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Report Produced: 05/25/2026 11:17 AM

Report Question ID Question Discussion Answer Year
20031158

Multiple Primaries (Pre-2007)--Trachea/Lung: Would synchronous lesions, of the same histology, diagnosed in the right upper lobe of the lung and trachea be a single primary when the physician feels they are two separate primaries?

For tumors diagnosed prior to 2007:

According to SEER rules, abstract as one primary because although these sites have separate topography codes in ICD-O-3, they were coded to the same three-digit topography code in the first edition of ICD-O (SEER Program Code Manual, 3rd Edition, page 8, Exception B). Simultaneous lesions of the same histology in trachea and lung are one primary. Code the primary site to C399 [Ill-defined sites within respiratory system].

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.

 2003
20031021 Primary Site--Head & Neck: What is the anatomical distinction among tonsillar fossa, tonsillar pillar, and tonsil NOS? Operative findings describe a right tonsil three times the size of the left tonsil. Tonsil is dissected from the tonsillar fossa. There appeared to be no involvement of tumor below the tonsillar capsule.

The tonsil lies in an indentation called the tonsillar fossa. The tonsillar fossa is bordered on either side by the tonsillar pillars. The tonsillar pillars are part of the supporting structure of the throat opening.

Code C09.9 [Tonsil NOS] as the primary site for the case above.

 2003
20031023 Grade, Differentiation: Can differentiation be coded from the pathology report for a biopsy from tissue involved by local recurrence? Code grade from original primary site. Do not code grade from a local recurrence. 2003
20031004 Surgery of Primary Site--Skin: When would one use codes 30-33 for this field on a skin primary?

Surgery of Primary Site codes 30-33 under "skin" are used for various types of biopsies followed by a gross excision of the lesion. The two procedures (biopsy and gross excision) may be performed on different days, at different facilities, by different physicians as long as both procedures are performed during the first course of treatment.

Answer applies to both pre-2002 and 2003+ surgury code definitions.

 2003
20031152 Ambiguous Terminology/Histology (Pre-2007): How do we code histology when there is a difference between the histology mentioned on a suspicious cytology and the clinical diagnosis by the treating physician? See Description. An FNA of pancreas is stated as "highly atypical cells present, suspicious for pancreatic ductal carcinoma." The attending physician states the patient has pancreatic carcinoma. Can histology be coded 8500/3 [infiltrating duct carcinoma, NOS] or should it be 8010/3 [carcinoma, NOS]?

For tumors diagnosed prior to 2007:

Code the histology from a suspicious cytology when this histology is supported by the clinical diagnosis.

Code the example above to 8010/3 [Carcinoma, NOS].

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.

 2003
20031189 Multiple Primaries (Pre-2007)--Thyroid: Would a papillary carcinoma of the right lobe of the thyroid diagnosed approximately 2 1/2 years after a papillary carcinoma of the left lobe be coded as a second primary? See Description.

8/31/1999: papillary carcinoma, left lobe thyroid, treated with lobectomy.

1/17/2002: papillary carcinoma, right lobe, treated with lobectomy, completion thyroidectomy.

For tumors diagnosed prior to 2007:

Yes, this is a second primary. The second papillary carcinoma was more than 2 months after the first and not specified as recurrent or metastatic.

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.

 2003
20031029 Histology (Pre-2007)/Grading--Head & Neck: Can terms that commonly modify histologic types or grades be used if they are only expressed in the microscopic portion of the pathology report? See Description. Final path diagnosis on a biopsy of the base of tongue is squamous carcinoma. The micro portion of the path report states the following: Multiple fragments of abnormal epithelium with a complex growth pattern. Many of the cells are small and poorly differentiated, interspersed with areas of well-differentiated keratinized epithelium. This is consistent with squamous cell carcinoma in situ with areas of invasive carcinoma. Do we code histology to 8070/3 or 8071/3?

For tumors diagnosed prior to 2007:

Yes, code using terms from the microscopic description if there is a definitive statement of a more specific histologic type.

Code the case example as 8070/33 [Squamous cell carcinoma, NOS, poorly differentiated]. The microscopic description adds grade information, but does not make a definitive statement of a more specific histologic type. "Keratinized epithelium" is not the same as keratinizing squamous cell carcinoma (8071/3). The mention of "areas of well-differentiated keratinized epithelium" refers to "normal" tissue within the specimen, in contrast to a type of neoplastic tissue.

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.

 2003
20031150 Histology (Pre-2007)--Breast: Should the histology "non-invasive papillary carcinoma" along with the comment "solid intraductal papillary proliferation includes cytologically atypical cells with scattered mitotic figures" be coded to 8503/2 [intraductal papillary carcinoma] or 8050/2 [papillary carcinoma in situ]?

For tumors diagnosed prior to 2007:

The best histology code for this breast case is 8503/2 [Noninfiltrating intraductal papillary carcinoma]. According to the WHO Classification of Tumors for Breast, Papillary carcinoma, non-invasive is a synonym for Intraductal papillary carcinoma. Further, code a more specific histologic type when found in the microscopic description, according to the SEER Program Code manual.

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.

 2003
20031119 EOD-Extension/EOD-Lymph Nodes--Colon: For this primary, under which field are satellite tumor nodules in mesenteric adipose tissue coded? See Description.

Sigmoid colon, low anterior resection: Invasive adenocarcinoma, 5.5 cm greastest dimension, moderately differentiated. Tumor invades through muscularis propria, into mesenteric adipose tissue. No penetration of visceral peritoneum. Proximal, distal, and radial margins free of tumor. Satellite tumor nodule present within mesenteric adipose tissue, 1.5 cm diameter, located 2.8 cm from main bowel wall tumor. Ten lymph nodes identified, with no evidence of metastatic tumor.

Comment: The satellite tumor nodule present within the mesenteric adipose tissue has an infiltrating, irregular contoured appearance and does not appear to represent a previously replaced lymph node. This appears to be a local metastasis with histologic features most commonly associated with venous invasion (see AJCC Cancer Staging Handbook, Sixth Edition, 2002, page 131 for current staging terminology).

 For cases diagnosed 1998-2003: For EOD, each grossly detectable nodule in the regional mesenteric fat is counted as one regional lymph node. 2003
20031167 Primary Site/Histology--CLL/SLL: How should these fields be coded when the pathological diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma is made on bone marrow biopsy only but scans show lymphadenopathy? See Description.

What histology would we give these two examples?

1. Bone marrow bx: CLL/SLL. CT chest/abdomen: Mediastinal and retroperitoneal adenopathy.

2. Bone marrow bx: CLL/SLL. CT chest/abdomen: Mediastinal and retroperitoneal adenopathy suspicious for lymphoma.

For cases diagnosed prior to 1/1/2010:If a lymph node or other solid tissue is involved initially, code to SLL. For lymphoma, any mention of lymph nodes is indicative of involvement. Involvement does not have to be proven pathologically in order to code to Small Lymphocytic Lymphoma (SLL). Code both of the examples to SLL.

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.

 2003