| Report | Question ID | Question | Discussion | Answer | Cancer Site Category | Data Item Category | Year |
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20220030 | Histology--Lung: Is it acceptable to code histology as 8042/3 for a 2020 lung primary when the pathology report states only "oat cell carcinoma?" See Discussion. |
In the old 2007 Multiple Primaries/Histology rules, Lung Equivalent Terms and Definitions section, oat cell carcinoma (8042) was listed as one of the obsolete terms that was no longer recognized for small cell carcinoma. That note is not in the current 2018 Solid Tumor Manual lung chapter, and ICDO-3.2 lists oat cell carcinoma as the preferred term for code 8042/3. Would rule H4, Note 2 apply -- only one histology present, if not listed in Table 3 use ICD-O and all updates, to code oat cell carcinoma as 8042/3? |
While oat cell carcinoma is an outdated term, if that is all the pathology report states, code histology as 8042/3. Yes, Rule H4 applies: the diagnosis was a single histology. H4 instructs you to refer to the solid tumor H table, and if the term is not found there, check ICD-O and ICD-O updates. All possible histologic types that could occur in the lung may not be included in the table. |
Lung | Histology | 2022 |
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20220029 | Histology/Behavior--GI Tract: What is the difference between high grade dysplasia and severe dysplasia for tumors in the cervix and gastrointestinal (GI) tract? Are these terms synonymous with in situ/behavior code /2? See Discussion. |
In the WHO Classification of Female Genital Tumors, 5th edition, for the uterine cervix squamous intraepithelial lesions, there is related terminology for high grade squamous intraepithelial lesion HSIL (CIN3) 8077/2 and it is severe squamous dysplasia; squamous cell in situ. However, in the online WHO Classification of Digestive System Tumors, 5th edition, there is no related terminology for esophageal high-grade squamous dysplasia, 8077/2. Can you collect cases of severe dysplasia the same as cases of high grade dysplasia? |
According to a leading GI pathologist, severe dysplasia is equivalent to high grade dysplasia in the GI tract. |
N/A | Behavior, Histology | 2022 |
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20220028 | Reportability/EOD Primary Tumor--Ovary: Bilateral ovary shows gonadoblastoma with germ cell neoplasia in situ (9064/2). Pathology report clearly states in situ. Is this case reportable? If this case is reportable, how would you code Extent of Disease (EOD) Primary Tumor and SEER Summary Stage (SS)? In situ code 000 for primary tumor and code 0 for SS 2018 is not given as an option. |
Report germ cell neoplasia in situ (9064/2). Assign 999 for EOD Primary Tumor and assign 9 for SS2018. This particular histology is in the Soft Tissue Abdomen and Thoracic schema where EOD PT 000 and SS2018 0 are not available. This histology will be moved to the Ovary schema after redefining certain schemas and thus making the more accurate choices for EOD and SS2018 available. The schema redefine is planned for 2024 implementation. |
Ovary | EOD Primary Tumor | 2022 | |
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20220022 | Tumor Size--Pathologic--Anus: In 2019, the pathology report of an anal canal squamous cell carcinoma stated the tumor size is 2.5 cm from proximal to distal (3.5 cm in circumference). Is the pathologic tumor size tumor size 025 or 035? |
Based on the information provided, code the tumor size as 035. We asked an expert pathologist to review this question and she said to use the larger measurement. She also said "the pathologist usually cuts the anus and rectum open like a tube; the “circumference” would be measured flat." |
N/A | Tumor size | 2022 | |
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20220018 | Solid Tumor Rules/Histology--Thyroid: What is the correct histology code for the following thyroid primary with multiple tumors abstracted as one primary diagnosed prior to 2021? See Discussion. |
2016 Total thyroidectomy, Multifocal -Dominant Tumor: Right Lobe, Papillary thyroid carcinoma (8260/3) -Tumors two through five: Three tumors Papillary thyroid carcinoma (8260/3), and one tumor Papillary thyroid carcinoma, follicular variant (8340/3) -An additional tumor: Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (8343/2) |
Code this multifocal thyroid carcinoma, single primary, as papillary thyroid carcinoma, follicular variant (8340/3) using Solid Tumor Rules, Other Sites, Rule H13 that says to code the most specific histologic term. We consulted with our endocrine specialty pathologist and when there is a mix of papillary and follicular variants, assign 8340. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features is coded as 8349/1 beginning in 2021. According to the WHO Classification of Endocrine Organs, 4th edition, it was formerly classified as non-invasive encapsulated follicular variant of PTC (FVPTC) (8343/2) but was reclassified based on extremely low malignant potential. |
Thyroid | Histology | 2022 |
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20220017 | Histology--Thyroid: What is the correct histology code for a thyroid resection showing papillary carcinoma, tall cell variant with oncocytic features with 30% of largest tumor (right) is tall cell variant and both foci contain benign multinucleated giant cells? See Discussion. |
There is an ICD-O histology code for papillary carcinoma, tall cell (8344/3) as well as papillary carcinoma, oxyphilic cell (8342/3). Per SINQ 20150045, the term oncocytic is synonymous with oxyphilic in this context. The term “variant” can be used for the Other Sites (non-updated STR sites) primaries when the ICD-O-3.2 (or ICD-O-3 for older cases) includes the term “variant” in the histology name. The MPH General Instructions did not include the term “variant” as a term that can be used to code histology. |
Code papillary carcinoma, tall cell variant with oncocytic features to papillary carcinoma, tall cell (C73.9) (8344/3). The WHO Classification of Endocrine Organs states that this variant is composed of cells that are as tall as they are wide, and show abundant eosinophilic (oncocytic-like) cytoplasm. Tall cells must account for greater than or equal to 30% of all tumor cells. |
Thyroid | Histology | 2022 |
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20220036 | Solid Tumors Rules/Histology--Head and Neck: How is histology coded for head and neck primaries when a tumor is diagnosed as an invasive squamous cell carcinoma with multiple subtypes? See Discussion. |
Example Case 1: 2022 mobile tongue tumor biopsy shows squamous cell carcinoma, basaloid non-keratinizing type. Example Case 2: 2022 base of tongue mass biopsy shows squamous cell carcinoma, basaloid non-keratinizing type, p16 positive. Table 5, Note 2 (Head and Neck Equivalent Terms and Definitions) instructs us to code non-keratinizing squamous cell carcinoma which is p16 positive to 8085 (Squamous cell carcinoma HPV-positive), ignoring the non-keratinizing subtype. Does p16 or HPV positivity also take priority over multiple subtypes (basaloid non-keratinizing type)? |
Assign 8083/3, basaloid squamous cell carcinoma (BSCC), in both examples. It is more important to capture the variant than to code 8085 or 8086. WHO Classification of Head and Neck Tumors, 5th ed., states that BSCC is a distinctive form of SCC, characterized by prominent basaloid morphology, squamous differentiation, and aggressive behavior. Some primary sites capture p16 status as a Site Specific Data Item; you may record the p16 results when that is the case. |
Head & Neck | Histology | 2022 |
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20220033 | When coding the Covid testing results, does SEER have any guidance on whether or not at home tests fall within reportability? For instance, if a medical provider says pt tested positive on an at home test, do we record that? |
When you have information about home COVID tests, record this information. For example, if the home test was positive record as follows: COVID-19 rapid viral antigen test POS 08/09/2022 |
N/A | N/A | 2022 | |
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20220012 | EOD 2018/Regional Nodes--Corpus Uteri: Are lymph nodes found on imaging post-surgery included in Extent of Disease (EOD) Regional Nodes if surgery is already completed? See Discussion. |
11/16/20: Patient diagnosed with endometrial cancer on by MRI of the pelvis; 11.5 cm uterine mass consistent with cancer with no lymphadenopathy. 1/6/21: Patient had a total abdominal hysterectomy/bilateral salpingo-oophorectomy and pelvic lymph node dissection. Operative report stated patient had mildly enlarged bilateral pelvic nodes. Path report: Endometrioid adenocarcinoma with invasion of the serosa. Five bilateral pelvic nodes were sampled and negative. Originally, staging had patient as node negative. 1/22/21: Patient had post op imaging done that showed metastatic retroperitoneal, aortocaval, and possibly left iliac lymph nodes. Physician changed staging to include the lymph node involvement. |
EOD includes all information available within four months of diagnosis in the absence of disease progression or upon completion of surgery(ies) in first course of treatment, whichever is longer. Since the imaging was within the four-month window, and the nodes could have been positive during surgery but not assessed by the surgeon, use the information from the imaging. Assign code 600 for EOD Regional Nodes for involvement of the aortocaval and retroperitoneal nodes (para-aortic nodes), size unknown. |
Corpus uteri | EOD Regional Nodes | 2022 |
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20220011 | Reportability/Ambiguous Terminology: When the only source of information states the diagnosis as two terms, one reportable and one non-reportable, separated by a "slash" (/), should we report the case using the reportable term? See Discussion. |
For example: -ultrasound of the right eye: consistent with a nevoma/melanoma; we could not find any indication that nevoma is a reportable term -bladder biopsy pathology report: severe urothelial dysplasia/carcinoma in situ (CIS) As a central registry, we receive some limited information cases like this where there is no record of treatment or possibility to follow-back to physicians for clarification, so we want to make sure we are reporting them correctly. |
If possible, try to obtain further information. If no further information can be obtained, accession the case using the reportable term, melanoma and CIS in the respective examples, when there is a single report in which both reportable and non-reportable diagnostic terms are listed with a slash and there is no other information. Most often, the slash indicates the terms are being used synonymously. |
N/A | N/A | 2022 |
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