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SEER Inquiry System - Report
Produced: 02/04/2026 12:05 AM
Question 20110128
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 case should be accessioned as one primary. Per Rule PH26, code the primary site to bone marrow (C421) when lymphoma is present only in the bone marrow. (We assumed all available physical exams, scans, and other work-up were negative for lymph node, tissue, or organ involvement.) Histology is coded to 9680/3 [Diffuse large B-cell lymphoma (DLBCL)]. Under the Alternate Names section of the Heme DB, a synonym for DLBCL is B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma.
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.
This case should be accessioned as one primary. The steps used to arrive at this decision are:
Enter in the Heme DB to find the histology. Click on the SEARCH button. The first match term on the screen is "diffuse large B-cell lymphoma (DLBCL)" [9680/3].
Check the ALTERNATIVE NAMES section and you find that one alternate name is "B-cell lymphoma, unclassified, with features between diffuse large B-cell lymphoma and Burkitt lymphoma."
Click on the 2010 HEMATOPOIETIC CODING MANUAL (PDF). Once in the manual, 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 7 Primary Site Rules for Lymphomas Only 9590/3-9729/3 PH25-PH37. Stop at the first rule that applies to the case you are processing. Code the primary site to bone marrow (C421) when lymphoma is present only in the bone marrow. (We assumed all available physical exams, scans, and other work-up were negative for lymph node, tissue, or organ involvement given.)
