SEER Inquiry System - Search

Assign 8503/3, intraductal papillary adenocarcinoma with invasion, to capture the more specific features of the adenocarcinoma. Histology Rule H13 for Other Sites states to code the most specific histologic term. Examples include Adenocarcinoma and a more specific adenocarcinoma. Note: The specific histology may be identified as type, subtype, predominantly, with features of, major, or with ___ differentiation.

Both histologic plus immunophenotyping or genetic testing should be positive to assign code 3 for Diagnostic Confirmation. The Hematopoietic and Lymphoid Neoplasm Coding Manual Diagnostic Confirmation instructions state, assign 3 for

Cases positive for neoplasm being abstracted (including acceptable ambiguous terminology and

provisional diagnosis) AND Immunophenotyping, genetic testing, or JAK2 is listed in the Definitive Diagnosis in the Heme DB AND a.) Confirms the neoplasm OR b.) Identifies a more specific histology (not preceded by ambiguous terminology).

Because the patient was diagnosed with DLBCL by histology, and flow cytometry was positive for CD antigens (immunophenotyping) 20, 22, and 30 for DLBCL, code 3 is appropriate.

We recommend coding endometrium, C541, as the primary site for this case. While coding to fundus would not be incorrect, according to our expert pathologist consultant, "it is more appropriate in a setting in which the region of the uterus is of importance, e.g. with a myoma or a myosarcoma, or if the endometrioid carcinoma were NOT in the endometrium but arising in a focus of adenomyosis within the fundic myometrium."

Code primary osteosarcoma of the breast to breast, C500-C509. Not all site and histology combinations can be staged in CS or AJCC. 9180/3 of breast cannot be staged using the CS breast schema. Breast (C500-C509) cannot be staged using the CS soft tissue schema. The same is true for AJCC. You can stage this case using SEER Summary Stage.

Important: Do NOT change the primary site or histology code based on whether or not the case can be CS or AJCC staged. We need to know how many cases are unable to be staged because of their primary site and histology combinations.

The 2016 diagnosis is the same primary. MP/H Rule M10 for breast cancer applies. Do not change the original histology code. Use text fields to document the later histologic type -- duct and lobular.

The most appropriate available topography code is C681, paraurethral gland. Skene's gland is also referred to as paraurethral gland.

Code the histology based on the pathology report from the lymph node biopsy for this case. Pathology has higher priority than a physician's statement for assigning histology code. Use text fields to document the physician's statement.

Code the histology to renal cell carcinoma, NOS (8312/3). While WHO lists succinate dehydrogenase-deficient renal cell carcinoma in the latest edition, no specific histology code is provided. MP/H Rule H10 applies since only one histology type is provided, though no code is listed.

Assign code 9983/3 refractory anemia with excess blasts. Refractory anemia is a type of myelodyplastic syndrome. We will add this to the Heme & Lymphoid database during the next update.

For now, report the case and code to 8310/3.

In the 3rd Ed WHO Tumors of the Urinary System, multilocular clear cell RCC is coded as 8310/3, however the recent 4th Ed WHO Tumors of Urinary System notes this term is obsolete and a synonym for multilocular cystic renal neoplasm of low malignant potential (8316/1) which would be non-reportable. Per WHO 3rd Ed these tumors never recur or metastasize which may be why the behavior code is shown as /1. The standard setters must review this terminology change in relation to reporting the case as it may impact incidence rates.