An official website of the United States government
Home
SEER Inquiry System - Report
Produced: 06/05/2025 8:00 PM
Question 20100085
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Discussion:
Answer:
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the histology to 9837/3 [T lymphoblastic leukemia/lymphoma].
To determine the primary site for leukemia/lymphoma histologies, first go to Module 4. Per Rule PH8, code the primary site to the site of origin when lymph nodes, tissue or organs are involved. To determine a more specific histology, go to Module 7, rules for coding primary site for lymphomas. Per Rule PH20, code the lymph node region when multiple lymph node chains within the same region are involved. Mediastinal and hilar lymph nodes are intrathoracic lymph nodes. The substernal mass is also intrathoracic and is presumed to be a lymph node mass which involved the pericardium. For this case, code the primary site to C771 [Intrathoracic lymph nodes].
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:
This SINQ question has been updated to the Hematopoietic & Lymphoid Neoplasm Manual & Database published January 2014.
The original answer below was written based on the rules in 2010
For cases diagnosed 2010-2011, use the 2010 Hematopoietic Database to find provisional ICD-O-3 codes and verify site/histology agreement. Start by doing a "smart search" by entering only the word "lymphoblastic" in the search mechanism.
Click on the "Matched Term" label in the grid header above the displayed results. The terms are now alphabetized. Scroll down to "T" and you will see T lymphoblastic leukemia/lymphoma [9837/3].
Click on that term so the additional information about this disease process is displayed.
Click on Display Abstractor Notes button. Always use the Abstractor Notes when you question what primary site to code. The first information says this code is effective for cases diagnosed 2010 and later. It states that most patients present with widespread lymph node involvement as well as peripheral blood involvement. The skin is the most common extralymphatic site, but the disease is usually systemic involving spleen and extranodal sites including lung, liver, GI tract, and CNS.
Now that you have this information, go to the 2010 Hematopoietic Manual.
Reportability rules: 9837/3 is within the reportable range.
MP Rules: M2 applies because this case represents an example of a single histology is a single primary.
PH Rules: Go to module 7, rules for coding primary site for lymphomas. PH29, code the lymph node region when multiple lymph node chains within the same region (mediastinal and hilar) are involved. For this case, code C771 [Intrathoracic lymph nodes] because both mediastinal and hilar LN are coded C771.
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.
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.
