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SEER Inquiry System - Report
Produced: 07/12/2025 5:43 AM
Question 20110134
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 two primaries per Rule M15. Rule M15 instructs one to use the Heme DB Multiple Primaries Calculator to determine the number of primaries for all cases that do not meet the criteria of M1-M14. Code the histology for the 1999 primary to 9687/3 [Burkitt high grade B cell lymphoma] and code primary site to C739 [thyroid.] Code the second primary to 9680/3 [diffuse large B-cell lymphoma] with primary site coded to C079 [parotid gland] per Rule PH24 which instructs one to code the to the when lymphoma is present only in an .
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 a single primary: B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma [9680/3] diagnosed in 1999. The steps used to arrive at this decision are:
When searching the Heme DB, use the most unique word for the case to limit the number of potential matches to review. In this case, search by the term Burkitt.
Enter in the Heme DB to find the histology. Click on the SEARCH button. Four results will be returned. The first result listed is Burkitt lymphoma [9687/3]. Ensure that the term "Burkitt lymphoma" [9687/3] is highlighted on the screen.
Scroll down and review the DEFINITION and ABSTRACTOR NOTE sections. This information does not seem to match the presentation of this patient's 1999 primary.
Go back to the RESULTS panel of the Heme DB, click on the third result, Diffuse large B-cell lymphoma (DLBCL). Ensure that the term "Diffuse large B-cell lymphoma (DLBCL)" [9680/3] is highlighted on the screen.
Scroll down to the ALTERNATIVE NAMES section. Note that "B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma" is a synonym for DLBCL [9680/3].
Scroll down to the ABSTRACTOR NOTE section. Note that patients with B-cell lymphoma, unclassifiable with features intermediate between DLBCL and Burkitt present with lymphadenopathy or mass lesions in extranodal sites. This fits the presentation of the patient's 1999 primary.
The histology for the first primary (involving the thyroid and cervical lymph nodes) should be coded as 9680/3. If it was not, the histology should be changed.
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. A single histology is a single primary. This patient was diagnosed with DLBCL (B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma) in 1999 and again recently on the parotid gland biopsy. Timing is not a factor in this case.
