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| Report | Question ID | Question | Discussion | Answer | Year |
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20130005 | Reportability--Brain and CNS: Are spinal schwannomas and neurofibromas reportable or non-reportable? | The most accurate and most current instruction is to report these spinal tumors when they arise within the spinal dura or spinal nerve roots, or when they are stated to be "intradural" or "of the nerve root." Do not report these tumors when they arise in the peripheral nerves. The peripheral nerves are the portion of nerve extending beyond the spinal dura. | 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. |
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20130183 | Reportability--Heme & Lymphoid Neoplasms: Is a peripheral blood finding consistent with involvement by monoclonal, lambda-restricted mature B cell population with co-expression of CD5 and CD23 reportable if, immunophenotypically, the case is consistent with a chronic lymphocytic leukemia/small lymphocytic lymphoma? See Discussion. |
Peripheral blood: Final diagnosis: Leukocytosis absolute lymphocytosis monoclonal, lambda restricted B-cell population w/co-expression of CD5 and CD23 absolute increase in CD4=helper T cells. See comment. Comment: Peripheral blood findings are consistent with involvement by monoclonal, lambda-restricted mature B cell population with co-expression of CD5 and CD23, which is immunophenotypically consistent with a chronic lymphocytic leukemia/small lymphocytic lymphoma immunophenotype. However, the absolute monoclonal population is only 3.02k/ul. According to WHO criteria, in the absence of extramedullary tissue involvement, the monoclonal lymphocyte population must be greater than or equal to 5.0 k/ul. Therefore, in the absence of clinical evidence of extramedullary tissue involvement, the diagnosis is most consistent with a monoclonal B cell lymphocytosis. Review of initial analysis reveals well-defined groups of cells within lymphocyte, monocyte and granulocyte gates as defined by CD45 and sid-scatter characteristics (%'s are listed). Overall, peripheral blood findings are consistent with involvement by monoclonal, lambada-restricted B cell population with a chronic lymphocytic leukemia/small lymphocytic lymphoma immunophenotype. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case is reportable. Code histology to 9823/3 [CLL/SLL]. Ambiguous terminology is used to accession cases (determine reportability) because it has been used for over 30 years to do so. Any deviation from using ambiguous terminology to determine case reportability would cause the reporting of incidence counts to vary. In this case, there was a reportable, ambiguous terminology diagnosis on peripheral blood that is "consistent with" involvement by chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) immunophenotype. The ambiguous terminology "consistent with" in the flow cytometry report is acceptable to determine reportability. Given that it is the only reportable histology mentioned in the scenario, it is also used to code histology. The instruction "Do not code histology based on ambiguous terminology" is intended to be used when there is a reportable NOS histology and reportable more specific histology stated in the diagnosis. Ambiguous terminology cannot be used to report the more specific diagnosis in cases of Heme & Lymphoid neoplasms. 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. |
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20130097 | Reportability--Heme & Lymphoid Neoplasms: Are either heparin-induced thrombocytopenia or heparin-induced thrombocytopenia that becomes refractory thrombocytopenia reportable? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Heparin-induced thrombocytopenia is not reportable.
If the diagnosis is changed to refractory thrombocytopenia, then this case is 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. |
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20130113 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a patient diagnosed and treated for multiple myeloma is subsequently diagnosed with multiple large plasmacytomas involving the scalp and thorax? See Discussion |
The patient was diagnosed with multiple myeloma, underwent treatment and subsequently was in remission. The patient later presented with lesions on the scalp and thorax lesions. The final diagnosis on the pathology report for the scalp lesion was multiple myeloma with plasmablastic transformation (high grade). The physician states this is an aggressive, recurrent multiple myeloma with multiple large plasmacytomas involving the scalp and thorax. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. Accession a single primary, multiple myeloma [9732/3] per Rule M2. The multiple myeloma is in an advanced stage when plasma cells are being deposited on the scalp and thorax. Clinically, those plasma cells are rightly called plasmacytomas by the physician. However, the patient has a late-stage multiple myeloma causing the plasma cells/plasmacytomas. Note that under the myeloma Recurrence and Metastases section of the Heme DB it indicates that extramedullary involvement (e.g., the scalp and thorax involvement) usually indicates advanced disease. Therefore, this scenario represents a case of a single histology that is accessioned as a single primary per Rule M2. 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. |
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20130201 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are reported for a patient with a 6/5/12 RUL biopsy that is positive for MALT lymphoma and a 6/7/12 cervical lymph node biopsy that is positive for follicular lymphoma? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Per Rule M15, abstract two primaries for this case. According to M15, use the Heme DB Multiple Primaries Calculator to determine the number of primaries for all cases that do not meet the criteria of M1-M14. The result is two primaries, MALT lymphoma [9699/3] and follicular cell lymphoma [9690/3].
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. |
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20130120 | Primary site--Heme & Lymphoid Neoplasms: What is the primary site for a Langerhans cell Sarcoma of the lower extremity? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
If the bone is involved, code the primary site to bone. Langerhans more commonly starts in the bone and extends to the soft tissue.
If bone is not involved, code primary site to C492, Connective, subcutaneous and other soft tissues of lower limb and hip.
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. |
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20130156 | Other therapy--Heme and Lymphoid Neoplasms: Based on the hematopoietic manual instructions, is plasmapheresis coded as treatment for Waldenstrom macroglobulinemia? See Discussion. | A patient, who was diagnosed with Waldenstrom macroglobulinemia at another facility, presented to our facility for plasmapheresis on 12/27/2012. No other treatment was given.
How is the plasmapheresis coded for treatment? |
Do not code plasmapheresis as treatment. It does not modify the neoplasm. | 2013 |
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20130206 | Primary site--Heme & Lymphoid Neoplasms: What rule applies to code a primary site for a peripheral blood diagnosis of marginal zone lymphoma that has a positive flow cytometry/FISH analysis when no biopsies are performed, scans show no evidence of disease, exam indicates no lymph nodes are palpable and the physician's clinical diagnosis "marginal zone lymphoma, unspecified site, stage 1"? See Discussion. | PE: No palpable lymph nodes.
PET scan: No spleen or lymph node uptake; no uptake anywhere in the body.
Peripheral blood and flow cytometry/FISH analysis diagnosis: Marginal zone lymphoma.
No bone marrow or biopsy of any lymph nodes done. Doctor states "marginal zone lymphoma, unspecified site, stage 1." |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Per Rule PH27, code the primary site to C809 [unknown primary]. According to Rule PH27 one is to code the primary site to unknown primary site C809 when there is no evidence of lymphoma in lymph nodes AND the physician documents in the medical record that he/she suspects that the lymphoma originates in an organ(s) OR multiple organ involvement without any nodal involvement.
If further workup is done and a primary site is determined, update the primary site for this case.
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. |
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20130084 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient is diagnosed on a 3/16/12 lymph node biopsy with diffuse large B-cell lymphoma which was followed on 4/18/12 with bone marrow biopsy diagnosis of follicular lymphoma? See Discussion. | The patient has extensive right-sided cervical, supraclavicular, hilar, mediastinal and gastrohepatic adenopathy. A cervical node biopsy on 3/16/2012 showed DLBCL. On 04/18/2012 a bone marrow biopsy showed follicular lymphoma. The patient was started on CHOP/Rituxan after the bone marrow biopsy. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case is accessioned as a single primary, diffuse large B-cell lymphoma [9680/3] per Rule M12. Abstract the acute neoplasm (DLBCL) when a patient is originally diagnosed with an acute neoplasm and the neoplasm reverts to the chronic neoplasm (follicular lymphoma) AND the patient has not been treated for the acute neoplasm.
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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