SEER Inquiry System - Question 20130121 Details

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Produced: 11/23/2024 9:32 AM

Question 20130121

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Inquiry Details

References:

Heme & Lymph Manual & DB

Question:

Reportability--Heme & Lymphoid Neoplasms: Is "early essential thrombocythemia" reportable? See Discussion.

Discussion:

The bone marrow biopsy diagnosis was, "Combined bone marrow morphologic, flow cytometric, immunohistochemical, molecular and cytogenetic findings are most consistent with early or evolving essential thrombocythemia with low level JAK2 V617F mutation documented on molecular testing." The physician is calling this a benign process. Is this reportable as essential thrombocythemia? Are the terms early or evolving ignored? Does the presence of a JAK2 mutation make this reportable? Without JAK2 testing is this case reportable?

Answer:

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

Yes, this is a reportable case. The histology is coded to 9962/3 [essential thrombocythemia]. The positive JAK2 mutation testing and bone marrow biopsy results taken together support the diagnosis of essential thrombocythemia in this case.

In the Abstractor Notes section of the Heme DB, it indicates that only 50-60 percent of patients with essential thrombocythemia will have a positive JAK2 mutation. A diagnosis of essential thrombocythemia can still be made in the absence of a JAK2 mutation. For example, if the bone marrow biopsy final diagnosis or a physician's clinical diagnosis is essential thrombocythemia, despite a negative JAK2 mutation test, the neoplasm is still reportable.

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:

Yes, this is a reportable case. The histology is essential thrombocythemia (ET).

This is a reportable case because the positive JAK2 is diagnostic of a clonal process. The positive JAK2 and the bone marrow results taken together support a diagnosis of ET.

If the JAK2 was negative, this case would not be reportable because there would be no solid clinical diagnosis of ET.

Cancer Site Category:

Heme & Lymphoid Neoplasms

Data Item Category:

N/A

Other Category:

Reportability

Year:

2013