SEER Inquiry System - View

Question: 20130080 Status
Final

References
Source 1:   Heme & Lymph Manual & DB
pgs:  
Notes:  
Source 2:  
pgs:  
Notes:  


Question
Primary site/Histology--Heme & Lymphoid Neoplasms: How are the primary site and histology coded when a right neck mass and spinal mass both show B-cell lymphoma, favor Burkitt lymphoma? See Discussion.

Discussion
2/5/11 Right neck swelling. Biopsy of mass B-cell lymphoma, favor Burkitt lymphoma.

7/5/11 Hemi-laminectomy, L2-L5 spinal mass: Malignant lymphoma, B-cell phenotype, favor Burkitt lymphoma.

Should the primary site be C779? Is the correct histology Burkitt lymphoma [9687/3] or malignant lymphoma, diffuse large B-cell [9680/3]?

Answer
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the primary site to C779 [lymph nodes] per Rule PH22 and the histology to 9591/3 [B-cell lymphoma, NOS].

Code the primary site to C779 [lymph nodes, NOS] when lymphoma is present in an organ and lymph nodes that are not regional for that organ and the origin cannot be determined even after consulting the physician. The patient has involvement of a lumbar spine mass and cervical lymph nodes. Cervical lymph nodes are not regional to the lumbar area of the spine.

Do not use ambiguous terminology to code histology for hematopoietic neoplasms. "Favor" is ambiguous terminology. Therefore, the histology must be coded to B-cell lymphoma and not to diagnosis which is “favored” (Burkitt lymphoma). Remember that ambiguous terminology is only used to determine case reportability, not to code histology for hematopoietic neoplasms.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

History
For cases diagnosed 2010 and forward, access the Hematopoietic Database at Click on Hematopoietic and Lymphoid Database. In the search box, enter your histology or the ICD-O-3 code. Click on the link to that disease. In the "Help me code for dx year" field, enter the year of diagnosis. The Hematopoietic Coding Manual (PDF) button will appear. Code to B-cell lymphoma, 9590/3. Do not use ambiguous terminology to code histology for hematopoietic neoplasms. "Favor" is ambiguous terminology. Do not code the histology as Burkitt lymphoma in this case.

Per the Hematopoietic Database, Go to MODULE 7: Primary Site Rules for Lymphomas Only 9590/3-9729/3, 9735/3-9738/3, 9811/3-9818/3, 9823/3, 9827/3, 9837/3 PH18-PH27 as instructed in the PRIMARY SITE(S) section. Start at PH18. Based on the information provided, this lymphoma is present in the cervical lymph nodes and the lumbar area of the spine. Cervical lymph nodes are not regional to the lumbar area of the spine. Stop at Rule PH22, code to Lymph nodes, NOS, C779.



Last Updated
07/02/2014

Date Finalized
07/11/2013