SEER Inquiry System - Search

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 when CLL/SLL [9823/3] involves the bone marrow.

In the later stages of CLL/SLL, there may be involvement of bone marrow AND lymph node(s), lymph node region(s), organ(s), or tissue(s). As long as the peripheral blood and/or bone marrow are involved, the primary site is bone marrow.

WHO states that the diagnostic criteria for CLL versus SLL is not clearly defined. According to WHO guidelines, it is better to code to CLL/SLL and code the primary site to bone marrow when the marrow is involved and to lymph nodes, organ, or tissue when there is no bone marrow 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.

Intramedullary hemangiomas in T5 and T6 are not reportable.

These benign tumors originate in the bone, not spinal canal, cord or dura. Benign tumors of the bone are not reportable.

According to WHO, the most common sites of involvement are the vertebral bodies, followed by craniofacial skeleton and long bones.

For cases diagnosed 1998-2003:

Code the Number of Regional Lymph Nodes Positive field to 03 and the Number of Regional Lymph Nodes Examined field to 17. Each grossly detectable nodule in the pericolonic fat is counted as one regional lymph node.

Code Rituxan as chemotherapy. Code 90-Yttrium as radioisotope. Code 131-Iodine as radioisotope when given with Rituxan as treatment for lymphoma.

Zevalin is a monoclonal antibody conjugated to Yttrium 90. Bexxar is a monoclonal antibody conjugated to Iodine 131. In both drugs, the monoclonal antibody is only the delivery agent for the radioisotope. Both drugs should be coded as radioisotopes. The one-two-three punch of Rituxan and zevalin followed by Rituxan and Bexxar should be coded as chemotherapy plus radioisotopes. Zevalin is also used by itself for people who have not responded to Rituxan.

Code 550 is missing “< equal to 6 cm.” In addition, code 650 should include ipsilateral lymph nodes as well.

Revised codes:

Code 550

CLINICAL ASSESSMENT only

Bilateral or contralateral lymph nodes, < equal to 6 cm WITH clinical evidence of ENE

Code 650

CLINICAL ASSESSMENT only

Ipsilateral, Bilateral or Contralateral lymph nodes > 6 cm WITH or WITHOUT clinical evidence of ENE

These changes will be implemented in Version 3.4 (October 2026). We apologize for the error.

This answer has been corrected. Previous answer is shown below under "History."

Assign 9591/3 for this case.

See also SINQ 20190070.

Yes, Breast rule M10 applies. This case is a single primary.

Follow the MP/H rules even though the "pathologist specifically states the tumors are morphologically different" so that situations like this are reported consistenty accross cancer registries, regions, and states for consistent national reporting.

For cases diagnosed 2007 or later, assign histology code 8503 [Papillary adenocarcinoma]. Rule H14 applies.

ICD-O-3 code 8050 does not apply in this case. Refer to the numeric listing in ICD-O-3. 8050 is a squamous cell neoplasm. Papillary carcinoma of the breast is NOT a squamous cell neoplasm. It is a neoplasm of the breast parenchyma - ducts, lobules or connective tissue. 8503 is the correct code in this case.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Pericolonic lymph nodes are "regional" lymph nodes for an ovarian primary. If you do not have enough information to assign codes 12-30, assign code 50 [Regional lymph nodes, NOS].