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SEER Inquiry System - Report
Produced: 04/17/2026 3:07 AM
Question 20110032
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 PH30, use the Heme DB to determine the primary site and histology when PH1-29 do not apply, In this case, code the primary site to C449 [Skin]. According to the Abstractor Notes section in the Heme DB, the solitary form of Langerhans cell histiocytosis (LCH) [9751/3] occurs less commonly than the multisystem form of the disease; but can appear in nodes, skin and lung. This is a solitary form of LCH. Code the primary site to skin [C449].
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, access the 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.
Code the Primary Site to C449 [Skin]. The steps used to arrive at this decision are:
Enter in to the Heme DB to search for the histology. Click on the SEARCH button. The term "Langerhans cell histiocytosis" [9751/3] is highlighted on the screen under RESULTS FOR ALL TERMS section.
Scroll to the ABSTRACTOR NOTE section to check to see whether there is information related to the coding of primary site. The Abstractor Note section oftentimes provides information related to common and rare primary sites for a given histology. According to the Abstractor Notes for LCH [9751/3], the solitary form of LCH occurs less commonly in nodes, skin and lung. This is a solitary form of LCH. Code the primary site to skin [C449].
