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| Question: 20120073 |
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Status Final References Source 1: 2012 Heme & Lymph Manual & DB pgs: Notes: Source 2: pgs: Notes: Question Primary site--Heme & Lymphoid Neoplasms: The Hematopoietic Database online shows C421 as primary site for systemic mastocytosis. Is this true for 2011 or only for 2012? See discussion. Discussion A 72 yr old female presented with leukopenia, anemia & monoclonal gammopathy. A bone marrow biopsy in 2011 showed SYSTEMIC MASTOCYTOSIS (9741/3). Later a shave bx of skin of upper abdomen was done that showed SUPERFICIAL PERIVASCULAR LYMPHOCYTIC INFILTRATE WITH NUMEROUS MAST CELLS & the histological features were consistent with a diagnosis of mastocytosis. A bone marrow biopsy was performed that showed PROGRESSIVE SYSTEMIC MASTOCYTOSIS, HYPERCELLULAR MARROW (99%) WITH MASTOCYTIC INFILTRATION & TRILINEAGE HEMATOPOIESIS, MODERATE PARATREBECULAR MYELOFIBROSIS & PLASMA CELL PROLIFERATION WITH MORE LAMBDA LIGHT CHAIN EXPRESSION. Oral chemo was started 3/19 (sprycel). This patient has a history of Diabetes Type II, hypertension & breast cancer (left breast in 1989). Answer Code systemic mastocytosis with bone marrow involvement diagnosed prior to 2012 to 9741/3 and code the primary site to bone marrow.
Since the first edition of the Hematopoietic Database did not give clear instructions about coding primary site for this histology, apply the primary site coding instructions in the 2012 database to code pre-2012 diagnoses of systemic mastocytosis.
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