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Report Produced: 09/21/2026 22:41 PM

Report Question ID Question Discussion Answer Cancer Site Category Data Item Category Year
20071049 MP/H Rules/Histology--Colon: If a tubulovillous (TV) adenoma is in situ and other polyp(s) have an invasive component, does the in situ TV adenoma still have priority and should rule H18 be applied?

For cases diagnosed 2007 or later, always give precedence to coding the invasive. Rule H18 applies UNLESS the adenocarcinoma in the TV is in situ and the others are invasive. In this case, code the histology of the invasive adenocarcinoma.

This clarification will be added when the MP/H manual is revised.

 Colon Histology 2007
20071084 MP/H Rules/Histology--Prostate: How is an "acinar adenocarcinoma with focal large duct adenocarcinoma" coded?

For cases diagnosed 2007 or later:

As long as this is NOT urothelial carcinoma extending to the prostatic ducts, code histology to 8140/3 [adenocarcinoma] using rule H10.

Do not code histologies designated as "focal."

 Prostate Histology 2007
20071103 MP/H rules/Histology--Breast: How many primaries and what histologies are coded for a left breast when a bi-lumpectomy path reveals one tumor with a microscopic focus of mucinous adenocarcinoma and extensive DCIS and a second .9 cm mucinous adenocarcinoma with extensive DCIS, and the subsequent mastectomy reveals foci of residual DCIS and Paget's disease of the nipple?

For cases diagnosed 2007 or later:

There are two primaries. Primary 1: The two tumors described on the pathology report from the lumpectomy are a single primary using rule M13. Primary 2: Disregard the foci of residual DCIS. Paget disease of the nipple is a separate primary using rule M12.

Primary 1: invasive mucinous adenocarcinoma and extensive ductal carcinoma in situ: Code the histology as 8480/3 [mucinous adenocarcinoma] using rule H27.

Primary 2: Paget disease of nipple: Code the histology as 8540/3 [Paget disease] using rule H14.

 Breast Histology 2007
20071102 Systemic/Surgery Sequence--Breast: How is this field coded for a breast cancer patient treated with a lumpectomy followed by chemotherapy and then a mastectomy? Assign code 2 [Systemic therapy before surgery]. The code in Systemic Treatment/Surgery Sequence is related to the surgery coded in Surgery of Primary Site. For SEER, the mastectomy will be coded in the surgery field. The chemotherapy occurred before the mastectomy. N/A Systemic / Surgery Sequen 2007
20071005 EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank?

For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.

Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis.

 Prostate N/A 2007
20071123

MP/H Rules/Reportability/Diagnostic Confirmation--Colon: Please clarify how to code diagnostic confirmation when there is no mention of a malignant polyp in the pathology report of a familial polyposis case given this statement: "Even if you have only one malignant polyp it is a single primary if there is a diagnosis of FAP. Even if there is no mention of a malignant polyp, if there is a diagnosis of FAP you will use this rule."

For cases diagnosed 2007 or later:

In the very unlikely event of a FAP diagnosis with no malignancy, the case would not be reportable.

When FAP is diagnosed along with a colon malignancy, it is presumed that the malignancy originated in one of the numerous polyps, even if this is not explicitly stated. Use rule M3 for any colon malignancy (in a polyp, frank, or not stated) with a diagnosis of FAP and abstract as a single primary.

Colon N/A 2007
20071111 MP/H Rules/Histology--Lung: How many primaries should be abstracted when a patient has an adenocarcinoma with bronchioalveolar-like features in the right upper lobe, adenocarcinoma in the right middle lobe and non-small cell carcinoma with clear cell features in the right lower lobe? See Discussion.

A RUL lung wedge resection and RML and RLL lobectomies were performed. The RUL resection showed invasive adenocarcinoma with bronchioalveolar-like features. Tumor size 9x.9x.8cm. The RLL lobectomy showed invasive non-small cell carcinoma with clear cell features. Tumor size 4.1x2.5x1.8cm. The RML lobectomy showed invasive adenocarcinoma. Tumor size 3.0x1.6x2.2cm.

Comment: Essentially three invasive tumors and a focus of bronchioalveolar carcinoma were identified in 3 specimens. All of the tumors appear somewhat histologically different. The larger tumors in the right upper and middle lobe were somewhat similar but still appear histologically different and therefore the pathologic staging is done based on all tumors being separate. The pathologic staging for this case is pT2(4) pN0 pMX.

What histology code and what site code are to be used on each abstract?

For cases diagnosed 2007 or later:

Abstract two primaries:

  1. C349 with histology coded to 8140 - invasive adenocarcinoma (RUL and RML)

  • C343 with histology coded to 8310 - invasive non-small cell carcinoma with clear cell features (RLL)

    • First, determine the number of tumors. There are three separate tumors in right lung in the example above:

    • RUL: invasive adenocarcinoma, bronchioalveolar-like features (8140, "-like" is not on the list of ambiguous terms used to code histology)

  • RLL: invasive non-small cell carcinoma with clear cell features (8310)

  • RML: invasive adenocarcinoma (8140)

    • Because there are three tumors, begin with rule M3 in the Multiple Tumors module. Stop at rule M11, multiple primaries for the tumor in the RLL (8310) compared to the tumors in the RUL and RML (8140 and 8140).

    Now evaluate the tumors in the RUL and RML using the multiple primary rules. Start at rule M3 and stop at rule M12, single primary.

    		 Lung N/A 2007
    		20071030 Reporting Source: If the only patient record available for a physician office biopsy is the pathology report identified from a freestanding laboratory, is reporting source coded to 3 [Laboratory Only (hospital-affiliated or independent)] or 4 [Physicians office/Private Medical Practitioner (LMD)]? See Discussion. A case was identified through a pathology report from a freestanding lab. The doctor who submitted the specimen left the state. His records cannot be located. Because the patient had the specimen removed at a physician's office, not at a path lab, is Type of Reporting Source field coded to the physicians office?

    Reporting Source is the source that provided the best information used to abstract the case.

    For this case, assign code 3 [Laboratory Only (hospital-affiliated or independent)]. Reporting source should reflect the lab where this case was identified. The MD office added nothing to the case, not even a confirmation of malignancy.

    		 N/A Reporting Source 2007
    		20071007 MP/H Rules/Histology: In the absence of a tissue diagnosis, should the histology field be coded based on the findings of a suspicious cytology or a CT scan that clinically confirmed the diagnosis? See Discussion. Cytology (brushings at ERCP) which are highly suspicious of adenocarcinoma. A CT of the abdomen performed the next day shows a mass, most likely Klatskin tumor. Can the histology be coded to Klatskin tumor [8162/3] based on the CT findings?

    For cases diagnosed 2007 or later, code the histology to 8162/3 [Klatskin tumor] using the histology from the CT. This case is confirmed clinically based on the CT. It cannot be accessioned based on suspicious cytology.

    Rule H8 in the 2007 Histology Coding Rules for Other Sites provides instructions for coding histology when the pathology report and cytology report are not available.

    		 N/A Histology 2007
    		20071083 MP/H Rules/Multiple Primaries--Bladder/Renal Pelvis: Is a non-invasive papillary transitional cell carcinoma of the bladder diagnosed one year after the occurrence of an invasive papillary transitional cell carcinoma of the renal pelvis reported as one or two primaries?

    For cases diagnosed 2007 or later:

    This is a single primary with renal pelvis as primary site.

    Use the 2007 MP/H rules to determine if the 2007 diagnosis is a new primary. Use the Urinary rules, multiple tumors module. Start with rule M3. Follow the rules down to Rule M8 and stop. This is an example of implantation effect.

    		 Bladder N/A 2007