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SEER Inquiry System - Report
Produced: 10/22/2025 4:10 PM
Question 20100096
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.
Per Rule M11, this case is to be accessioned as two primaries; follicular lymphoma, grade 1 [9695/3] and diffuse large B-cell lymphoma (DLBCL) [9680/3]. The case represents a chronic neoplasm (follicular lymphoma, grade) and an acute neoplasm (diffuse large B-cell lymphoma) diagnosed within 21 days of one another and there is documentation of two biopsies, one confirming the chronic disease and the other confirming the acute disease.
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
The follicular lymphoma (FL) was diagnosed on 9/30/10 and the diffuse large B-cell lymphoma (DLBCL) was diagnosed on 10/11/10. The steps to determine whether this is a single primary or multiple primaries begin with using the 2010 Hematopoietic Database.
For cases diagnosed 2010-2011, look up "FL" in the DB to get a provisional ICD-O-3 code which is 9690/3. Click on the Display button and scroll down to check the documentation in the "Transformations" box. Note that FL transforms to DLBCL which means that for your case you have an acute and chronic disease diagnosed within 21 days.
Look up DLBCL in the DB to obtain the histology code 9680/3.
Per the reportability rules: Both ICD-O-3 histology codes are in the reportable range.
MP rules: Rule M8 applies because this case has a chronic and acute disease diagnosed within 21 days and two positive bone marrows, one confirming the chronic disease and the other confirming the acute disease.
We will be modifying this rule to state "two biopsies or two bone marrows" in the upcoming revision.
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.
