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Report Produced: 09/18/2025 04:18 AM

Report Question ID Question Discussion Answer Year
20061045 CS Lymph Nodes/CS Mets at Dx--Melanoma: How are these fields coded for a melanoma primary when melanoma is identified in lymph nodes but no primary skin tumor is found? See Discussion.

Excisional biopsy of an inguinal lymph node revealed metastatic melanoma. Multiple skin biopsies did not reveal the primary site.

Subsequent lymph node dissection of superficial inguinal nodes showed microscopic focus of malignant melanoma in subcutaneous fat adjacent to previous procedure site. No evidence of metastatic melanoma in 7 lymph nodes. Dissection of external iliac lymph nodes showed no evidence of melanoma in 5 lymph nodes.

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 Lymph Nodes 80 [Lymph nodes, NOS]. Code CS Mets at DX 00 [None]. Since it cannot be determined whether the lymph nodes are regional or distant, code CS Lymph Nodes to lymph nodes, NOS.

 2006
20061076 Laterality--Breast: Should laterality be coded to 9 [Paired site but no information concerning laterality] or to the side with the positive lymph nodes for a case in which no breast mass is found but positive axillary lymph nodes are found on only one side? Code laterality of the primary site to the side with the positive nodes when there are unilateral positive nodes and the laterality of the primary site is otherwise unknown. 2006
20061033

Reportability--Brain and CNS: Is benign neural tissue compatible with a glioneuronal hamartoma of the cerebellopontine angle reportable?

No. A glioneuronal hamartoma is not neoplastic and not reportable. See page 2 of the 2004 SEER Program Coding and Staging manual for the list of reportable brain/CNS tumors. There is no ICD-O-3 code for hamartoma.

 2006
20061023 Reportability--Skin: Is a pilomatrix carcinoma of the skin reportable if it is described as being a malignant diagnosis based on poor circumscription, infiltrative growth pattern, and focal abundant mitoses? No. Pilomatrix carcinoma is not reportable to SEER. Please see page 1 of the 2004 SEER manual. Skin primaries with histology codes from 8090 to 8110 are not reportable. Pilomatrix carcinoma is coded 8110/3. 2006
20061034 Primary Site--Unknown & ill-defined site: Is the primary site code C809 [Unknown primary site] preferred over the use of a site code for an organ system (e.g., biliary tract, NOS) or a specific primary site (e.g., colon, NOS) when these are "favored" but other potential sites "cannot be excluded"? See Discussion.

Case 1 - CT: Mult pulm nodules, bilat pleural effusions; paraaortic, paracaval, celiac lymphadenopathy. Lytic lesions L4&L5.

Bx L3: Met pd adenoca. Based on the histopathologic features and the results of the immunostains, cholangiocarcinoma is regarded as the most likely primary. However, other possible primaries include pancreas, stomach, and (remotely) lung.

Should primary be coded as C26.9, digestive organ, NOS?

Case 2 - CT: Mult liver masses. Liver Bx: Mod diff adenoca. The most likely primary sites include cholangiocarcinoma, stomach and pancreas.

FDx per attending: Met adenocarcinoma to the liver, probably biliary origin.

What primary site code do we use?

Case 3 - Admitting Dx: Unknown primary with mets to lungs, liver and cerebellar area. Liver Bx: Met adenoca. The combination of morphological and immunohistochemical staining favor a colon primary. However other possibilities include cholangiocarcinoma and pancreatic ca.

Should we code site as C18.9 or C26.9?

Code the primary site according to the physician's opinion. An ill-defined site code or an NOS code for the organ system is preferred over C809 [Unknown primary site] whenever possible. Code C809 only when there is not enough information to use an ill-defined or NOS code.

Case 1 and Case 2 - Assign code C249 [Biliary tract, NOS]. Based on the available information, the physicians believe these are most likely biliary primaries.

Case 3 - Assign code C189 [Colon]. According to the available information, the physician believes this is most likely a colon primary.

 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
20061129 Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are abstracted if a patient has bilateral involvement of tonsils with the same histology (e.g. squamous cell carcinoma)? See Discussion. Patient was initially found to have mass on right tonsil. Biopsy of right tonsil on June 16 showed invasive carcinoma, favor squamous cell. On July 17 patient underwent right neck dissection, radical resection of right tonsil tumor and left tonsillectomy. Right tonsil showed squamous cell carcinoma, poorly differentiated. Left tonsil showed squamous cell carcinoma, poorly differentiated. Microscopic report stated: Right tonsil: Invasion of deep peritonsillar tissue and skeletal muscle. Sections of left tonsil demonstrate squamous cell ca focally distributed in the tonsil, predominantly in situ, but with focal microscopic invasion. Path staged each tonsil specimen. Right tonsil was T2N1. Left tonsil was T1Nx.

For tumors diagnosed prior to 2007:

Code as two primaries. Squamous cell carcinoma diagnosed in both left and right tonsils are multiple primaries unless one is stated to be metastatic from the other.

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
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
20061080 Histology (Pre-2007): Is histology for an anorectal biopsy of "Cloacogenic carcinoma (squamous cell carcinoma with basaloid features)" coded to 8124/3 [Cloacogenic carcinoma] or 8083/3 [Basaloid squamous cell carcinoma]?

For tumors diagnosed prior to 2007:

Code histology to 8124/3 [Cloacogenic carcinoma]. These are squamous cell carcinomas of basaloid type that are found in the cloacogenic (transitional) zone of the anal canal.

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
20061041 CS Site Specific Factor--Prostate: How is SSF 6 coded for this site when there is only one Gleason number documented and the number is less than 5 (e.g., Gleasons 3)?

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 999 [unknown or no information]. Note 1 was revised in September 2006 to clarify this situation.

Note 1 states "If only one number is given and it is less than or equal to 5, code the total score to 999, unknown or no

information.

 2006