An official website of the United States government
Home
SEER Inquiry System - Report
Produced: 10/24/2025 4:46 AM
Question 20110037
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Discussion:
The patient was diagnosed with a composite lymphoma of a cervical lymph node 8 years after diagnosis of follicular lymphoma that involved lymph nodes and organs on both sides of the diaphragm. The patient's follicular lymphoma was diagnosed in 2002.
In 2010 an excisional biopsy of a left neck lymph node showed classical Hodgkin lymphoma, nodular sclerosis type, grade 2 (predominant component) associated with (minor component) low grade follicular lymphoma (composite lymphoma).
Should the primary site for the 2010 primary be coded to C770 [lymph nodes of head, face & neck] or C778 [multiple lymph node regions]?
Answer:
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the primary site to C770 [lymph nodes of the head and neck]. Per Rule PH19, code the primary site to the specific lymph node region when only one lymph node or one lymph node region is involved. No involvement other than the cervical lymph nodes is mentioned for the disease in 2010.
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.
The primary site is C770. The steps used to arrive at this decision are:
Determine the primary site of the new 2010 primary. Click on the 2010 HEMATOPOIETIC CODING MANUAL (PDF) button. Once in the manual, locate one of the three formats (i.e., flowchart, matrix or text) to check the Primary Site Histology Rules. The rules are intended to be reviewed in consecutive order within the module. You stop at the first rule that applies to the case you are processing.
Go to Module 7. This module is specifically written to help code primary site for lymphomas. . Per this rule, code the primary site to the specific lymph node region when only one lymph node or one lymph node region is involved. No involvement other than the cervical lymph nodes is mentioned, so code the primary site to C770 [lymph nodes of the head and neck].
