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Report Produced: 12/01/2022 17:48 PM

Report Question ID Question Discussion (Ascending) Answer
20081044 MP/H Rules/Behavior--Melanoma of Skin: How are histology and behavior coded for a "malignant melanoma in situ with regression"? See Discussion. Per the microscopic portion of the path report, there is a zone of regression within the confines of the lesion, such that the possibility of antecedent invasive disease at the site cannot be ruled out with certainty.

For cases diagnosed 2007 or later:

Code malignant melanoma in situ with regression to 8720/2 [Melanoma in situ].

Code the histology according to the histologic type specified in the pathology report final diagnosis. Code the behavior as specified in the pathology report. Regression does not affect the coding of histology or behavior. See Melanoma Histology Coding rule H5. See 2007 SEER manual instructions for coding behavior, page 84.

20130204 MP/H Rules/Histology--Kidney, renal pelvis: How is histology coded for a tubulocystic renal cell carcinoma? See Discussion. Per the resected specimen final diagnosis COMMENT in the pathology report: Tubulocystic renal cell carcinoma is a relatively new renal epithelial neoplasm that has been added to an updated WHO classification of renal tumors. (Srigley et al. The International Society of Urologic Pathology Vancouver Classification of Renal Neoplasia Am J Surg Pathol. 2013;37:1469-1489). The majority of tubulocystic renal cell carcinomas reported in the literature (greater than 90%) have behaved in an indolent manner. Code the histology to 8312/3 [renal cell carcinoma, NOS] per Rule H3. The term "tubulocystic" is not a specific renal cell histology according to our kidney pathology expert.
20100027 Reportability: Is AIN III reportable if it arises in the perianal skin? See Discussion. Physical exam states patient has a suspicious area of anal skin. Operative findings show a raised, suspicious lesion in the right perianal region. Our interpretation of the primary site would be skin and therefore not reportable. However, the final diagnosis on the pathology report indicates "AIN III/squamous cell carcinoma with focal areas suspicious for microinvasion. "SINQ #20041056 states that AIN III is reportable. AIN III of the anus or anal canal (C210-C211) is reportable. AIN III (8077) arising in perianal skin (C445) is not reportable.
20021028 EOD-Clinical Extension--Prostate: If the tumor arises in the prostatic apex, does that take priority over coding clinical extension based on the stage of cT1c? See discussion. Physician states prostate primary is a cT1c. Pathology states adenocarcinoma, Gleason 3+3, right apex. All other biopsies were negative. Because the primary appears to be in the prostatic apex, do we code 33 or 15 for clinical extension? Which is more important for SEER? Do you want to capture the "apex" information or the "cT1c" information?

For cases diagnosed 1998-2003:

Code the EOD-Clinical Extension field to 33 [arising in prostatic apex]. Apex information takes priority. The only statement we have is cT1c by the urologist, and we don't know how that stage was determined.

20130114 Histology--Heme & Lymphoid Neoplasms: How is the histology coded when the bone marrow biopsy shows acute myeloid leukemia, but the physician states this is therapy-related AML secondary to prior radiation treatment? See Discussion. Physician states this patient has radiation therapy-related AML due to radiation received as treatment for a prior prostate cancer. The bone marrow and other immunophenotyping do not state this is therapy-related AML. Should the histology be coded AML, NOS [9861/3] or therapy-related AML [9920/3]?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the histology as therapy-related acute myeloid leukemia, NOS [9920/3] when the physician states this is a therapy-related AML.

The therapy-related diagnosis may be either clinically or pathologically stated to code the histology to 9920/3. In this case, the physician is aware of the previous chemotherapy, hormone therapy or radiation and adds that knowledge to the histologic findings of AML. The pathology report did not include this clinical, historical information as part of the final diagnosis. However, one can code therapy-related acute myeloid leukemia because clinically it was stated.

We recommend that you clearly document in the abstract that you are coding a clinical histology.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

20130077 Reportability--Heme & Lymphoid Neoplasm: What is the histology code if a myeloproliferative disorder is reportable should a physician suspect this diagnosis and treats the patient? See Discussion. Physician suspects patient has a myeloproliferative disorder and treats her with a phlebotomy and Hydrea. Patient receives Hydrea during an inpatient stay, but does not see the Heme/Onc again. The patient is subsequently only seen by a Palliative Medicine physician who also states she has an underlying myeloproliferative disorder. The patient died while an inpatient.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This is a reportable diagnosis and should be accessioned with the histology coded to 9975/3 [myelodysplastic/myeloproliferative neoplasm, unclassifiable].

The term is a reportable ambiguous term per the Hematopoietic Coding Manual (Case Reportability Instructions, Rule 4). Also, the patient was treated for a myeloproliferative disorder, making this a reportable clinical diagnosis per the SEER Manual (Reportability, Pg 4, Exception 1).

Myeloproliferative disorder is synonymous with myeloproliferative disease. Myeloproliferative disease is listed as an alternate name for myelodysplastic/myeloproliferative neoplasm, unclassifiable.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

20031199 CS Extension/Polyp--Colon: How is CS extension coded for tumor invasion described as "Haggitt level 4"? See Description. Polypectomy specimen revealed adenocarcinoma of the rectum in a tubulovillous adenoma. Per path extent of invasion was Haggitt level 4. The micro description of the tumor stated that there was malignant epithelial neoplasm in colonic mucosa.

In a 1985 Gastroenterology journal article, Haggitt described five levels of polyp invasion:

Level 0-confined to mucosa

Level 1-head

Level 2-Neck

Level 3-Stalk

Level 4-Submucosa of underlying colonic wall.

For cases diagnosed 2004 and forward:

Use the best information available to code CS extension. The following conversion may be used when the only information available is the Haggitt level.

Level 0 - Extension 10

Level 1 - Extension 13

Level 2 - Extension 15

Level 3 - Extension 14

Level 4 - Extension 16

20051125 CS Site Specific Factor--Prostate: Is there an established range of values that can be used to code negative, borderline or elevated PSA values? See Discussion. Previous SEER prostate coding guidelines listed a PSA range that could be used to code negative, borderline, or elevated values in the absence of any statement concerning elevated PSA in the medical record. Is this still in effect for SSF 2, or do we need a definite statement when only a numeric value is given?

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.

This matter is under consideration by the CS Steering Committee. The CS Steering committee is reviewing options for incorporating SEER guidelines into the CS manual.

20051122 CS Lymph Nodes--Prostate: How is this field coded when no scan, scope or surgical evaluation of regional lymph nodes is performed for a case with localized disease in the primary site? See Discussion. Prior to initiation of collaborative stage, SEER prostate guidelines instructed us to code lymph node involvement as negative when clinical or pathologic extension was coded 10-34 and there was no lymph node information. Is this guideline still in effect, or do we follow the collaborative stage rules which require lymph node information or, in absence of node info, usual treatment for localized 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.For prostate and other "inaccessible sites" with localized disease, code the regional lymph nodes as clinically negative when not mentioned on imaging or exploratory surgery.

20020050

EOD Clinical Extension--Prostate: Can you assign code 15 if there is no TURP and no physical exam? See discussion.

[Code 15 = Tumor identified by needle biopsy, e.g. for elevated PSA, (T1c)]

Prostate case: Elevated PSA, Prostate u/s: no abnormal findings, Prostate biopsy: adenocarcinoma. Can this be clinically coded as 15? According to Prostate EOD Coding Guide (6/2001), code 15 requires documentation that the physical exam was negative, but in this case, we have no physical info.

For cases diagnosed 1998-2003:

Code the EOD Clinical Extension field to 30-34 when there is no documentation saying that the physical examination was negative.