SEER Inquiry System - Question 20120050 Details

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Produced: 09/21/2026 3:30 PM

Question 20120050

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Inquiry Details

References:

Heme & Lymph Manual & DB

Question:

Multiple primaries/Histology--Heme & Lymphoid Neoplasms: How many primaries are accessioned and what histology codes apply if a patient has a 1998 diagnosis of essential thrombocythemia and a recent clinical diagnosis of secondary myelofibrosis? See Discussion.

Discussion:

The patient has a history of essential thrombocythemia (ET) since 1998. This has been treated daily with aspirin. A recent bone marrow biopsy was consistent with myeloproliferative disorder with excess blasts, marked extensive reticulin marrow fibrosis with osteosclerosis, excess blasts (11%) in the marrow aspirate and peripheral blood. JAK2 mutation was present in a small minority of cells. The physician stated patient was, "considered to have secondary myelofibrosis and was started on Jakafi."

Answer:

Updated April 2026

For cases diagnosed 2010 and forward, access the Hematopoietic Database (Heme DB) at http://seer.cancer.gov/seertools/hemelymph.

Per the Heme DB, entry Myelofibrosis, a secondary myelofibrosis is not a reportable case.

Secondary myelofibrosis is not listed as a synonym for primary myelofibrosis in the Heme DB. The term "secondary myelofibrosis" means that the myelofibrosis was caused by, in this case, the essential thrombocythemia.

The diagnosis "consistent with myeloproliferative disorder" is also not a new reportable diagnosis. "Myeloproliferative disorder" refers to a group of diseases (an NOS category) that includes essential thrombocythemia, which was originally diagnosed in 1998, prior to reportability for this disease type.

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) button will appear to indicate the correct version of the program is available now for query.

Given the information available, this is not a reportable case. Do not accession a new primary. The steps used to arrive at this decision are:

Enter in the Heme DB to find the histology. Click on the SEARCH button. Ensure that the term "primary myelofibrosis" [9961/3] is highlighted on the screen.

Scroll down to the ALTERNATIVE NAMES information. Note that secondary myelofibrosis is not listed as a synonym for primary myelofibrosis and, therefore, this case is not reportable.

The term "secondary myelofibrosis" means that the myelofibrosis was caused by the essential thrombocythemia. Only primary myelofibrosis is reportable per the Heme DB. The diagnosis "consistent with myeloproliferative disorder" is also not reportable. "Myeloproliferative disorder" refers to a group of diseases (an NOS category) that includes essential thrombocythemia.

Cancer Site Category:

Heme & Lymphoid Neoplasms

Data Item Category:

Histology

Other Category:

Multiple primaries

Year:

2012