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.
Primary Site: What site code best reflects the final diagnosis of a metastatic "pancreatobiliary" adenocarcinoma to the liver? See Discussion.
CT showed multiple masses in the liver and lymphadenopathy in areas of gastrohepatic ligament, celiac axis, superior mesenteric and left periaortic regions. No mention of a mass in pancreas or common duct. When the term "pancreatobiliary" primary is stated in the final diagnosis, what site code should be used?
Contact the physician for clarification of the term "pancreatobiliary." If no further information can be obtained for this case, assign code C249 [Biliary tract, NOS] based on the CT findings for the specific case in this question.
When the primary is described as "pancreatobiliary" with NO FURTHER INFORMATION, assign C269.
Multiple Primaries/Histology--Lymphoma: If a gastric biopsy demonstrates large B cell lymphoma arising in a low grade MALT lymphoma, how many tumors should be abstracted and how should the histology field(s) be coded? See Discussion.
Final path for gastric biopsy on 12/2005 is "consistent with malignant lymphoma" and Micro says "morphologic findings consistent with MALT lymphoma and an increased proportion of large atypical cells is concerning for large cell transformation. However, since the large cells are present only focally, a definitive diagnosis of large cell lymphoma cannot be rendered"
A second gastric biopsy a week later said: Final Path: Diffuse large B cell lymphoma arising in low grade MALT lymphoma. Micro says: "Compared to patient's previous biopsy...the current specimen contains a higher percentage of large atypical cells which stain positively for CD79a, a B cell marker. The morphologic and immunohistochemical findings are consistent with a large B cell lymphoma arising in a low grade MALT lymphoma."
These are different primaries according to the table of single versus subsequent primaries of lymphatic and hematopoietic diseases.
For cases diagnosed prior to 1/1/2010:
This is one primary. Code as 9699 [Marginal zone B-cell lymphoma, NOS].
The first biopsy was not conclusive. The biopsy one week later was more definitive. The reports are describing a difference between specimens, not a difference in disease.
According to the WHO classification, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is an extranodal lymphoma with B-cells, cells resembling monocytoid cells, small lymphocytes and scattered immunoblast and centroblast-like cells.
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.
Reportability--Colon: Is a pathologically confirmed "tubulovillous adenoma with high grade dysplasia" reportable if clinical diagnosis at the time of the subsequent re-biopsy states "follow-up for colon polyps with ca in situ"? See Discussion.
SINQ 20000245 states that high grade dysplasia is not synonymous with behavior code 2 (in situ). However, the 2004 SEER manual states that "cases clinically diagnosed are reportable. If the physician treats a patient for cancer in spite of the negative biopsy, accession the case."
A pathologic diagnosis has priority over a clinical diagnosis. According to the pathologist, this case is not reportable. A re-biopsy is not treatment.
Histology (Pre-2007)--Melanoma: How is a "plaque-like nodular spitzoid malignant melanoma" coded?
For tumors diagnosed prior to 2007:
Code histology to 8721 [nodular melanoma]. Essentially, "plaque-like nodular spitzoid malignant melanoma" is nodular melanoma. Code 8721 is the most specific ICD-O-3 histology code available for this diagnosis.
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.
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.
CS Tumor Size--Lung/Breast: Explain why the SEER instructions differ from the CS Manual regarding priority order of sources to code tumor size? See Discussion.
Regarding the 2004 SEER Manual, Appendix C, Site Specific Coding Modules, Lung and Breast. The priority of sources for coding tumor size is Pathology, Operative Report, PE, imaging for breast and pathology, operative, endoscopic, and imaging for lung. This differs from the CS Manual instructions.
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 in 2007 and forward, follow the instructions in the 2007 SEER manual and the CS manual.
Reportability: Is an AIN III that arises in perianal skin, skin tags or condyloma acuminatum reportable or must an AIN III arise in the anus or anal canal in order to be reportable?
AIN III arising in perianal skin [C445] is not reportable.
AIN III [8077/2] of the anus or anal canal is reportable.
Histology (Pre-2007)--Pancreas: Is a "composite mucinous adenocarcinoma and squamous cell carcinoma" coded to 8560 [adenosquamous carcinoma] or should 8480 [mucinous adenocarcinoma] be coded rather than 8070 [squamous carcinoma] because mucinous adenocarcinoma is a higher histology code than squamous carcinoma?
For tumors diagnosed prior to 2007:
Assign code 8560 [adenosquamous carcinoma]. According to our pathologist consultant, the mix of adenocarcinoma and squamous carcinoma is adenosquamous carcinoma. Adenosquamous tumors are rare, but known, representing 3-4% of pancreatic carcinomas.
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.
CS Extension/CS Mets: For primary sites within the peritoneum (abdominalpelvic walls) such as stomach, colon, does the presence of malignant ascites affect the coding of CS Extension or CS Mets?
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.
The Collaborative Staging system is governed by site-specific coding rules. Refer to each set of site rules rather than looking for a general answer for all sites in peritoneum. In particular, Ovary and Corpus allow malignant ascites to be coded in CS Extension, but not CS Mets at Dx. For each site, both CS Extension and CS Mets at Dx should be checked for the proper field to code malignant ascites.
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