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Report Produced: 02/23/2026 05:33 AM

Report Question ID Question Discussion Answer Year
20020035

First Course Treatment--Lymphoma: How should an antibiotic regimen such as bismuth or omeprazole, amoxicillin, and metronidazole be coded for a MALT lymphoma of the stomach associated with Helicobacter pylori infection? See discussion.

If we do not count the antibiotic regimen as cancer-directed treatment but this is the only treatment given and the lymphoma disappears, is it problematic to have a cancer status of "no disease" recorded in a patient that supposedly was not "treated"?

Do not code antibiotic regimens as Cancer-Directed Therapy. These drugs are intended to treat the bacteria and not the cancer. This type of treatment is ancillary even if it is the only type of treatment given. You may designate a user-defined field to capture this information if desired. The coding combination of a cancer status of "no disease" and all treatment fields coded to "no treatment" is allowable.

 2002
20021194

Grade/Histology (Pre-2007)--All Sites: What code is used to represent these fields for the histology "High grade dysplasia (adenocarcinoma in situ)" or "AIN III/High grade AIN"?

For tumors diagnosed prior to 2007:

Code the Histology field for the first example to 8140/2 [Adenocarcinoma, NOS, in situ] and for the second example to 8077/2 [AIN, grade III]. For both of the cases code the Grade, Differentiation field to 9 [Cell type not determined not stated or not applicable]. The 6th digit (grade code) of ICD-O-3 describes how much or how little a malignant tumor resembles the normal tissue from which it arose. In contrast, "grade" is used in the examples above to describe the degree of dysplasia, from mild dysplasia (low grade) to severe dysplasia (high grade). Do not record the degree of dysplasia in the 6th digit grade field.

For tumors diagnosed 2007 or later, refer to the MP/H rules for histology coding instructions. 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
20020020

Multiple Primaries (Pre-2007)--Breast: When two breast tumors with two different histologies, such as duct and mucinous are diagnosed in the same breast at the same time, are they reportable as two primaries? See discussion.

Our rule is that multiple lesions of different histologic types are separate primaries. However, for separate tumors of duct and lobular, we report as a single primary. Since we now have a combination code for duct and other types of ca, do we report as a single primary or continue to report as separate primaries?

For tumors diagnosed prior to 2007:

When there are two breast tumors, one mucinous, the other duct carcinoma, report as two primaries when the pathologist's opinion clearly states that there are separate primaries.

If there is no such information from the pathologist, the two tumors must be separate with clear (negative) margins to be reported as two primaries. Otherwise, report as one primary.

The ICD-O-3 combination codes are not intended to combine tumors of different histologic types.

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
20021060 EOD-Size of Primary Tumor: The EOD Manual instructs us not to code the size of a cyst. Can we code the size of tumor lesions described as being multicystic, multiloculated, or as a complex mass with cystic areas? See discussion.

Example 1: Large multicystic ovarian mass lesion measuring 10 cm. Sections through the specimen show a multicystic and solid mass with abundant fluid exuding from the cut surfaces (Size of the solid portions is not stated).

Example 2: A brain MRI: 9-cm. complex mass with cystic areas.

For cases diagnosed 1998-2003:

Yes, if the cystic mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field based on the size of the mass in the absence of a more precise tumor size description. For the examples in the discussion section, code the EOD-Size of Primary Tumor field to: 1) 100 [10 cm]. 2) 090 [9 cm].

As a point of interest, the size of tumor for ovarian and brain primaries is not used in either analysis or as a prognostic indicator for survival. Therefore, spending time separating the cystic and solid portions of the tumor is unnecessary.

 2002
20021007 Scope of Regional Lymph Node Surgery: If a named regional lymph node is aspirated should this field be coded to 1 [Regional lymph node removed, NOS], as is stated on page 127 of the SEER Program Code Manual, or should this field be coded to a more specific code when that is available (e.g. Lung primary code 3 [Ipsilateral mediastinal and/or subcarinal nodes])? For cases diagnosed 1/1/2003 and after: A generic scheme was created for the Scope of Regional Lymph Node Surgery field. As a result, there no longer are codes available that represent specific named lymph node chains. Code aspiration of a lymph node to 1 [Biopsy or aspiration of regional lymph node, NOS]. 2002
20021204 EOD-Size of Primary Tumor--Cervix: When both a depth and diameter of the tumor are provided and the description of the diameter is provided in a range, how do you code the size of the primary tumor? See discussion.

Path states "microscopic focus of endocervical glands considered invasive adenoca...maximum depth of that focus measures approximately 2 mm. Maximum diameter of that focus measures 3-4 mm."

What size would be coded for this case: 999, 002, 003, or 004?

Code the EOD-Size of Primary Tumor field to 004 [4 mm]. Code the diameter dimension in the EOD-Size of Primary Tumor field and the depth dimension iin the EOD-Extension field. Code the largest number associated if a range is provided for the diameter of the invasive tumor.

If the size of the diameter had not been mentioned, the EOD-Size of Primary Tumor field would have been coded to 001 [microscopic focus or foci only], which ignores the size associated with the depth dimension of the tumor.

 2002
20021059 Surgery of Primary Site--Soft Tissue: What code is used to represent this field when an excisional biopsy of a soft tissue sarcoma is followed two weeks later with a wide excision (re-excision)? For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 26 [partial resection]. According to the CoC, "Excision" in the surgery codes refers to the lesion and "partial resection" refers to the organ. The biopsy is a local excision (code 25). The wide resection is code 26, presuming that more than just the remaining lesion was removed. 2002
20021187

Reportability: When a hospital pathologist sends the slides from an original biopsy to two or more outside reviewers and the reviewers differ on whether or not the case is reportable, is the case SEER reportable? Does the decision to treat the patient have any bearing on whether the case would be reportable?

Typically, the final diagnosis of the reviewing pathologist is the one used to determine whether the case is SEER reportable. If two or more reviewing pathologists disagree as to whether the case should be reportable, determine reportability based on the following priority order:

1) If the patient is treated for cancer, the case is reportable.

2) If the patient is not treated for cancer, use the amended diagnosis on the original pathology report if the hospital pathologist used the reviewing pathologists' opinions in establishing his new diagnosis.

3) If there is not an amended diagnosis for the original hospital pathology report, use the clinician's opinion regarding what the diagnosis is to determine whether the case is reportable.

 2002
20021138 Grade, Differentiation--All Sites: What code is used to represent this field when a pathology report describes a tumor as a low grade neoplasm consistent with a specific histologic type (e.g., Low grade neoplasm consistent with carcinoid)? Code the Grade, Differentiation field to 2 [Low grade]. 2002
20021121 Multiple Primaries (Pre-2007)--Kidney: How many primaries are reportable in a patient treated with a bilateral nephrectomy that revealed multiple tumors within each kidney and the histology in both the left and the right kidney was "renal cell carcinoma, indeterminate type: multiple histologically identical tumors" and the clinical discharge diagnosis was "bilateral renal cell carcinoma, probably surgically cured"? See discussion. The SEER manual states "If only one histologic type is reported and if both sides of a paired site are involved within two months of diagnosis, a determination must be made as to whether the patient has one or two independent primaries." Frequently, the only statement we have is that "bilateral organs are involved." Additional guidelines for determining number of primaries would be helpful.

For tumors diagnosed prior to 2007:

Report this case as two primaries, left and right kidneys. According to our pathologist consultant, "The description sounds like bilateral multiple primaries. Multicentricity in the same kidney occurs in about 4% of all cases, and bilaterality in 0.5 to 3% (Atlas of Tumor Pathology, Tumors of the Kidney, Bladder, and Related Urinary Structures)."

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