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Report Produced: 11/21/2025 02:45 AM

Report Question ID Question Discussion Answer Year
20061106 Reportability--Hematopoietic, NOS: Is a "Myelodysplasia, refractory macrocytic anemia with multilineage dysplasia" reportable?

For cases diagnosed prior to 1/1/2010:Yes, myelodysplasia, refractory macrocytic anemia with multilineage dysplasia is reportable. This is a type of refractory anemia. Refractory anemia is reportable.

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.

 2006
20061036 CS Extension--Lymphoma: For lymphoma cases, can extension be coded to 80 [Nodular involvement of lungs] based on imaging or operative findings when there is no positive statement of involvement? See Discussion.

Specifically, CS Ext code 80 includes nodular involvement of the lungs. The CT report for this patient states that the lungs are nodular. Is that enough to use code 80? Can the liver be coded as involved based on the operative findings?

Scenario: The patient was diagnosed with lymphoma. The CT showed pulmonary nodules. The pt had an exploratory laparotomy with a positive mesenteric LN bx and a positive ileocecectomy. The operative findings included a nodular liver. No staging was done by the oncologist and he has the pt on CHOP-R.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

Extension code 80 can be assigned based on imaging or operative findings as in the lymphoma case described above. The fact that this extension was not based on pathological evidence is captured in the evaluation code. Assign CS/TS Ext-Eval code 0 [No staging laparotomy done. No autopsy evidence used (clinical)].

 2006
20061097

Reportability--Lymphoma: Is a lymphoma diagnosed on a bone marrow biopsy reportable if the cytogenetics evaluation performed does not confirm the malignancy? See Discussion.

Bone marrow Bx: Marginal zone lymphoma/leukemia. The morphology of the lymphoma/leukemia cells and the immunophenotypic characteristics identified by flow cytometry are consistent with marginal zone lymphoma/leukemia.

Addendum Report: Cytogenetic evaluation revealed a 46,XY male karyotype. This is the normal male chromosome karyotype. Based on the limits of this methodology, no evidence of hematologic malignancy was observed in this specimen.

For cases diagnosed prior to 1/1/2010:

Yes, this case is reportable. The cytogenetic evaluation cited in the addendum report does not disprove the bone marrow biopsy diagnosis.

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.

 2006
20061092 CS Tumor Size--Breast: Should this field be coded to 999 [Unknown] or 008 [0.8 cm tumor] when the tumor size is not provided on a stereomammotomy biopsy for an in situ malignancy and a subsequent excision demonstrates 0.8 cm tumor of residual in situ disease?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

Code CS tumor size 008 [0.8cm]. A mammotomy specimen is very small, so for this case, the residual tumor size is quite accurate. Size is not a critical data element for in situ breast cancer.

 2006
20061031 CS Extension--Head & Neck: If a 2 cm left tonsil primary extends to the lateral aspect of the soft palate, should extension be coded to 40 [Soft palate, inferior surface including uvula or soft palate NOS] or 42 [Soft palate, superior (nasopharyngeal) surface] for a tonsil primary?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

Extension code 40 is for extension from the tonsil to the back (lower) part of the soft palate, or soft palate, NOS. Code 42 is for extension to the front (higher, nasopharyngeal surface) part of the soft palate.

Inferior soft palate is the back (lower) part of the soft palate (C051). Superior soft palate is the front, (nasopharyngeal surface) of the soft palate (C113).

Assign CS extension code 40 to the case above.

 2006
20061142 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Skin: How many cases are to be abstracted and how is the histology field(s) coded for cases in which a fibrosarcoma arises in or transforms from a dermatofibrosarcoma protuberans? See Discussion.

1. If the fibrosarcoma occurs after DFP, and is called metastatic, is it a recurrence or is it a new primary? Example: Pt diagnosed in 7/05 with a high grade fibrosarcoma arising in a dermatofibrosarcoma protuberans. The path indicated "The presence of high grade fibrosarcoma, the extent of the tumor necrosis and the mitotic rate are all adverse prognostic findings that indicate a significant risk for mets." The patient had a recurrence in 8/06 called a low grade fibrosarcoma mets from prev." The DFP code is 8832/3 and a fibrosarcoma code is 8810/3. Our pathologist feels that the fibrosarcoma is a more aggressive tumor so should the case be coded to the 8810/3.

2. If DFSP has areas of fibrosarcoma, should it be coded to the latter because it is more aggressive? Example: Skin and subcutaneous tissue reads: Low grade sarcoma - tumor extends to margin. Comment: "Although the predominant pattern of this tumor is consistent with dermatofibrosarcoma protuberans, focal presence of hypercellularity and increased mitotic figures suggest transformation to Grade I fibrosarcoma. This progression, although focal, carries an increased risk of mets over classic DFSP. Code to 8810/31?

For tumors diagnosed prior to 2007:

Code histology to 8832/3 [Dermatofibrosarcoma protuberans] for both cases. DFSP with transformation to fibrosarcoma and DFSP with areas of fibrosarcoma are coded to 8832/3.

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.

 2006
20061127 CS Lymph Nodes--Esophagus: Is a resected positive "periesophageal nodule" coded as an involved lymph node for an esophagus primary? See Discussion. Per SINQ 20000846: Each gross nodule of metastatic carcinoma in the fat surrounding an organ is counted as one positive regional lymph node. SINQ 2000846 applied to EOD. Can this concept be used for Collaborative Stage?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

For cases diagnosed on or after January 1, 2004:

Search for additional information on the "nodule." Review the gross and microscopic descriptions to determine whether or not the nodule is a lymph node. If it is not possible to obtain further information, apply the downstaging rule and select the Extension or LN code that results in the lower category.

 2006
20061044 CS Site Specific Factor--Head & Neck: If a lymph node dissection of the neck reveals that 1/24 lymph nodes is positive and the positive 5.6 cm lymph node extends throughout levels II-IV, how are the SSF 3 (status of levels I-III lymph nodes) and SSF4 (status of levels IV-V lymph nodes) fields coded?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.According to the CS Steering Committee, code 999 for SSF 3 and SSF 4. In this case, do not make assumptions about which level of lymph nodes were involved.

 2006
20061107 Histology (Pre-2007)/Flag--Pancreas: How is histology coded given that 8046 [non-small cell carcinoma] of the pancreas is not on the SEER Site/Type validation listing?

For tumors diagnosed prior to 2007:

Assign 8046 [non-small cell carcinoma] for "non-small cell carcinoma" of the pancreas. If necessary, override any site/type edits.

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.

 2006
20061141 Reportability--Leukemia: Is the diagnosis "a minority abnormal T-cell population (2-3%) with phenotypic features of large granular lymphocyte leukemia cells" reportable if it is from a flow cytometry procedure performed on a non-diagnostic bone marrow biopsy specimen? See Discussion.

Pt had only a bone marrow Bx done at the hospital.

Bone marrow biopsy and aspirate:

Peripheral blood showing mild relative lymphocytosis and mild relative neutropenia.

Normocellular bone marrow (50%) with mild eosinophilia. No conclusive morphologic evidence of a neoplastic process.

Flow cytometry of the marrow shows a minority abnormal T-cell population (2-3%) with phenotypic features of large granular lymphocyte leukemia cells. PCR is positive for a clonal T-cell population. The significance of these findings is unclear.

COMMENT: Flow cytometry, PCR and morphologic correlation were performed at [names removed]. The significance of a minimal, clonal, large granulocyte leukemia population absent absolute lymphocytosis is unclear. Positive results for a T-cell receptor PCR study in the setting of mild leukopenia alone is reportedly relatively common and usually regarded as nonspecific. In essence, this could be characterized as a small, monoclonal T-cell proliferation of uncertain significance associated with mild leukopenia. Appropriate follow up is suggested.

For cases diagnosed prior to 1/1/2010:Do not report this type of case until there is a definitive reportable diagnosis. Based on the information provided, this case is not yet reportable. It could develop into a reportable case in the future.

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.

 2006