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SEER Inquiry System - Report
Produced: 12/23/2025 7:50 AM
Question 20120014
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 9732/3 [multiple myeloma].
Ambiguous terminology is used to accession cases (determine reportability) because it has been used for over 30 years to do so. Any deviation from using ambiguous terminology to determine case reportability would cause the reporting of incidence counts to vary. In this case, there was a reportable, ambiguous terminology diagnosis of multiple myeloma on the pathology report.
The instruction "Do not code histology based on ambiguous terminology" is intended to be used when there is a reportable and reportable stated in the diagnosis. Ambiguous terminology cannot be used to report the more specific diagnosis in cases of Heme & Lymphoid neoplasms. For example, if the pathology report final diagnosis was "Myeloproliferative neoplasm, probably Polycythemia Vera" the histology would be coded as myeloproliferative neoplasm, unclassifiable [9975/3]. The ambiguous terminology indicates that the genetic testing, immunophenotyping, etc., probably are not complete or are not diagnostic of the more specific disease. Wait to code the histology until there is a definite diagnosis given.
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 2012
For cases diagnosed 2012 and later, access the Hematopoietic Database at
http://seer.cancer.gov/tools/heme/.
Click on Hematopoietic Project. Click on Hematopoietic and Lymphoid Database. The 2012 Hematopoietic Coding Manual (PDF) will appear which indicates the correct version of the program is available now for query.
Code the histology as multiple myeloma [9732/3]. The steps used to arrive at this decision are as follows:
Enter in the Heme DB to find the histology. Click on the SEARCH button. Ensure that the term "plasma cell myeloma" [9732/3] is highlighted on the screen. Scroll down to the ALTERNATIVE NAMES section. Note that multiple myeloma is another name for plasma cell myeloma. Code the histology as 9732/3.
This is a reportable case. Ambiguous terminology is used to accession cases (reportability) because it has been used for 30+ years and any deviation from using ambiguous terminology for case reportability would cause problems with incidence counts. In this case, there was a reportable, ambiguous terminology diagnosis of multiple myeloma on the pathology report.
The instruction "Do not code histology based on ambiguous terminology" is intended for when there is an NOS histology and more specific histology. Ambiguous terminology is not used to report the more specific diagnosis for the Heme & Lymphoid neoplasms. For example, if the pathology report final diagnosis was "Myeloproliferative neoplasm, probably polycythemia vera (PV) or essential thrombocythemia (ET)" the histology would be coded as Myeloproliferative neoplasm, unclassifiable [9975/3]. The ambiguous terminology indicates that the results are equivocal between the two diseases OR it means that the genetic testing, immunophenotyping, etc., probably are not complete and therefore cannot specify the more specific disease. These instructions will be clarified in the next revision.
