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20081048 | CS Lymph Nodes/CS Mets at Dx--Ovary: How are renal lymph nodes coded for ovary primaries? | 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 involvement of renal lymph nodes under CS Mets at Dx. Renal lymph nodes are not listed as regional lymph nodes for ovary; therefore, code involvement of renal lymph nodes under CS Mets at Dx. |
2008 | |
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20081039 | Diagnostic Confirmation/Histology--Hematopoietic: How are these fields coded when the final pathologic diagnosis for a bone marrow biopsy differs from the final clinical diagnosis of a hematopoietic disease? See Discussion. | Frequently, pathology reports describe hematopoietic diseases using ambiguous terms. Flow cytology and cytogenetics may be obtained. It appears that the clinician is the person who pulls all the information together for a diagnosis. Example: Bone marrow biopsy is most compatible with chronic phase myeloproliferative disease. Path comment: Differential would include CML. Outside hematology report indicates an elevated peripheral WBC, primarily neutrophils. Flow cytometry showed 1.0 % of the white cells are myeloid blasts of abnormal phenotype, additionally finding 7.3 % basophils. Flow reported peripheral blasts at 1.2 % and peripheral basophilia. Cytogenetics report showed abnormality with trisomy of chromosomes 13 and 21. This finding is consistent with a clonal abnormality suggestive of acquired disease. Results were consistent with the absence of the t(9,22)(q34;q11) translocation or fusion product associated with CML. Subsequent clinical impression: Bone marrow evaluation most consistent with CML. Overall features most consistent with CML. |
For cases diagnosed prior to 1/1/2010:Code the Diagnostic Confirmation field as 1 [positive histology]. Code the ICD-O-3 morphology based on the clinician's statement. The code in Diagnostic Confirmation pertains to the best method used to confirm the presence of cancer over the entire course of the disease. Therefore, if a bone marrow report confirms cancer, code 1 [positive histology] in Diagnostic Confirmation. Code the histology using all of the information available. The clinician has access to all of the information relating to this case. The pathologist had only the bone marrow. Code the histology recorded by the clinician. For cases diagnosed 1/1/10 and later, 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. |
2008 |
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20081100 | MP/H Rules/Histology--Rectum: When not specifically mentioned as part of the histology, is the adenoma a second histologic type, or just a further physical description of the tumor? See Discussion. |
Rectal tumor resection (APR) path report final dx: "mucinous carcinoma, see comment". The comment is the CAP-format tumor summary, which states "histologic type: adenocarcinoma with extensive mucin production (mucinous or colloid carcinoma). Additional pathologic findings: adenomas - tumor arises in a tubulovillous adenoma". If you follow the rules and only use the final dx, you would code a different histology than if you use the 'additional path findings.' |
For cases diagnosed 2007 or later Other Sites histology rule H12 applies in this case. Assign histology code 8263 [adenocarcinoma in tubulovillous adenoma]. Use information from the CAP protocol and from comments associated with the final diagnosis to code histology. The fact that the malignancy arose in a polyp can be taken from anywhere in the medical record; not limited to the final diagnosis. Based on the information provided for this case, the histology is adenocarcinoma with extensive mucin production (mucinous or colloid carcinoma) arising in a tubulovillous adenoma. |
2008 |
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20081028 | Multiplicity Counter--Ill-defined sites: How is this field coded for Ill-Defined sites (C760-C768)? | Code the number of tumors present if known. If the number of tumors present is not known, code 99 [unknown number of tumors, unknown if multiple tumors]. | 2008 | |
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20081096 | Computed Ethnicity: Should the Name--Alias field be used when generating Computed Ethnicity? | No, "Alias" is not used and should not be used to generate Computed Ethnicity. Computed Ethnicity records the ethnicity based on last name and/or maiden name using a computer algorithm. Alias is not part of the algorithm. | 2008 | |
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20081062 | MP/H Rules/Date of Diagnosis/Behavior--Brain and CNS: How many primaries would be reported when a December 2004 MRI shows a pineal region mass with the major differential consideration being pineocytoma; a November 2007 MRI that shows the mass has almost tripled in size; and the December 2007 resection final diagnosis is consistent with pineoblastoma? How would diagnosis date[s] and behavior code[s] be coded? See Discussion. | Dec. 2004 MRI of brain: Pineal region mass. The major differential consideration given patient's gender, age group, and imaging characteristics is pineocytoma. The differential includes pineoblastoma or germ cell line tumor. These are felt less likely. Nov. 2005 MRI brain: stable exam since last MRI. No change in size. Nov. 2007 MRI studies: pineal mass has almost tripled in size. Dec. 2007 Surgical resection of pineal tumor: High grade (WHO Grade IV) pineal parenchymal neoplasm consistent with pineoblastoma. |
For cases diagnosed 2007 or later: Abstract as separate primaries:
Complete two abstracts when a previously diagnosed non-malignant tumor transforms or progresses to a malignancy. Refer to the CDC/NPCR guidelines for Data Collection of Primary Central Nervous System Tumors, 2004. Malignant transformation is discussed on page 50. |
2008 |
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20081082 | Histology--Head & Neck: How do you code histology for a myofibroblastic sarcoma of the soft tissue of the head and neck? | Assign code 8825/3 [Myofibroblastoma, malignant]. According to the WHO Classification of Soft Tissue Tumors, "Low grade myofibroblastic sarcoma represents a distinct atypical myofibroblastic tumor often with fibromatosis-like features and predilection for the head and neck." Also called myofibrosarcoma. | 2008 | |
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20081064 | MP/H Rules--Bladder: Is a TURBT in 4/07 that demonstrates papillary carcinoma (8130/3) followed two weeks later with biopsies that demonstrate high grade flat dysplasia/carcinoma in situ (8010/2) two primaries? |
For cases diagnosed 2007 or later, rule M6 applies and this is a single primary. Flat transitional cell carcinoma and carcinoma in situ of the bladder are synonymous. See the definition of "Flat Tumor (bladder)/Noninvasive flat TCC" in the Urinary Terms and Definitions section of the 2007 MP/H manual. |
2008 | |
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20081063 | MP/H Rules--Breast: How many primaries should be abstracted when a patient has a mass at 6:00 that showed poorly differentiated ductal carcinoma and a hypoechoic nodule at 9:00 that was excised with no real tumor present there though path showed angiolymphatic invasion by carcinoma throughout the entire specimen? See Discussion. | Palpable mass in right breast at 6:00. Path stated 'poorly differentiated ductal carcinoma with extensive necrosis and extensive angiolymphatic invasion. Focal high grade comedocarcinoma (1%)'. Another hypoechoic nodule was seen at the 9:00 position. This mass was excised from surrounding tissue. This mass was more like an inflammatory mass; there was no real tumor present there. Path report stated "Breast mass 9:00 excisional biopsy - angiolymphatic invasion by mammary carcinoma throughout the entire specimen." Is this two primaries because of the two different histology codes: 8500 and 8010? |
For cases diagnosed 2007 or later, abstract as a single primary using rule M3 (a single tumor is always a single primary). There was one tumor present according to the information provided. The second specimen was not a separate tumor ("There was no real tumor present there"). | 2008 |
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20081022 | CS Extension/CS Mets at Dx--Wilm's Tumor: Is the fact that a Wilm's tumor case is bilateral captured in the CS Extension field or is the CS Mets at Dx field coded to 40? | 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 laterality as bilateral, code the greatest extension from either side in CS extension. Code CS Mets at diagnosis 00 [None] UNLESS true distant metastases were identified. |
2008 |
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