular lymphoma, grade 3 [9698/3] and follicular lymphoma, grade 1 [9695/3] are comparable to follicular lymphoma [9690] as stated in the section. 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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20130008 | Primary site--Kidney, renal pelvis: Should primary site be coded C809 [unknown] or C649 [kidney] when a patient is diagnosed with renal cell carcinoma in a transplanted kidney? | Code the primary site to C649 [kidney]. Per the SEER Manual, code the site where the neoplasm originated. There are no separate instructions for coding primary site for transplanted organs. This patient's renal cell carcinoma originated in the kidney [C649]. | 2013 | |
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20130178 | Reportability--Heme & Lymphoid Neoplasms: Is refractory iron deficiency anemia reportable? | Per Appendix F, refractory iron deficiency anemia is not reportable. It is not a clonal disorder and, therefore, is not malignant. Refractory iron deficiency anemia is a condition that is unresponsive to oral iron treatment. | 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 | |
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20130061 | Histology--Heme & Lymphoid Neoplasms: How is the histology coded for "post-transplant lymphoproliferative disorder (diffuse large B-cell lymphoma)"? | 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 PH1. Code the histology as 9680/3 [DLBCL], the histology of the accompanying lymphoma, when the diagnosis is PTLD and any B-cell lymphoma.
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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20130060 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned for a diagnosis of bilateral extranodal orbital lymphoma when the same histology is present in both orbits? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case should be accessioned as a single primary lymphoma of bilateral orbits per Rule M2. Abstract a single primary when there is a single histology. Both orbits showed the same histology. Note 1 for Rule M2 states bilateral involvement of lymph nodes and/or organs 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 | |
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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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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 | |
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20130082 | Ambiguous terminology/Histology--Heme & Lymphoid Neoplasms: How is histology coded when a skin of lip pathology report demonstrates neoplastic lymphoid infiltrate with small B cells, compatible with B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia? See Discussion. | Ambiguous terminology is not used to code histology. What is the correct histology for this case? There was no other clinical statement from the physician regarding the histology following the release of the pathology report diagnosis. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the histology to 9823/3 [chronic lymphocytic leukemia/small lymphocytic lymphoma]. This primary was accessioned based on reportable ambiguous terminology. The surgical pathology report was compatible with B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia, "compatible with" is a reportable ambiguous term. A neoplastic lymphoid infiltrate is not a reportable diagnosis. Therefore, a diagnosis compatible with CLL/SLL is coded as histology code 9823/3.
The statement that you do not use ambiguous terms to code histology is intended for those NOS histologies with an ambiguous term being used to describe the subtype.
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 |