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Report Produced: 05/02/2026 07:04 AM

Report Question ID Question Discussion Answer Year
20130112 Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded for a diagnosis of post-transplant lymphoproliferative disorder (PTLD) diagnosed on an inguinal lymph node biopsy with CT scan evidence of lymphadenopathy in the chest, abdomen and pelvis if the bone marrow is also involved?

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

Code the primary site to multiple lymph node regions, NOS [C778] per Rule PH21 when multiple lymph node regions, as defined by the ICD-O-3, are involved and it is not possible to identify the lymph node region where the lymphoma originated

In the Abstractor Notes section in the Heme DB for PTLD it states PTLD commonly involves lymph nodes, GI tract, lungs and the liver. This patient has extensive lymph node involvement. Rule PH26 states to code the primary site to the bone marrow when ONLY the bone marrow is involved; however, that does not apply in this case.

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.

2013
20130106 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2009 diagnosed Hodgkin lymphoma, nodular sclerosis type is treated and subsequently presents in 2010 with the same diagnosis? See Discussion.

2009 diagnosis of Hodgkin lymphoma, nodular sclerosis type involved the superior mediastinal nodes, AP window nodes, bilateral axillary nodes and pulmonary nodules. The patient received chemotherapy and went into remission.

Patient presents in 2010 with Hodgkin lymphoma, nodular sclerosing type in the superior mediastinum.

Does timing play any part in determining if this reported as one or two primaries? There is no timing rule in the Heme Manual.

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

Accession a single primary, Hodgkin lymphoma, nodular sclerosis type [9663/3] diagnosed in 2009 per Rule M2.

Accession a single primary when there is a single histology. Note 2 for Rule M2 indicates timing is not relevant. This is disease progression or recurrence and not a new primary.

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.

2013
20130189

Reportability--Brain and CNS: Are the terms 'mass' and 'lesion' reportable terms for accessioning brain and CNS primaries? See Discussion.

With respect to reportability, the SEER Manual mentions 'tumor' and 'neoplasm,' but not 'mass' or 'lesion.' The SEER MP/H Manual states tumor, mass, lesion and neoplasm are equivalent terms for determining multiple primaries, but does this apply to reportability? If not, what is the distinction?

'Mass' and 'lesion' are not reportable terms for benign/borderline brain and CNS tumors.

Reportable terms for benign/borderline brain and CNS primaries are 'tumor' and 'neoplasm.' These terms appear in the ICD-O-3. 'Lesion' and 'mass' do not appear in the ICD-O-3. Do not use the MP/H Manual to determine reportability; page 2 of the SEER Manual is the correct source for reportability instructions.

 2013
20130068 Reportability--Heme & Lymphoid Neoplasms: Is polycythemia, NOS reportable? See Discussion. The physician states the patient has polycythemia. There is no confirmation of primary polycythemia nor is there mention of polycythemia vera. JAK2 was negative.

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

Polycythemia, NOS is not reportable. Polycythemia, NOS is not a synonym for polycythemia vera and, therefore, is not reportable. To be reportable the diagnosis must be polycythemia vera, or one of the other terms listed in the Alternate Names section of the Heme DB.

Polycythemia (also known as erythrocytosis) is a disease state in which the proportion of blood volume that is occupied by red blood cells increases. Blood volume proportions can be measured as a hematocrit level. It can be due to an increase in the mass of red blood cells ("absolute polycythemia"); or to a decrease in the volume of plasma ("relative polycythemia").

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.

2013
20130058 Reportability--Heme & Lymphoid Neoplasms: Is EBV-positive hemophagocytic lymphohistiocytosis (HLH) reportable when diagnosed in a 5 year old child and resulted in death in less than two months?

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

Hemophagocytic lymphohistiocytosis (HLH) is not a reportable disease because it is not listed in the Heme DB.

Per our expert pathologist consultant, "HLH is a lymphocyte driven hemophagocytic syndrome which may be either genetically based or caused by over-activated lymphoid cells, often in response to a viral infection. It is an abnormal immune response and is not considered a malignant disease, and is, therefore, not reportable. It is not synonymous with EBV-positive T-cell lymphoproliferative disease of childhood (9724/3)."

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.

2013
20130185

Reportability/Behavior: Is HGSIL (high grade squamous intraepithelial lesion) of the vulva or vagina reportable and is it a synonym for histology code 8077/2 [squamous intraepithelial neoplasia, grade III]?

For cases diagnosed 2018 and later

HGSIL of the vulva or vagina is reportable. HGSIL is a synonym for squamous intraepithelial neoplasia, grade III.

 2013
20130180 Histology--Pancreas: What is the difference between pancreatic endocrine neoplasm (PanNETs) [8240/3] and the new ICD-O-3 terms pancreatic endocrine tumor, benign [8150/0] and pancreatic endocrine tumor, malignant [8150/3]? See Discussion. SEER Inquiry 20120035 discusses the reportability of pancreatic endocrine neoplasm (PanNETs) tumors.

The difference is that 8150 is for islet cell tumors. The preferred name was changed by WHO/IARC to reflect the current language used by pathologists to describe islet cell tumors [8150].

The 8240 histology code added the neuroendocrine tumor, grade 1, low or well differentiated terms to the carcinoid ICD-O name.

Islet cell tumors are more aggressive than the pancreatic NET tumors. Treatment and prognosis are determined by the histologic type. While the histology code 8150 is not new, the histology name has been updated.

2013
20130109

Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2004 diagnosis of acute myeloid leukemia is followed by a 2013 diagnosis of myeloid sarcoma? See Discussion.

Patient was diagnosed in 2004 with acute myeloid leukemia [9861/3] and treated with chemotherapy and transplant. Now the patient has a biopsy of an umbilical mass that is positive for myeloid sarcoma (granulocytic sarcoma) [9930/3].

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

Accession a single primary, acute myeloid leukemia [9861/3] diagnosed in 2004 per Rule M3.

When there is a myeloid sarcoma diagnosed simultaneously or after a leukemia of the same lineage, it is a single primary. The myeloid sarcoma is actually caused by the AML progressing. The myeloid cells in the bone marrow or blood literally "seep out" and implant in the tissue.

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.

2013
20130065 Histology--Heme & Lymphoid Neoplasms: Should the higher histology code associated with grade 1 follicular lymphoma [9695/3] be used rather than grade 2 follicular lymphoma [9691/3] in cases of follicular lymphoma grade 1-2? Code histology to 9691/3 [follicular lymphoma, grade 2], histology. For follicular lymphoma, when there is a grade such as 1-2 indicated, take the histology associated with the higher grade disease process, even though the lower grade histology code is higher. 2013
20130111 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned if a 2008 diagnosis of extralymphatic follicular lymphoma in the breast is subsequently diagnosed in 2011 with ocular follicular lymphoma? See Discussion.

The patient was diagnosed with follicular lymphoma in the breast in 2008. Per notes, there was no evidence of disease again until 2011 when the patient presented with ocular lymphoma. The physician stated this was part of the same disease process as the prior breast diagnosis. The bone marrow was not involved in either case.

Is this a single primary (recurrence) of follicular lymphoma? Or are these multiple primaries because they arise in different extralymphatic sites?

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

Accession a single primary, follicular lymphoma [9690/3] of the breast diagnosed in 2008 per Rule M2.

Accession a single primary when there is a single histology. This is a recurrence of the patient's 2008 follicular lymphoma.

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.

2013