Update to Current Manual/2018 EOD Manual/EOD Primary Tumor--Bladder: According to the American Joint Commission on Cancer (AJCC), a transurethral resection of the bladder (TURB) cannot make a distinction between involvement of the superficial muscle-inner half (Stage T2a) and the deep muscle-outer half (Stage T2b). Is this same criteria applied to Extent of Disease (EOD)?
EOD follows AJCC criteria in this situation and we have confirmed with AJCC that Stage T2a (superficial muscle) and Stage T2b (deep muscle) cannot be assigned when only a TURB is done.
For EOD Primary Tumor, Bladder, codes 200, 250, 300, 350, can only be used when
Cystectomy is performed
Muscularis propria is involved, AND
Pathology report states superficial muscle (200, 250) or deep muscle (300, 350) is involved
If a TURB is done and there is mention of the muscularis propria invasion (superficial muscle or deep muscle), use EOD codes 370 or 400. If a TURB is done and the pathology report states superficial or deep muscle, ignore and coded as “invasion of muscularis propria, NOS” (EOD codes 370 or 400).
Instructions and code descriptions for EOD Primary Tumor have been updated to indicate this. These updated instructions and code descriptions will be available when SEER*RSA is updated for 2024, Version 3.1 (Sept/Oct 2023). These updates are included here for reference and can be applied for cases diagnosed 2018+.
Histology (Pre-2007)--Kidney, renal pelvis: What codes are used to represent the histologies of 1) "renal papillary (chromophil) carcinoma" and 2) "chromophil renal cell carcinoma?"
For tumors diagnosed prior to 2007:
Code "chromophil" to 8260 [papillary renal cell]. According to our pathologist consultant, in the case of chromophil, most authors regard this as more or less synonymous with papillary renal cell [8260]. "More or less" because papillary is an old term descriptive of the microscopic structure, while chromophil is newer and based on the cytology; because most of the latter are papillary the current usage assumes them to be equivalent.
1) The diagnosis "renal papillary (chromophil) carcinoma" tells us that the pathologist who wrote it was seeing both pattern and cytologic features, and is regarding papillary equivalent to chromophil; thus, code to 8260.
2) Code "chromophil renal cell carcinoma" to 8260.
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 Reg LN Pos/Exam--Melanoma: How should these fields be coded for a case that is an unknown primary site melanoma with liver involvement and a positive axillary lymph node?
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 regional lymph nodes positive 01 [one positive lymph node] and regional lymph nodes examined 01 [one lymph node examined] (assuming the positive node was the only node examined).
If the only lymph node involvement is the positive axillary lymph node, it is reasonable to conclude that this is a regional lymph node. When only one chain of lymph nodes is involved with metastatic melanoma, the metastatic cells had to come from skin with direct drainage to those lymph nodes.
EOD-Extension--Corpus Uteri: How is this field coded for a stage III A endometrial primary with positive pelvic washings, involvement of the omental serosa, and negative lymph nodes?
For cases diagnosed 1998-2003: Code EOD-extension as 85 [Metastasis]. According to our TNM consultant, Omental metastasis is M1, Stage IVB [EOD 85].
Date Multiple Tumors--Prostate: For a prostate biopsy done 10/20/08, both lobes involved with tumor, unknown how many tumors, what would be coded in date of multiple tumors?
In this case, code the date of the biopsy in Date of Multiple Tumors [10202008]. When the number of tumors is unknown, code the date of diagnosis as the Date of Multiple Tumors. This is the date on which it was determined that there were an unknown number of tumors. This instruction will be added to next edition of the MP/H manual.
Reportability/Histology--Tongue: Is high grade squamous dysplasia of the tongue reportable; and is it the same as carcinoma in situ (CIS), code 8077/2?
High grade squamous dysplasia of the tongue is reportable as of 2021 and later as 8077/2.
MP/H Rules/Histology--Pancreas: What is the histology code of invasive adenocarcinoma, non-mucinous with intraductal tubulopapillary features, moderately differentiated, from the pathology report final diagnosis of the pancreas? Does 'intraductal" refer to a non-invasive/in-situ component or describe the pattern of growth?
Assign 8503/3, intraductal papillary adenocarcinoma with invasion, to capture the more specific features of the adenocarcinoma. Histology Rule H13 for Other Sites states to code the most specific histologic term. Examples include Adenocarcinoma and a more specific adenocarcinoma. Note: The specific histology may be identified as type, subtype, predominantly, with features of, major, or with ___ differentiation.
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--Melanoma: Regarding SINQ #20081044, when would you apply Rule H6 rather than Rule H5 for a cutaneous malignant melanoma given that you normally always have a specific cell type mentioned?
For cases diagnosed 2007 or later, Rule H6 is used when you do not have a specific cell type other than regressing melanoma, or malignant melanoma, regressing. If you have regressing melanoma with a specific cell type, apply rule H5.
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