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SEER Inquiry System - Report
Produced: 11/29/2024 5:28 AM
Question 20110084
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.
Code histology to 9680/3 [diffuse large B-cell lymphoma]. Code 9684/3 [malignant lymphoma, diffuse large B-cell, immunoblastic NOS] is obsolete for cases diagnosed 2010 and later per the Heme DB.
Under the Definitions section in the Heme DB, it states that this is a lymphoma with diffuse proliferation of large neoplastic B lymphoid cells with nuclear size exceeding macrophage nuclei, more than twice size of normal lymphocytes. Normal architecture of node or extranodal tissue replaced in diffuse pattern. Morphologic variants: centroblastic, immunoblastic, plasmablastic, T-cell/histiocyte-rich, anaplastic.
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 correct histology code is 9680/3 [diffuse large B-cell lymphoma]. The steps used to arrive at this decision are as follows:
Enter (abbreviation for diffuse large B-cell lymphoma) in the Heme DB to find the histology. Click on the SEARCH button. Insure that the term "diffuse large B-cell lymphoma (DLBCL)" [9680/3] is highlighted on the screen under the RESULTS FOR ALL TERMS area.
Refer to the DEFINITION section which states that morphologic variants of DLBCL include: "centroblastic, immunoblastic, plasmablastic, T-cell/histiocyte-rich, anaplastic." The correct code for DLBCL, immunoblastic variant is 9680/3.
Coding the histology to 9680/3 is also confirmed if you check the histology code 9684/3 in the Heme DB. Enter 9684 in the Heme DB. Click on the SEARCH button. Scroll to the ABSTRACTOR NOTE section. Per the notes for histology code 9684/3, "Diffuse immunoblastic large B-cell diffuse lymphoma is now treated as a subtype of Diffuse large B-cell lymphoma (DLBCL)."
