SEER Inquiry System - Question 20100048 Details

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Produced: 06/18/2026 4:10 AM

Question 20100048

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Inquiry Details

References:

Heme & Lymph Manual & DB

Question:

Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded for a patient diagnosed with Langerhans cell histocytosis/eosinophilic granuloma involving both the seventh rib and the right temporal bone? See Discussion.

Discussion:

Patient was diagnosed with Langerhans cell histiocytosis/eosinophilic granuloma following a biopsy of the seventh rib on 3/22/10. On 4/13/10 the patient had a right external ear canal mass (right temporal bone) biopsy with same diagnosis. Should the primary site be coded to bone, NOS [C419]?

Answer:

Updated May 2026

Per the Hematopoietic database, if a primary site of LCH is not able to be determined, default to C419. So, assign C419 for this case.

Langerhans cell histiocytosis can occur as a solitary lesion, multifocal lesions, or multisystem disease. In this case, the patient has multifocal disease of the bone.

For cases diagnosed 2010-2020, LCH is reported as 9751/3 for all diagnoses.

For cases diagnosed 2021+, only Langerhans, disseminated (multifocal, multiorgan, multisystem) is reportable as 9751/3.

History:

Code the primary site to bone, NOS [C419]. Langerhans cell histiocytosis can occur as a solitary lesion, multifocal lesions, or multisystem disease. In this case, the patient has multifocal disease of the bone. The abstractor notes in the 2010 Hematopoietic DB were used as a reference for this answer.

The answers for SINQ questions with 2010 ID numbers were written using the 2010 Heme & Lymph Manual & DB. The instructions for using the 2010 Hematopoietic Database were written for the version of the software in use as of 5/24/2011. The user interface of the web-based 2010 Hematopoietic Database available from the SEER website varies slightly from the 5/24/2011 version in that the web-based version provides all the disease information in one scrollable window.

The original answer below was written based on the rules in 2010 (or 2012)

For cases diagnosed 2010-2011, access the 2010 Hematopoietic Database at http://seer.cancer.gov/tools/heme/. Click on Hematopoietic Project. Click on Hematopoietic and Lymphoid Database. For 2010-2011 diagnoses, click on the "use the 2010 database" label in the upper right corner of the screen. The 2010 Hematopoietic Coding Manual (PDF) button will appear to indicate the correct version of the program is available now for query.

Cancer Site Category:

Heme & Lymphoid Neoplasms

Data Item Category:

Primary site

Other Category:

N/A

Year:

2010