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SEER Inquiry System - Report
Produced: 05/25/2026 10:27 PM
Question 20130104
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Discussion:
Intrasinusoidal DLBCL was diagnosed by liver biopsy. The bone marrow was involved based on abnormal cytogenetic findings. Per a physician's note, a PTA CT Abd/Pelvis showed hepatosplenomegaly and mild periportal/peripancreatic lymphadenopathy. A GI physician stated the lymphoma involves the veins of the liver.
Should the primary site be coded to the liver [C220] and the histology to 9680/3 [DLBCL]?
Answer:
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the primary site to the intra-abdominal lymph nodes [C772] per Rule PH20.
Code the primary site to the specific lymph node region when multiple lymph node chains within the same region as defined by the ICD-O-3 are involved. Periportal and peripancreatic nodes are both intra-abdominal region nodes.
Based on the information provided, there is involvement of lymph nodes, the liver, spleen and bone marrow, but no other documentation of the primary site. Given that a primary lymphoma of the liver is very rare; it is unlikely that this lymphoma arose from the liver. Involvement of the liver and spleen is very common for patients with lymphoma. The involvement of the liver, spleen and bone marrow is coded in the CS fields as Stage IV involvement.
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:
Use Rule PH22 and code primary site to C779. Based on the information provided, there is involvement of lymph nodes, liver and spleen and no clear documentation of primary site.
A primary lymphoma of the liver is very rare. It is unlikely that the lymphoma started there. Also, it is very common for patients with lymphoma to have liver and splenic involvement.
