SEER Inquiry System - Question 20100100 Details

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Question 20100100

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Inquiry Details

References:

Heme & Lymph Manual & DB

Question:

Primary site/Histology--Heme & Lymphoid Neoplasms: How are these fields coded for a Langerhans cell histiocytosis diagnosed on an excisional biopsy of the T8 vertebral bone? See Discussion.

Discussion:

The patient had an excisional biopsy of the T8 vertebral bone, but no other tissue biopsy. The doctor confirms the case is malignant. However, Langerhans cell histiocytosis, NOS is listed as /1 (borderline) in the ICD-O-3.

Answer:

For cases diagnosed 2010 and forward, do not use the ICD-O-3 book to determine the hematopoietic and lymphoid histology codes. Use the Hematopoietic Database and access it at http://seer.cancer.gov/seertools/hemelymph.

Code the histology to 9751/3 [Langerhans cell histiocytosis] and the primary site for unifocal disease to C412 [bone, vertebral column]. Per Rule PH 30, use the Heme DB to determine the primary site and histology when PH1-PH29 do not apply. Per the Abstractor Notes section in the Heme DB, lytic bone lesions are the most common primary site.

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 2010-2011, do not use the ICD-O-3 to look up hematopoietic and lymphoid histology codes.

Enter "Langerhans" in the 2010 Hematopoietic Database search. The ICD-O-3 code is 9751/3, which is reportable. Next, click on the Display button and then the Display Abstractor Notes button for Langerhans cell histiocytosis. According to the Abstractor Notes, the lytic bone lesions are the most common primary site. Code the primary site to C412 [Bone, vertebral column].

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.

Cancer Site Category:

Heme & Lymphoid Neoplasms

Data Item Category:

Primary site, Histology

Other Category:

N/A

Year:

2010