03-27-2026 TURB only-not eligible for AJCC Path Stage
Scenario:
- 3/7/26 PET Scan: Enlarged Cervical, Mediastinal, Axillary & Mesenteric Adenopathy most compatible with Lymphoproliferative Disorder Such As CLL.
- 4/3/26 Peripheral Blood: B-Cell Population detected (83% lymphoid cells). Flow cytometry shows monotypic B-Cells with co-expression of CD5. Immunophenotype most consistent with CLL/SLL.
Question: How would you assign the Date of Diagnosis?
- 03/07/2026
- 04/03/2026
Answer: 04/03/2026
References
SEER Program Coding and Staging Manual
- Ambiguous Terminology
- Equivalent to “Not diagnostic for” malignancy or reportable diagnosis. These phrases are NOT reportable when no other information is available.
- Highly suspicious for, but not diagnostic of [malignancy or reportable diagnosis].
- Most compatible with a [non-reportable diagnosis] such as a [reportable diagnosis].
- High probability for [malignancy or reportable diagnosis]
SEER Hematopoietic and Lymphoid Neoplasm Database: https://seer.cancer.gov/seertools/hemelymph/
- Lymphoproliferative Disease, NOS- 9970/1.
SEER Program Coding and Staging Manual
- Date of Diagnosis
- Code the month, day, and year the tumor was first diagnosed, clinically or microscopically, by a recognized medical practitioner. Medical practitioner includes physician, physician assistant, nurse practitioner, nurse midwife, residents, fellows, medical trainees, and licensed recognized medical practitioner as determined by a state.
- When the first diagnosis includes reportable ambiguous terminology, record the date of that diagnosis
- Code the month, day, and year the tumor was first diagnosed, clinically or microscopically, by a recognized medical practitioner. Medical practitioner includes physician, physician assistant, nurse practitioner, nurse midwife, residents, fellows, medical trainees, and licensed recognized medical practitioner as determined by a state.
Discussion:
The 3/7/26 PET scan described adenopathy suspicious for a lymphoproliferative disorder such as CLL. Lymphoproliferative disorder is a non‑reportable term (/1). Per SEER ambiguous terminology rules, use of an ambiguous term with a non‑reportable diagnosis followed by “such as” a reportable malignancy does not meet reporting criteria.
On 4/3/26, peripheral blood findings were reported as most consistent with CLL/SLL, establishing a definitive diagnosis. Therefore, the case becomes reportable effective 4/3/26.
