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SEER Inquiry System - Report
Produced: 02/06/2026 2:45 AM
Question 20110107
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 the histology to 9837/3 [adult T cell leukemia/lymphoma] and the primary site to C778 [lymph nodes, multiple regions]. Per Rule PH8, code the primary site to the site of origin when lymph node(s) or lymph node region(s), tissue(s) or organs are involved. A statement of "mediastinal mass" and lymphadenopathy for lymphoma primaries is equivalent to lymph node involvement. To identify the more specific primary site, you need to move to Rule PH21 that indicates you are to code the primary site as multiple lymph node regions, NOS [C778] when multiple lymph node regions, as defined by ICD-O-3, are involved and it is not possible to identify the lymph node region where the lymphoma originated.
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 histology as adult T cell leukemia/lymphoma [9837/3] and the primary site to lymph nodes, multiple regions [C77.8]. The steps used to arrive at this decision are:
Enter in the Heme DB to find the histology. Click on the SEARCH button. Scroll down and insure that the term "Adult T-cell leukemia/lymphoma, NOS" [9837/3] is highlighted on the screen under the RESULTS FOR ALL TERMS area. Scroll to the ALTERNATIVE NAMES section. Note that this is synonymous with the term precursor T-cell lymphoblastic leukemia
Check the PRIMARY SITE(S) section. It indicates, "See Abstractor Notes and Module 7."
Scroll to the ABSTRACTOR NOTE section which states that this disease is characterized by peripheral blood involvement and widespread lymph node involvement. (Responder's NOTE: These characteristics are the reason WHO made the separate lymphoma and leukemia codes obsolete and now classifies this disease as a leukemia/lymphoma.)
Determine the primary site. 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 appropriate module.
Go to MODULE 7: Primary Site Rules for Lymphomas Only 9590/3-9729/3 PH25-PH37 as instructed in the PRIMARY SITE(S) section. Start at PH25. Stop at the first rule that applies to the case you are processing. In this case note that cervical lymph nodes [C770] are classified as the head and neck lymph node region and mediastinal lymph nodes [C771] are in the intrathoracic lymph node region. Code the primary site as multiple lymph node regions, NOS [C778] when multiple lymph node regions, as defined by ICD-O-3, are involved and it is not possible to identify the lymph node region where the lymphoma originated.
