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SEER Inquiry System - Report
Produced: 05/23/2025 8:32 AM
Question 20130123
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded for a diffuse large B-cell lymphoma, immunoblastic variant involving the left maxillary vestibule and entire left maxilla? See Discussion.
Discussion:
The clinical history indicates a destructive, quickly growing intra-oral lesion in the left soft tissue vestibule and the entire left maxilla.
Pathology report final diagnosis: Oral cavity, left maxilla, incisional biopsy: Malignant lymphoma, non-Hodgkin, diffuse large B-cell type, immunoblastic variant.
Answer:
Code the primary site to C068 [overlapping lesion of the mouth] per Rule PH24. Code the primary site to the organ when lymphoma is present only in an organ.
This lesion overlaps the left soft tissue of the maxilla (the maxillary gingiva) [C030] and the left vestibule of the mouth [C061]. There is no documentation indicating in which specific site the lesion arose. The maxilla is the upper jawbone. The soft tissue that overlies the maxilla is a part of the oral cavity. It is reasonable to interpret the documentation such that the tumor in the maxilla is an extension of the overlapping oral mucosa tumor.
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.
