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Report Produced: 04/03/2025 22:21 PM

Report Question ID Question Discussion Answer Year
20000465 Grade, Differentiation--Lymphoma: What code is used to represent this field when the only grade/differentiation given is "low grade", "intermediate grade" or "high grade"?

Code the Grade, Differentiation field to 9 [cell type not determined, not stated or not applicable]. For lymphomas, do not code the descriptions "high grade," "low grade," and "intermediate grade" in the Grade, Differentiation field. These terms refer to categories in the Working Formulation and not to histologic grade for lymphoma histologies.

Generally, for histologies other than Non-Hodgkin lymphoma, the Grade, Differentiation field is coded to 2 [low grade], 3 [intermediate grade] and 4 [high grade] for most cancers.

 2000
20000493 EOD-Clinical Extension--Prostate: For prostate cancer, can an elevated PSA be used to code metastasis? See discussion.

5/31/98 PE: 30 gm prostate with nodularity, suspicious for CA.

Final diagnosis: Stage D Ca of prostate with mets, NOS

PTA IVP: Normal collecting system

5/11/98 CXR: NED

PSA 86.3 Suggestive of prostate Ca per MD

5/13/98 TURP and bilat. orchiectomy: Plan was to perform orchiectomy as treatment of choice if biopsy was positive. Appears MD feels that the patient has mets, NOS based on the elevated PSA.

5/13/98 TURP Adenocarcinoma, PD

For cases diagnosed 1998-2003, do not code the EOD-Clinical Extension field based on elevated PSA alone. If a recognized practitioner states that there is metastasis, then metastasis should be coded.

In this case, code the EOD-Clinical Extension field to 85 [Metastasis] because it is Stage D. But if you had D1 or D2 staging based on the involvement of lymph nodes, then that involvement would be coded under EOD lymph nodes and not under the clinical extension field.

 2000
20000259 Histology (Pre-2007): What code is used to represent the histology for a "malignant invasive gastrointestinal stromal tumor (GIST)"?

For tumors diagnosed 2001-2006: Malignant GIST is coded 8936/3.

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.

 2000
20000437

EOD-Extension--Lymphoma: Should "bilateral" inguinal lymph node involvement by lymphoma be two chains for the purpose of coding EOD?

Yes. Bilateral inguinal lymph nodes are coded as two chains/regions.

 2000
20000848 Primary Site--Lymphoma: How should you code the primary site for a lymphoma that presents in a "mediastinal mass"? Code the Primary Site field to C77.1 [mediastinal lymph nodes]. 2000
20000244 Behavior Code--Bladder/Lymphoma: Should the "in situ" designation on a bladder primary's pathology report be ignored that states a diagnosis of "in situ lymphoma"? Ignore the in situ designation. You cannot assign an in situ behavior code to a lymphoma primary. The term or designation of "in situ" is limited to solid tumors; carcinoma and/or cancer. 2000
20000438 EOD-Extension/SEER Summary Stage 2000--Kidney/Eye: What codes are used to represent these fields for simultaneous bilateral Wilms tumor or simultaneous bilateral retinoblastoma?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 85 [Metastasis] and the SEER Summary Stage 2000 field to 7 [Distant] for both types of tumor. Each kidney and each eye are staged separately in the AJCC, 6th ed., but for SEER we would abstract these diagnoses as one case and code the EOD and stage fields to distant to reflect the involvement of both eyes or both kidneys.

 2000
20000449 EOD-Extension/EOD-Lymph Nodes--Lung: Is "subcarinal extension" with no mention of lymph nodes coded in the EOD extension field or in the EOD lymph node involvement field? See discussion.

Should "subcarinal extension" with no mention of lymph nodes be assumed to be direct contiguous extension of the primary tumor or does it represent lymph node involvement?

If it is direct extension, should we code it as 70 in the extension field? If not, should we code it as 2 in the lymph node involvement field?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 70 [mediastinum, direct extension].

 2000
20000256 EOD-Size of Primary Tumor--Melanoma: How do you code tumor size for a melanoma diagnosed by a positive lymph node biopsy when the primary site is coded C44.9 because no primary site was identified? See discussion. Should the size be 000 because no primary was found or 999 for unknown?

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field to 000 [No mass; no tumor found] when primary site is coded to C449.

 2000
20000419 EOD-Extension--Corpus Uteri: How do you code myometrial involvement described as 1) "to the level of the middle one-third" or 2) "superficial"?

For cases diagnosed 1998-2003:

Evaluate each case carefully.

1. Code the EOD-Extension field to 12 [Myometrium-inner half] because the pathology report indicates involvement of the myometrium "to the level of." However, if you feel that you cannot make that determination with certainty and you cannot ask a pathologist for clarification, then code the EOD-Extension field to 14 [Myometrium, NOS].

2. Code the EOD-Extension field to 12 [Myometrium-inner half] for cases with "superficial" myometrial invasion.

 2000