Report | Question ID | Question | Discussion | Answer | Year |
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20130188 | Reportability--Heme & Lymphoid Neoplasms: Is plasma cell neoplasm reportable? See Discussion. | A previously submitted question in 2012 stated this was reportable, but recent answers seem to indicate this is not reportable. Please clarify whether this is reportable or not. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Plasma cell neoplasm is not reportable.
We apologize for the confusion that this has caused. The term "plasma cell neoplasm" was not included in the 2010 Heme DB and Manual. It was added to the 2012 Heme DB and Manual after repeated questions were received regarding this diagnosis. After further investigation, this term is being removed from the Manual and DB.
According to WHO, 'Plasma cell neoplasm' is an umbrella term that includes MGUS, plasma cell myeloma, solitary plasmacytoma of bone, immunoglobulin deposition diseases, extraosseous plasmacytoma, and osteosclerotic myeloma. Of these, only plasma cell myeloma, solitary plasmacytoma of bone, and extraosseous plasmacytoma are reportable. Physicians may use the term 'plasma cell neoplasm' when they are not sure what the specific disease is. Plasma cell neoplasm is not reportable; however, follow up on these types of patients is recommended because continued evaluation is likely to determine a more specific disease. A reportable neoplasm may be diagnosed at a later date.
Cases of plasma cell neoplasm diagnosed 2010 or later are not reportable. This change should not have taken place as a result of the update in the 2012 Manual. At this time SEER is not requiring registries to go back and review plasmacytoma or multiple myeloma cases that were collected based on this terminology.
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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20130218 | 2013 | |||
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20130195 | Laterality--Heme & Lymphoid Neoplasms: Is laterality coded to 0 [not paired] for all lymphoma cases including paired sites (e.g., breast, lung)? | Laterality coding for lymphomas is based on the primary site not histology. Laterality describes the side of a paired organ or side of the body on which the reportable tumor originated. Determine whether laterality should be coded for each primary.
Laterality coding instructions are located in the SEER Program Coding and Staging Manual. See pages 68-70 in the 2013 manual, http://www.seer.cancer.gov/manuals/2013/SPCSM_2013_maindoc.pdf. |
2013 | |
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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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20130030 | Histology--Heme & Lymphoid Neoplasms: How is histology coded for a patient diagnosed with diffuse large B-cell lymphoma, immunoblastic [9684/3] in 2009 and a recurrence in 2010 at another facility was referred to as plasmablastic lymphoma [9735/3]? See Discussion. |
Which code is correct for the merged record? Is code 9735/3 [plasmablastic lymphoma] correct because code 9684/3 [DLBCL, immunoblastic] is now obsolete? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. This case was originally diagnosed in 2009, prior to the development of Hematopoietic Database. Therefore it is necessary to use the ICD-O-3 to code histology to 9684/3 [diffuse large B-cell lymphoma, immunoblastic]. Use the original histology diagnosed for the merged record because DLBCL, immunoblastic, and plasmablastic lymphoma are the same primary. Do not change the histology to code 9735/3 [plasmablastic 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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20130050 | Multiple Primaries/Primary site/Histology--Heme & Lymphoid Neoplasms: How many primaries are accessioned and what is the primary site and histology for each if a 6/12/12 left shoulder mass specimen suspicious for large B-cell lymphoma is followed on 7/10/12 with three skin nodules excised from the back with a diagnosis of "composite lymphoma? See Discussion. | 6/12/12 Excisional biopsy left shoulder soft tissue mass: Suspicious for large B-cell lymphoma.
7/10/12 Excisional biopsy three skin nodules of back: "Composite lymphoma" - primary cutaneous anaplastic large cell lymphoma (CD3 pos, CD4 pos, CD30 pos, ALK neg with partial loss of CD5) and CONCURRENT cutaneous follicular center lymphoma (CD20 pos, PAX5 pos, BCL-6 pos, partially CD10 pos) and flow cytometry revealed results compatible with involvement by a lymphoproliferative disorder of T-cell lineage.
Per imaging performed, there was no involvement of lymph nodes or other organs.
Is the primary site C449 Skin, NOS and histology 9718/3 [Lymphoma, primary cutaneous anaplastic large cell] be correct? |
Code primary site to C445 [skin, back] and histology to 9718/3 [cutaneous anaplastic large cell lymphoma] .
Per Rule M6, abstract a single primary when two or more types of non-Hodgkin lymphoma are simultaneously present in the same anatomic location. For this case, there is cutaneous follicular (follicle) center lymphoma (9597/3) and cutaneous anaplastic large cell lymphoma (9718/3).
Per Rule PH22, code the primary site to the site or origin (skin, back) and the histology to the NHL with the numerically highest ICD-O-3 code. In this case, that would be 9718/3. |
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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20130215 | Reportability--Heme & Lymphoid Neoplasms: Is hemophagocytic lymphohistiocytosis synonymous with an EBV-associated lymphoproliferative disorder in children reportable? See Discussion. |
Pathology report states: Prominent T-cell infiltrate with frequent immunoblast-like cells. COMMENT: Findings consistent with an acute EBV-associated hemophagocytic process. In addition, there is a prominent CD8 + T-cell infiltrate with many large, activated forms. This T-cell process may represent an EBV-associated lymphoproliferative disorder in children. EBV-associated lymphoproliferative disorder in children is listed in the Heme database. However, throughout multiple admissions, the oncologist states the diagnosis as "hemophagocytic lymphohistiocytosis". Are the two the same condition? The patient is being treated with Etoposide. |
Per Appendix F, do not report this case based on the information provided. The oncologist likely used the pathology report and clinical factors to determine the diagnosis of hemophagocytic lymphohistiocytosis, which is not reportable. Hemophagocytic lymphohistiocytosis is caused by an over stimulated immune system (infection, etc.). This clinical syndrome is associated with a variety of underlying conditions. To be reportable, it must state "fulminant hemophagocytic syndrome" (in a child) to be reportable (9724/3). The pathology report for this case is not definitive. It states that the process "may" represent the EBV-associated lymphoproliferative disorder in children. Follow back on this case to confirm reportability if possible. |
2013 |
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20140065 | Summary Stage 2000--Melanoma: How should Summary Stage 2000 be coded for 2014+ diagnosed melanoma cases with satellite nodules or in transit metastases? See discussion. |
The SEER SS (SSS) 2000 Manual indicates satellite nodules (NOS or less than/equal to 2cm from primary tumor) are regional by direct extension (code 2) and in-transit metastasis (satellite nodules greater than 2 cm from primary tumor) are coded as involvement of regional lymph nodes (code 3). However, CSv0205 indicates mapping for satellite nodules/in transit metastasis (coded in CS LN) was changed to Regional, NOS (code 5). There are no definitions listed for code 5 in the SSS 2000 Manual.
Our staff independently code SSS 2000. Should we code the existence of satellite nodules and in transit metastases according to the current definitions in the SSS 2000 Manual or using the mapping information from CSv0205? |
Code the existence of satellite nodules and in transit metastases according to the current definitions in the SSS 2000 Manual. Do not use the mapping information from CS to code SSS. |
2014 |
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20140027 | MP/H Rules/Histology--Bladder: What is the correct histology for the following bladder case and how do you determine? See discussion. |
8/1/10 CYSTOSCOPY -- MULTIPLE BLADDER TUMORS INVOLVING POSTERIOR WALL, DOME & BLADDER NECK AREA. LARGEST WOULD BE MORE THAN 5 CM IN SIZE. 8/17/10 path -- BLADDER TUMORS:PAPILLARY TRANSITIONAL CELL CARCINOMA OF urinary bladder, GRADE III. ONE FRAGMENT OF TISSUE SHOWS NECROTIC CHANGE WITH APPARENT TRANSFORMATION TO A HIGH GRADE SARCOMATOID VARIANT W ITH EXTENSIVE SUBMUCOSAL INVASION & FOCAL AREA SUGGESTIVE OF ANGIOLYMPHATIC INVASION NOTED. MAJORITY OF TUMOR APPEARS CONFINED TO MUCOSAL SURFACE W ITH NO OTHER AREAS OF DEFINITIVE SUBMUCOSAL INVASION FOUND. |
Code 8122/3 (UC/TCC, Sarcomatoid). Rule H5 and Table 1 apply.
This is based on the information provided: Transitional Cell Carcinoma with sarcomatoid variant, and Table 1 in Terms and Definitions for "Ureter/Renal Pelvis/Bladder". |
2014 |