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Report Produced: 01/15/2025 11:59 AM

Report Question ID Question Discussion Answer Year
20020012 MP/H Rules/Histology--Breast: What code is used to represent the histology "ductal carcinoma in situ and invasive lobular carcinoma"? See discussion. Is the histology coded to the combination code of 8522/3 (ductal and lobular) or to the invasive component 8520/3 (lobular)?

For cases diagnosed 2007 or later:

Assuming ductal carcinoma in situ and invasive lobular carcinoma are present in a single tumor, code 8520/3 [Infiltrating lobular carcinoma, NOS].

Using the 2007 MP/H rules for breast, the single tumor invasive and in situ carcinoma module, start and stop at rule H9 and code the invasive histology.

 2002
20021018 First Course Treatment--Prostate: How do you code "watchful waiting" in these fields for prostate primaries?

For cases diagnosed 1/1/2003 and later: When "watchful waiting" is the first course of therapy for prostate cancer, code the case as follows:

Date Therapy Initiated: 000000

Surgery of Primary Site: 00

Scope of Regional Lymph Node Surgery: 0

Surgical Procedure of Other Site: 0

Reason for No Cancer-Directed Surgery: 1

Radiation: 0

Chemotherapy: 00

Hormone Therapy: 00

Immunotherapy: 00

Hematologic Transplant and Endocrine Procedures: 00

Other Cancer Directed Therapy: 0

 2002
20020015 Histology (Pre-2001): For cases diagnosed before 1/1/01, what code is used to represent the histology "small cell neuroendocrine carcinoma"? For tumors diagnosed prior to 2001, code the Histology field to 8041/3 [small cell carcinoma] for "small cell neuroendocrine carcinoma". 2002
20021055 EOD-Extension--Liver: Can we use CT scan descriptions such as "portal vein thrombosis" or "extensive infiltration of the liver" or "diffuse infiltration of the liver" to code extension for liver primaries? See discussion.

1. Would you code portal vein involvement for a CT scan description of "portal vein thrombosis"?

2. Would you code more than one lobe of the liver as involved for CT scan descriptions of "extensive infiltration of the liver" or "diffuse infiltration of the liver"?

For cases diagnosed 1998-2003:

1. No. Thrombosis can be caused by non-cancerous conditions.

2. Yes. Code the EOD-Extension field to 65 [Multiple (satellite) nodules in more than one lobe of the liver] when "extensive infiltration" or "diffuse infiltration" is stated.

 2002
20021207 EOD-Lymph Nodes--Breast: How do you code this field when the gross description on the pathology report states "nodal tissue is matted" but only 1/18 lymph nodes is found to contain micrometastatsis per the microscopic description of the report?

For cases diagnosed 1998-2003:

Code the EOD-Lymph Nodes field to 1 [Micrometastasis] because the matted nodal tissue was found to contain only one node with micrometastasis when examined microscopically. Coding priority is given to the microscopic description over the gross description.

 2002
20021058

Multiple Primaries (Pre-2007)--Breast: When simultaneously diagnosed breast tumors of the same histology in the same breast are stated by the pathologist and/or clinician to be more than one primary, should these be reported as multiple primaries? See discussion.

For example, based on special pathology studies that showed a difference in appearance between tumors, a pathologist may state that two ductal, NOS tumors diagnosed at the same time in the same breast represent two primaries.

For tumors diagnosed prior to 2007:

Code as a single primary. Follow the guidelines in the SEER Program Code Manual for determining multiple primaries. Simultaneous multiple lesions of the same histologic type in the same site (same breast) are a single primary for SEER, even though the pathologist may perform special studies and state that the patient has more than one primary.

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.

 2002
20021189

Multiple Primaries--Lymphoma: How many primaries should be reported when a 5/99 diagnosis of stage III follicular large cell lymphoma [9698/3] of the conjunctiva [C69.0] is followed with a 6/01 diagnosis of small cleaved lymphoma [9591/3] of the breast [C50.9]? See discussion.

The Lymphatic and Hematopoietic Diseases folding table states that this should be one primary, but is this true when they are both extralymphatic in origin?

For cases diagnosed prior to 1/1/2010:Report as two primaries if that reflects the medical opinion for this case. The table is a guide, but does not overrule the clinician's opinion. These extranodal lymphomas are diagnosed in two different sites more than 2 months apart. They are listed as the same primary in the folding table because 9591/3 is generally a non-specific term and 9698/3 is a more specific cell type. If both histologies were diagnosed in the same organ or tissue, this is the same primary. However, the primary sites in this example are distinctly different.

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.

 2002
20021021 Reportability--Hematopoietic, NOS: Should we add the missing terms listed in the Abstracting and Coding Guide for the Hematopoietic Diseases to ICD-O-3 because these absent synonyms would not be identified during hematology casefinding? See discussion. The Abstracting and Coding Guide for the Hematopoietic Diseases gives a preferred term for each code followed by a list of synonyms, not all of which are listed in the ICD-O-3. Two examples are: 1) 9962/3 [Essential Thrombocythemia] has 6 synonymous terms listed, but the last three of them are not in ICD-O-3. 2) 9930/3 [Myeloid Sarcoma] has the synonym "extramedullary myeloid tumor" which is not in ICD-O-3.

For cases diagnosed prior to 1/1/2010:Do not add these synonyms to ICD-O-3. The Abstracting and Coding Guide for the Hematopoietic Diseases lists synonyms for the preferred terms to assist in the classification of these other terms. In the absence of a specific code for the synonym, code to the preferred term. For casefinding, these terms would be grouped in a broader category of hematologic diseases under an ICD-9-CM or ICD-10 code and, therefore, will be identified during casefinding procedures using the disease index.

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.

 2002
20021185 Surgery of Primary Site--Major salivary gland: How do you code Surgery of Primary Site for a submandibular gland primary when the operative report refers only to an excision of the submandibular "tumor" while the pathology report states the submandibular "gland" was removed? See discussion. The gross description on the pathology report indicates that the specimen consists of a "submandibular gland." A further description on the pathology report included, "the specimen was sectioned exposing a focally cystic mass that nearly replaces the entire specimen." For cases diagnosed on 1/1/2003 or after: Code the Surgery of Primary Site field to 40 [Total parotidectomy, NOS; total removal of major salivary gland, NOS], per the pathology report's gross description of the specimen unless the operative report description of procedure indicates that the removal was less than total. 2002
20021023

EOD-Size of Primary Tumor/EOD-Extension--Breast: How do you code extension when the tumor in the breast is in situ and the regional axillary lymph nodes are positive? See discussion.

For example, what extension code is used for a 4.5 cm DCIS (no invasive ca found in excisional biopsy or mastectomy specimen) with mets to 01/07 LNs?

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 045 [4.5 cm]. Document how the size was determined in the EOD-Extension field.

Code the EOD-Extension field to 16 [Invasive and in situ components present, size of entire tumor coded in Tumor Size (size of invasive component not stated) AND proportions of in situ and invasive not known]. By virtue of the lymph node metastasis, this must be an invasive breast carcinoma. The size of the invasive component is unknown.

 2002