| Report | Question ID | Question | Discussion | Answer | Year |
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20021055 | EOD-Extension--Liver: Can we use CT scan descriptions such as "portal vein thrombosis" or "extensive infiltration of the liver" or "diffuse infiltration of the liver" to code extension for liver primaries? See discussion. | 1. Would you code portal vein involvement for a CT scan description of "portal vein thrombosis"?
2. Would you code more than one lobe of the liver as involved for CT scan descriptions of "extensive infiltration of the liver" or "diffuse infiltration of the liver"? |
For cases diagnosed 1998-2003:
1. No. Thrombosis can be caused by non-cancerous conditions.
2. Yes. Code the EOD-Extension field to 65 [Multiple (satellite) nodules in more than one lobe of the liver] when "extensive infiltration" or "diffuse infiltration" is stated. |
2002 |
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20021190 | Histology (Pre-2007)--Bladder: What code is used to represent the histology "transitional cell and small cell carcinoma" of the bladder? See discussion. | Code 8045/3 is used for combination codes that represent a mixture of small cell carcinoma and any other carcinoma. When we use this histology code for bladder primaries with mixed transitional cell and small cell carcinoma, we encounter a problem with the SEER edits (site and morphology conflict). | For tumors diagnosed prior to 2007:
Please see SEER Inquiry question ID number 20041104.
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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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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20021158 | Multiple Primaries/Histology--Lymphoma: What is the primary site(s) for a patient who had a lymph node biopsy with the histology of "large B cell lymphoma arising in the setting of low grade B cell lymphoma c/w marginal zone B cell lymphoma with plasmacytic features"? See discussion. | This patient also had a bone marrow biopsy that demonstrated "low grade B cell lymphoma." Per the clinician, "Pt with discordant lymphoma. We will be approaching his lymphoma as two different diseases. The large B cell had cleared after chemotherapy and radiation therapy. The low grade lymphoma is incurable." | For cases diagnosed prior to 1/1/2010: Code as two primaries with each arising in lymph nodes [C77._]. The histology for the first primary is 9699/3 [marginal zone B cell lymphoma]. The histology for the second primary is 9680/3 [large B cell lymphoma]. 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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20021013 | Histology (Pre-2007)--Breast: What code is used for histology "tubular carcinoma with lobular carcinoma in situ"? | For tumors diagnosed prior to 2007:
Assign code 8211/3 [Tubular carcinoma]. According to histology rule #2 for a single tumor on page 86 of the 2004 SEER manual, code the invasive histology when both invasive and in situ tumor are present.
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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20020031 | Multiple Primaries--Hematopoietic, NOS: When the SEER Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table indicates that a disease is not a new primary, but a pathologist or clinician states that it is a new primary, do we use the physician information or the table? | For cases diagnosed prior to 1/1/2010:If the physician clearly states that this is a new primary, submit it as a new primary. Otherwise, use the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table.
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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20021045 | Histology/Grade, Differentiation--Lymphoma: What code is used to represent the histology "high grade malignant lymphoma with features of so called blastic NK cell cutaneous lymphoma [hematodermic lymphoma]" found on punch biopsy? | For cases diagnosed prior to 1/1/2010:Code the Histology field to 9709/3 [cutaneous lymphoma, NOS]. Code the Grade, Differentiation field to 8 [NK cell]. 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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20020044 | Terminology/EOD-Extension--Prostate: How does SEER define the prostatic "apex"? See discussion. |
Some pathologists define the prostatic apex as including the bottom third of the prostate whereas others regard only the bottom-most portion of the gland to be the apex. |
SEER defines the apex as being the bottom-most portion of the gland. Apex means "narrowest part," which in the prostate would be the bottom-most portion of the gland. |
2002 |
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20021117 | Multiple Primaries (Pre-2007)--Bladder/Prostatic Urethra: Is the prostatic urethra a new primary for a case with a history of recurrent noninvasive bladder cancer that was subsequently diagnosed with transitional cell carcinoma in situ of the prostatic urethra and had a subsequent clinical diagnosis of "refractory bladder carcinoma"? | For tumors diagnosed prior to 2007:
If the histology of the bladder primary is "transitional cell carcinoma" or "papillary transitional cell carcinoma," do not code the prostatic urethra as a new primary. This is probably a case of intraluminal (mucosal) spread of the original tumor, rather than separate primaries. The clinical diagnosis supports this view.
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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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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