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SEER Inquiry System - Report
Produced: 11/26/2024 3:40 PM
Question 20100087
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Discussion:
Case 1 - Patient has a history of marginal zone lymphoma diagnosed in 1994 with recurrences in 2007 and 2009. The patient now presents for a bone marrow biopsy in May 2010 and is found to have large B-cell lymphoma, transformation. The first primary, marginal zone lymphoma, falls under the 2009 rules and the second primary, large B-cell lymphoma, falls under the 2010 and forward rules?
Case 2 - Patient was diagnosed with B-cell CLL/SLL and a DLBCL in 2009. If the 2009 rules only apply, these are a single primary. If the patient is admitted and treated in 2010 are the rules still based on the diagnosis date?
Answer:
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Case 1: Accession two primaries per Rule M10 when a neoplasm is originally diagnosed as a chronic neoplasm AND there is a second diagnosis of an acute neoplasm more than 21 days after the chronic diagnosis. The histology for the first primary is 9699/3 [marginal zone lymphoma] represents a chronic neoplasm and the second primary is 9680/3 [diffuse large B-cell lymphoma] is an acute neoplasm which was diagnosed more than 21 days after the first primary.
Case 2: Do not use the Heme DB and Manual rules for this case. Both diagnoses were made prior to 2010. The Heme DB and Manual are only effective for cases diagnosed 1/1/2010 and forward. Use the ICD-O-3 Hematopoietic Primaries Table to determine the number of primaries for this case. Per the Table, a second diagnosis of DLBCL [9680/3] following a diagnosis of CLL/SLL [9823/3] is one primary.
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
Case 1: History of marginal zone lymphoma [9699/3]. The first step is to check the transformation information on marginal zone lymphoma. Enter 9699/3 in the search mechanism of the 2010 Hematopoietic Database. Click on the Display button and scroll down to the Transformations box. You will find that marginal zone lymphoma does transform to diffuse large B-cell lymphoma (DLBCL) which is the 2010 diagnosis. Because the DLBCL occurred in 2010, this case should be processed using the 2010 hematopoietic rules. Enter "DLBCL" in the search mechanism of the DB. The display shows DLBCL 9680/3 and the preferred term (listed midscreen) is diffuse large B-cell lymphoma. Now you have the ICD-O-3 code for DLBCL, go to the Reportability Instructions in the Heme Manual. 9680/3 falls in the reportability range. Per the MP rules: M13 applies and instructs you to use the multiple primaries calculator to determine the number of primaries. Enter 9699/3 and 9680/3 into the multiple primaries calculator. The result is "New Primary." Create a new abstract for the DLBCL.
Case 2: Do not use the 2010 rules for this case. Both diagnoses were made prior to 2010. The 2010 rules are only effective for cases diagnosed 2010-2011.
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.
