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SEER Inquiry System - Report
Produced: 06/14/2025 8:52 AM
Question 20110122
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..
This should be accessioned as a single primary per Rule M8 which states to abstract as a single primary and code the acute neoplasm when both a chronic (MDS) and an acute (AML) neoplasm are diagnosed simultaneously or within 21 days AND there is documentation of only one positive bone marrow biopsy, lymph node biopsy, or tissue biopsy. Code the histology to 9895/3 [acute myeloid leukemia with myelodysplasia-related changes].
NOTE: When you search with quotation marks around the phrase, the database will only return results with that exact wording. To only return results for the expression trisomy 13, enter in the Heme DB. In this case, a search for "trisomy 13" returns no results. Therefore, it does not impact the coding of histology for this case.
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 to AML, NOS [9861/3]. There is not enough information to code a specific type of AML. The steps used to arrive at this decision are:
Enter in the Heme DB to search for this histology because the AML is stated to have evolved from that disease process. Insure that the term "myelodysplastic syndrome, unclassifiable" [9989/3] is highlighted on the screen under the RESULTS FOR ALL TERMS area.
Scroll down to the TRANSFORMATIONS section which indicates that MDS (chronic neoplasm) transforms to AML (acute neoplasm). When a cell type is listed in the transformation section for a search term, the disease process in the transformation section is the acute process and the disease listed at the top of the screen display is the chronic process. In this case, chronic and acute disease processes were diagnosed simultaneously based on a single bone marrow biopsy.
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 Multiple Primary Rules. The rules are intended to be reviewed in consecutive order from Rule M1 to Rule M13. Stop at the first rule that applies to the case you are processing. This is a single primary because both the chronic and the acute phase of the neoplasm are diagnosed within 21 days there is documentation of one positive bone marrow biopsy.
Now locate one of the three formats (i.e., flowchart, matrix or text) to check the Primary Site and Histology Coding Rules. The rules are intended to be reviewed in consecutive order within the applicable module. Go to MODULE 5: Myeloid Neoplasms PH14-PH15. Stop at the first rule that applies to the case you are processing. The disease was limited to the bone marrow biopsy which showed AML [9861/3].
Because the person who submitted this question searched the Heme DB for the expression , possible matches of 9871/3 and 9911/3 were returned. The database tries to match each word you entered, meaning it will return results for all diseases with the word trisomy and/or 13. If only the term is entered, no results are returned.
When you search with quotation marks around the phrase, the database will only return results with that exact wording. To only return results for the expression trisomy 13, enter in the Heme DB. In this case, a search for "trisomy 13" returns no results. Therefore, a more specific histology for AML is not possible.
