SEER Inquiry System - Question 20130019 Details

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SEER Inquiry System - Report

Produced: 02/08/2026 8:58 AM

Question 20130019

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Inquiry Details

References:

Heme & Lymph Manual & DB

Question:

Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded when a patient has a lymph node biopsy and peripheral blood that are positive for B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma but refuses a bone marrow biopsy?

Discussion:

Answer:

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

Code the primary site to C421 [bone marrow] per Rule PH5. Note 1 for Rule PH5 states CLL always has peripheral blood involvement. If the peripheral blood is positive for CLL/SLL and no bone marrow biopsy is done, code the primary site to C421 [bone marrow].

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:

You are correct to code primary site to C421.

Per note 1 in Rule PH5, CLL always has peripheral blood involvement. So, if you have peripheral blood positive for CLL/SLL and no bone marrow biopsy, that is enough to assign primary site C421.

Cancer Site Category:

Heme & Lymphoid Neoplasms

Data Item Category:

Primary site

Other Category:

N/A

Year:

2013