| Report | Question ID | Question | Discussion | Answer | Year |
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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 |
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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 |
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20031200 | Reportability/Terminology, NOS--Hematopoietic, NOS: Is "smoldering" multiple myeloma reportable to SEER? | For cases diagnosed prior to 1/1/2010:Yes, "smoldering" multiple myeloma is reportable to SEER as multiple myeloma [9732/3]. According to our pathologist consultant, "smoldering" multiple myeloma would certainly refer to a diagnosed process. Smoldering means the process is progressing, but perhaps slowly, or even at a slower pace than might be expected.
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 | |
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20031073 | EOD-Pathology Extension--Prostate: Is extracapsular extension implied by the phrase, "involvement of periurethral or urethral margins"? See Description. | The prostatectomy final pathology diagnosis states that the tumor involves the periurethral margin. The microscopic describes involvement of the urethral margin. | For cases diagnosed 1998-2003: Code the EOD-Extension field in the 20-34 range, which implies no extension beyond the prostate. Disregard involvement of periurethral margin or urethral margin, NOS, unless the pathologist or surgeon specifically mentions "extraprostatic urethra" involvement. | 2003 |
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20031103 | Reportability--Ovary: Is a Stage IIIC serous borderline tumor (micropapillary type) of the ovary diagnosed in 2003 reportable? |
Serous borderline tumor of the ovary diagnosed in 2003 is not reportable to SEER. The behavior code is /1 in ICD-O-3. The high stage does not make this borderline tumor reportable. | 2003 | |
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20031162 | Multiple Primaries/Histology--Hematopoietic, NOS/Lymphoma: How many primaries are represented and what are the histologies for "B-cell lymphoma with immunophenotypic findings consistent with hairy cell leukemia" found on a bone marrow biopsy? See Description. | Pathologist completed AJCC lymphoma staging form indicating this case should be abstracted as a lymphoma. | For cases diagnosed prior to 1/1/2010:Abstract as one primary, 9591/3 [B-cell lymphoma, NOS]. The bone marrow diagnosis indicates that the main/definite diagnosis is B-cell lymphoma, with a lesser indication of hairy cell leukemia. Both of these are mature B-cell neoplasms according to the WHO histological classification. 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 |
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20031202 | Surgery of Primary Site--Head & Neck: How is this field coded for a surgery titled "Parotidectomy with facial nerve dissection"? See Description. | If the operative report is not titled "total parotidectomy," can we assume that less than total parotidectomy was done? Can we assume that "facial nerve dissection" and "facial nerve monitoring" are other ways of stating "facial nerve spared"? | Use the best information available to determine whether or not all of the parotid has been removed. It is important to read the entire operative report and review the content of the pathology report. The Op report will usually include wording about how much was removed, and this can be confirmed by the path report. Do not make assumptions about the extent of the surgery based solely on the title used on the operative report.
For cases diagnosed 1998-2003: Code 30 [less than total parotidectomy] can be used when the parotid is not totally removed, but the exact type of partial parotidectomy cannot be determined. "Facial nerve monitoring" and "Facial nerve dissection" are synonymous with "facial nerve sparing." |
2003 |
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20031116 | EOD-Size of Primary Tumor: Can the term "filling defect" be used to code tumor size? See Description. |
Site: Bladder CT abd/pelvis: 4 cm filling defect of the bladder encasing jetstream of distal ureter. 2-3 cm lesion may be extension to bladder. KUB: 3-4 cm filling defect within bladder. Cystoscopy: large bladder tumor with small tumor extending out of the large tumor. OP Findings: Large tumor on right of bladder extending from bladder neck lateral and posterior Pathology: TURB: High grade TCC, Grade III with focal lamina propria invasion. |
For tumors diagnosed 1998-2003:
Information on size from imaging/radiographic techniques can be used to code size when there is no more specific size information from a pathology or operative report, but it should be taken as low priority, just above a physical exam. The term "filling defect" from a CT or KUB may be used to code tumor size for bladder in the absence of more reliable size information from path, operative or endoscopic reports. |
2003 |
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20031036 | Histology--Hematopoietic, NOS: When both the path and clinical diagnoses simultaneously reflect reportable diagnoses but one is a worse form of the same disease process, which diagnosis do we code? See Description. | Would this case be coded to RAEB or AML? Bone marrow diagnosis: Hypercellular marrow with profound trilinieage dyspoietic changes. Comment: the features are consistent with RAEB. Clinical diagnosis five days later states: Myelodysplastic syndrome, early acute myelocytic leukemia (likely AML). | For cases diagnosed prior to 1/1/2010:When several diagnoses are made as part of the diagnostic process within two months, code the one with the worst prognosis. Code the case example as acute myelocytic leukemia. 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 |
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20031203 | Surgery of Primary Site--Skin: Should this field be coded to 45 [wide excision or reexcision of lesion or minor (local) amputation with margins more than 1 cm, NOS], 46 [with margins between 1 and 2 cm], or 47 [with margins greater than 2 cm] for a skin primary diagnosed in 2003 when margins are stated exactly as 2 cm? | Use code 46 [Wide excision...with margins more than 1 cm and less than 2 cm] when margins are exactly 2 cm. | 2003 |
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