Multiple primaries--Lymphoma: Is a splenectomy done for non-Hodgkin lymphoma diffuse large B-cell of the spleen a composite histology and a single primary if a perihilar lymph node with Hodgkin lymphoma classic type is found at the time of this surgery?
For cases diagnosed prior to 1/1/2010:This is two primaries -- Non-Hodgkin lymphoma (NHL) in the spleen and Hodgkin lymphoma (HD) in a lymph node.
Composite lymphoma is NHL and HD both in a single lymph node.
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.
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.
Surgery of Primary Site--Breast: How is this field coded when a re-excision follows a prior mastectomy?
Code the most extensive surgery in Surgery of Primary Site. This is a cumulative field. Assign the appropriate code including all surgeries of the primary site performed during the first course of treatment.
The correct code for mastectomy followed by re-excision will depend on the extent of the re-excision. For example, if the re-excision removed muscle, code radical mastectomy.
Primary Site/Surgery of Other Site--Leukemia: If hairy cell leukemia is diagnosed at splenectomy, and 1 month later a bone marrow confirms the same diagnosis, is the primary site coded to spleen or bone marrow? If the site is bone marrow, is the splenectomy coded to 2 (regional) or 4 (distant) in the surgery field?
For cases diagnosed prior to 1/1/2010:Primary site:
Code the primary site to C421 [bone marrow] per primary site coding instructions for leukemia in the 2007 SEER manual, page 70.
Surgery of other site:
Since all surgical procedures for hematopoietic diseases are coded in the data item Surgery of Other Site, assign code 1 [Nonprimary surgical procedure performed].
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.
MP/H Rules/Histology--Colon: How do you use Rule H5 or H6 to code "moderately diff adenoca with mucinous component"?
For cases diagnosed 2007 or later, code the histology 8140 [Adenocarcinoma]. Rule H6 applies because the final diagnosis is not "mucinous adenocarcinoma" and the percentage of mucinous adenocarcinoma is not stated.
Rule H13 does not apply because "component" is not a term that indicates a specific histology.
Reportability: Is a tubular adenoma reportable if the final diagnosis is "high grade atypia" and the diagnosis comment is "atypia limited to muscularis mucosa areas of pseudostratification [formerly qualifying for carcinoma in situ]"?
This case is not reportable.
The pathologist would need to include "carcinoma in situ" as part of the final diagnosis in order for this case to be reportable.
CS Tumor Size--Lung: If a 5/11/07 CT showed a 6.5 cm LLL mass and a 7/24/07 CT showed 8.4 cm LLL mass, do we code the larger tumor size identified within four months of diagnosis or do we code the first size documented at the time of diagnosis?
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 the larger tumor size.
MP/H Rules--Breast: Is inflammatory breast cancer always one primary per lifetime? Or is a subsequent inflammatory breast cancer a second primary if diagnosed more than five years later?
For cases diagnosed 2007 or later, a diagnosis of inflammatory breast cancer more than five years after a previous diagnosis of inflammatory breast cancer is a separate (new) primary. See rule M5 in the Breast Multiple Primary Rules.
MP/H Rules--Breast: Is a 2008 invasive ductal carcinoma counted as a new primary when it follows a 2005 invasive lobular carcinoma diagnosed in the same breast? See Discussion.
The patient has invasive lobular breast carcinoma excised in 2005. She returns in 2008 with a new invasive ductal carcinoma tumor same breast. Following MP/H rules, M10 seems to apply, which states this is still a single primary. Does this mean that this invasive ductal carcinoma is ignored and the patient remains in the registry with only a lobular carcinoma primary?
For cases diagnosed 2007 or later:
Rule M10 applies. The 2008 diagnosis is not a new primary.
The abstract for the 2005 diagnosis should be annotated to include the new information.
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