| Report | Question ID | Question | Discussion | Answer | Year |
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20021036 | EOD-Extension--Urinary Tract: Can the rules used to code bladder extension involving the term "no involvement of muscularis/and no mention of subepithelium/submuscosa" be used to code extension for other urinary tract primaries, such as ureter? | For cases diagnosed 1998-2003:
No. The inferred descriptions of noninvasion apply to bladder cases only. |
2002 | |
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20021050 | EOD-Extension--Pancreas: If the tumor involvement for a case falls between two different regional extension codes, should we code to the lesser of the two codes or should we code extension as unknown? See discussion. | Example 1: CT scan description: Mass in the head of the pancreas. The duodenum is "surrounded" by tumor. Should we code extension to 40 [peripancreatic tissue extension, NOS] or 99 [unknown] because the extension code could be further than 40. It could be 44 [extension to duodenum].
Example 2: CT scan description: Mass in region of pancreatic head and "root" of superior mesenteric artery consistent with pancreatic cancer. Should we code extension to 40 [peripancreatic tissue extension, NOS] or 99 [unknown] because the extension code could be further than 40? It could be 54 [extension to major blood vessels]. |
For cases diagnosed 1998-2003:
In both examples, code the EOD-Extension field to 40 [peripancreatic tissue extension, NOS]. Choose the lowest of a known possible extension code over an unknown code. |
2002 |
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20020053 | EOD-Extension--Meninges: How do you code extension for a malignant meningioma that invades into the adjacent brain tissue? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 60. Code 60 is defined as a brain tumor that extends into the meninges. It is also the appropriate code to use for a tumor that extends from the meninges to the brain. |
2002 | |
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20021165 | EOD-Size of Primary Tumor--All Sites: Is there a hierarchy for using information from clinical tests (scans, radiography) to determine clinical tumor size? When the size on a radiographic report prior to pathologic diagnosis is smaller than the size of the tumor on the radiographic report that is post pathologic diagnosis, which tumor size should be used? See discussion. | Which size should be used for these examples? 1) Tumor size on a mammogram is smaller than the tumor size on an ultrasound. 2) CT of the lung reveals a 2.5 cm RUL malignancy in June. A biopsy in July confirms a malignancy. A CT is done in August prior to initiating RT which reveals a 3.1 cm RUL nodule. |
For cases diagnosed 1998-2003:
Generally, code the EOD-Size of Primary Tumor field to the largest size identified in any scan. Use the largest tumor size for most cases. There is no hierarchy for multiple imaging studies, with the exception of the two situations represented in the question examples. 1). Code the size stated on the mammogram, even if that size is smaller than the one specified on the ultrasound. Generally the mammogram size is more accurate for breast cases than ultrasound. 2). Code the EOD-Size of Primary Tumor field to 2.5 cm. In this example, the second scan was the same type as the first. Usually there is not that much of a difference in size between the same tests, unless the tumor has an aggressive histology. The example does not mention the histology. With certain histologies, such as small cell of the lung, a rapid growth in a short amount of time is the normal process. The fact that the size increased that much in a short period of time, using the same type of scan, is an indication of a rapidly growing tumor. It would be better to use the size on the initial scan to code the EOD-Size of Primary Tumor. |
2002 |
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20021213 | Reportability/Behavior Code--Bone Marrow: Is T-cell large granular lymphocytic leukemia SEER reportable? Pages 102, 147, 156, 160-162 and 167 of the ICD-O-3 list it as 9831/1, but on page 17 this is listed as 9831/3. | For cases diagnosed prior to 1/1/2010:T-cell large granular lymphocytic leukemia [9831] is a very indolent form of leukemia. It was assigned a behavior code of 1 by the editors of ICD-O-3 (as noted on pages 102, 147, 156 160-162, and 167 of the ICD-O-3 manual). The table on page 17 is the World Health Organization list of hematopoietic and lymphoid tumors. WHO recognizes TCLGLL as a malignancy. The disease is infrequently symptomatic enough to be diagnosed. However, when any of the terms listed with code 9831 are described as malignant or aggressive, report to SEER as a malignancy with a behavior code of /3. For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2002 | |
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20020009 | EOD-Extension--Lymphoma: What code is used to represent this field for a lymphoma that involves the spleen and lymph nodes above the diaphragm (e.g., involvement of only the spleen below the diaphragm and cervical lymph nodes above the diaphragm)? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 32 [30 + involvement of the spleen; III S]. The spleen is counted twice (once as the spleen and a second time as a lymph node region below the diaphragm). As a result, the EOD-Extension field is coded to reflect involvement of lymph node regions on both sides of the diaphragm plus involvement of the spleen. See Note 1 on the EOD scheme that states "Any lymphatic structure is to be coded the same as a lymph node region." |
2002 | |
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20020059 | Grade, Differentiation: Can a FIGO grade be coded in this field or is the FIGO grading system to be used only for EOD/Stage coding? |
This answer pertains to cases prior to 2014. For cases diagnosed 2014 and forward, see http://seer.cancer.gov/tools/grade/
Do not use FIGO grade to code differentiation.
FIGO grade is something completely different from FIGO stage. FIGO stage is used to code EOD. FIGO grade is based on the percentage of non-squamous (i.e., solid) portions of the tumor and corresponds roughly to a three grade differentiation system: grade I, well differentiated (=<5% solid component); grade II, moderately differentiated (>5 - 50% solid); and grade III, poorly differentiated (> 50% solid). SEER is evaluating whether the ICD-O-3 6th digit differentiation codes (four grade categories) accurately represent the FIGO grade. For the time being, do not code FIGO grade.
For a diagnosis that includes commonly used differentiation term with a FIGO grade, such as "Moderately differentiated, FIGO grade II," disregard the FIGO grade and code the Grade, Differentiation field according to the term "Moderately differentiated." |
2002 | |
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20021025 | Histology: What code is used to represent the histology "endometrioid adenocarcinoma, villoglandular type"? | Assign code 8262/3 [Villous adenocarcinoma]. According to the WHO Classification of Tumours, Breast and Female Genital Organs (2003), villoglandular is one of four variants of endometroid adenocarcinoma. The corresponding ICD-O-3 code according to WHO is 8262/3. |
2002 | |
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20021034 | Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma in a tubulovillous adenoma with a mucinous component, the mucinous component is less than 50%"? See discussion. | For mucinous only, the tumor must contain at least 50% mucinous to be coded to the specific histology. | For tumors diagnosed prior to 2007:
Code the Histology field to 8263/3 [adenocarcinoma in a tubulovillous adenoma]. Because the mucinous component involves less than 50% of the tumor, the histology is not coded to mucinous. For mucinous only, the tumor must be at least 50% mucinous, mucin producing, to be coded to the specific histology.
For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules. |
2002 |
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20021207 | EOD-Lymph Nodes--Breast: How do you code this field when the gross description on the pathology report states "nodal tissue is matted" but only 1/18 lymph nodes is found to contain micrometastatsis per the microscopic description of the report? | For cases diagnosed 1998-2003:
Code the EOD-Lymph Nodes field to 1 [Micrometastasis] because the matted nodal tissue was found to contain only one node with micrometastasis when examined microscopically. Coding priority is given to the microscopic description over the gross description. |
2002 |
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