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Report Produced: 02/18/2026 12:30 PM

Report Question ID Question Discussion Answer Year
20031142 Other Therapy/Immunotherapy--Hematopoietic, NOS: How should erythropoietin be coded for leukemia or other hematopoietic diseases? Do not code Erythropoietin as treatment, it is used as an ancillary drug for leukemias or other hematopoietic diseases. Record information about erythropoietin in the text field. 2003
20031056

Multiple Primaries (Pre-2007)--Breast: For a patient with a remote history of lobular breast carcinoma, would a new diagnosis of lobular breast carcinoma with DCIS be a new primary, even though the physician designates it as recurrent? See Description.

A history of right breast lobular ca in 1991 treated with a partial mastectomy. Diagnosed 3/02 with "recurrent right breast ca" per physician; pathology in 2002 is lobular and DCIS.

Would the DCIS make this a new primary regardless of the physician's designation of 'recurrent' or is this the same primary?

For tumors diagnosed prior to 2007:

Accession as two breast primaries -- the first lobular ca in 1991; the second lobular and DCIS in 2002.

The differing histologies and the length of time between them negate the physician's designation as "recurrent" in this case.

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
20031083 Grade, Differentiation: How is this field coded when the only description in the pathology report is "non-high grade?" Code "non-high grade" as 9 [unknown]. 2003
20031005 Histology (Pre-2007): Do the terms "keratinizing" or "non-keratinizing" have to be present in the final diagnosis to use codes 8071 through 8073? See discussion. Should "squamous cell carcinoma, small cell variant" be coded to 8073 even though the final diagnoses does not include the phrase "non-keratinizing?"

For tumors diagnosed prior to 2007:

It is acceptable to assign code 8073/3 for squamous cell carcinoma, small cell, NOS. Code squamous cell carcinoma, large cell, NOS to 8072/3. Code to non-keratinizing unless the pathology report specifies keratinizing.

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
20031170 Terminology, NOS/Recurrence/Multiple Primaries (Pre-2007): Is the term "residual disease" equivalent to "recurrence"? See Description.

Example 1. Patient underwent excision and re-excision of lentigo maligna in 1998. Final path showed close but negative margins. In 1999 a biopsy of a brown patch (over the scar) in the same location was done. Pathology reported residual lentigo maligna. Is the 1999 melanoma a new primary because it was diagnosed more than two months after the first melanoma and there is no mention of recurrence? Or is the term "residual" another way of saying recurrence?

Example 2. In 1999, patient underwent excisonal biopsy of intraductal carcinoma of the right breast, followed by radiation therapy. In 2000, mammogram showed calcifications in right breast. Biopsy was done with path showing residual ductal carcinoma in situ. There is no mention of recurrence. Is this one or two primaries?

For tumors diagnosed prior to 2007:

According to our pathologist consultant, "residual" disease indicates incomplete eradication of the original disease process. Residual means that the disease process was not completely removed/eradicated in the initial therapy. Therefore cells from the original primary were never completely removed or destroyed.

In each example above, this is not a recurrence per se but rather

progression of disease. Do not abstract the latter diagnosis as a new primary.

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
20031078 EOD-Lymph Nodes--Colon: Are "multiple submucosal lymphoid collections infiltrated with tumor" or "lymphoid areas" coded as lymph node involvement, similar to the way nodules in the pericolic fat are coded? See Description. For an adenocarcinoma in the colon, under the "lymph node" section of the final path diagnosis it states "multiple submucosal lymphoid collections infiltrated with tumor" in addition to "one of two involved lymph nodes." The micro description states "There are multiple small lymphoid areas with tumor. A definite node excised from the mesentery shows...replacement of stroma and an additional very small node shows no tumor."

For cases diagnosed 1998-2003: No, do not code tumor infiltration of lymphoid collections or lymphoid areas as lymph node involvement.

However, code lymph node involvement for this case as 3 [mesenteric, NOS] because a mesenteric node is involved.

Regarding tumor infiltration of lymphoid collections or lymphoid areas from our pathologist consultant: Unless the anatomy of lymph node is evident (sinuses, trabeculae, primary and secondary follicles) these aren't lymph nodes and should not be coded as such. Unless there is evidence to the contrary in the path report, I would suggest that this be considered intramural spread, not lymph node spread.

 2003
20031060

Histology--Hematopoietic, NOS: Because histology 9895/3 [Acute myeloid leukemia with multilineage dysplasia] was recognized as a distinct entity by WHO with too few cases of the subtypes [with or without prior MDS] to warrant separate histology codes for each, should the wording for the non-bold definitions in ICD-O-3 be changed to the following in both the alpha and numeric sections? See Description.

AML with multilineage dysplasia and prior MDS

AML with multilineage dysplasia and without prior MDS

How do we code histology for the following case of AML?

Patient was admitted for profound anemia and thrombocytopenia with

no immediate explanation. Path final diagnosis on bone marrow biopsy: acute myelogenous leukemia (AML). Per micro description: findings are

characteristic of AML that appears to be arising within the context of a myelodysplastic syndrome. The discharge diagnosis (2 days after bone marrow biopsy) read: myelodysplastic syndrome with profound anemia and

thrombocytopenia.

Do we code the histology per the final path diagnosis (code 9861/3)?

Using the current version of ICD-O-3, we could arrive at a histology code of 9895/3 based on the micro findings of AML with prior myelodysplastic syndrome. However, per the above-mentioned SEER e-mail, we would not because there was no mention of multilineage dysplasia.

For cases diagnosed prior to 1/1/2010:To assign code 9895, it is important that the diagnosis includes "multilineage dysplasia." Use code 9895 when the diagnosis is with or without prior (not concurrent) myelodysplastic syndrome AND multilineage dysplasia. Acute myeloid leukemia without prior myelodysplastic syndrome and without multilineage dysplasia is coded 9861 [Acute myeloid leukemia, NOS].

Although the wording of 9895 cannot be changed, coders can make a note that the synonyms are intended to include:

-Acute myeloid leukemia WITH multilineage dysplasia with prior myelodysplastic syndrome

and

-Acute myeloid leukemia WITH multilineage dysplasia without prior myelodysplastic syndrome.

The histology code for the case example is 9861/3 [Acute myeloid leukemia, NOS].

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
20031120

Primary site: How is this field coded for a malignant spindle cell neoplasm in a subcutaneous mass of the right knee? See Description.

The pathology report says: Right knee tumor:

A. discrete subcutaneous mass 3.5x5.2x1.4 cm malignant spindle cell neoplasm (see Comment)

B. A focus of subcutaneous malignant neoplasm is identified in the superior resection margin.

C.All other margins are clear.

The comment mentions that the specimen has been sent to Mayo Clinic and the Mayo clinic consult says, "we still believe that the diagnosis of spindle cell carcinoma is correct. Obviously the differential diagnosis involves melanoma and sarcoma also. The results of the immunoperoxidase stains strongly support the prior diagnosis of a carcinoma."

Code the site to C49.2 [Connective, subcutaneous and other soft tissues of lower limb and hip]. The site is a subcutaneous mass. C49 with 8032/3 will not be impossible following the next updates to the SEER edits.

 2003
20031205 EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: How are these fields coded when an autopsy report reveals pathologically involved regional lymph nodes but does not state how many nodes were positive nor how many were examined? See Description. A final autopsy report described widely disseminated adenocarcinoma, probably lung primary. Metastatic tumor in brain, lungs, and in lymph nodes. The Gross description of the autopsy report stated that there were numerous metastases to hilar and mediastinal lymph nodes. The Micro description of the autopsy report did not add any clarification. In the absence of a stated number of lymph nodes, the options for coding number of regional lymph nodes examined are codes 96-98. These codes include descriptions of surgical procedures such as sampling and dissection. How do we code number of regional lymph nodes examined when the pathological examination of lymph nodes was done only at autopsy and not during a surgical procedure?

For cases diagnosed 1998-2003: The rules that apply to the use of pathology reports for EOD coding also apply to autopsy reports.

When a cancer diagnosis is made and positive lymph nodes are discovered on autopsy, in the absence of a stated number of lymph nodes, code the number of lymph nodes positive to 97 [Positive nodes but number of positive nodes not specified]. Code the number of lymph nodes examined to 97 [Regional lymph node removal documented as dissection and number of lymph nodes unknown/not stated]. An autopsy is a dissection.

 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