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Report Produced: 03/01/2026 16:40 PM

Report Question ID Question Discussion Answer Year
20130220 Reportability--Thyroid: Is a hyalinizing trabecular neoplasm of the thyroid reportable? See Discussion. The pathology comment states: Hyalinizing trabecular neoplasm is considered by some to represent a variant of papillary thyroid carcinoma because of the similar nuclear cytology, immunoprofile and RET-oncogene rearrangements.

Hyalinizing trabecular neoplasm is not reportable.

Hyalinizing trabecular neoplasm, or hyalinizing trabecular tumor, is a synonym for hyalinizing trabecular adenoma [8336/0] in the ICD-O-3. The 2004 WHO classification states that "fine needle aspiration biopsy is often interpreted as papillary carcinoma because of the nuclear features in the tumor."

2013
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
20130069 Reportability--Heme & Lymphoid Neoplasms: Is chronic myeloproliferative neoplasm reportable? See Discussion. The Heme DB indicates myeloproliferative neoplasm is reportable, but does not indicate whether chronic myeloproliferative neoplasm is. Does the word "chronic" make this non-reportable?

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

Chronic myeloproliferative neoplasm is reportable. The preferred term is myelodysplastic/myeloproliferative neoplasm, unclassifiable (MPN). Chronic myeloproliferative neoplasm is listed in the Heme DB under the Alternate Names section for this neoplasm.

The term chronic does not affect the reportability of this neoplasm. The newer terms are myeloproliferative neoplasm or myeloproliferative disorder and chronic is not used in most diagnoses.

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
20130042 Reportability--Heme & Lymphoid Neoplasms: Is follicular lymphoma in situ reportable? See Discussion.

Parotid mass and intraparotid lymph node biopsy: Follicular lymphoma in situ (see note).

Note: The morphologic findings in conjunction with the results of immunohistochemical stains demonstrate focal follicular lymphoma in situ in a background of reactive follicular hyperplasia. Cytogenetic studies on the parotid mass demonstrated a normal karyotype. FISH analysis for BCL2 and BCL6 gene rearrangements has been requested and will be reported separately.

Per the Note under Case Reportability Instructions Rule 3 in the Hematopoietic and Lymphoid Neoplasm Manual, do not report in situ [/2] lymphomas. 2013
20130030

Histology--Heme & Lymphoid Neoplasms: How is histology coded for a patient diagnosed with diffuse large B-cell lymphoma, immunoblastic [9684/3] in 2009 and a recurrence in 2010 at another facility was referred to as plasmablastic lymphoma [9735/3]? See Discussion.

Which code is correct for the merged record? Is code 9735/3 [plasmablastic lymphoma] correct because code 9684/3 [DLBCL, immunoblastic] is now obsolete?

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

This case was originally diagnosed in 2009, prior to the development of Hematopoietic Database. Therefore it is necessary to use the ICD-O-3 to code histology to 9684/3 [diffuse large B-cell lymphoma, immunoblastic]. Use the original histology diagnosed for the merged record because DLBCL, immunoblastic, and plasmablastic lymphoma are the same primary. Do not change the histology to code 9735/3 [plasmablastic 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
20130016 Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient is diagnosed with small lymphocytic lymphoma in 1996, received chemotherapy on and off for 15 years due to relapses, and was subsequently diagnosed with diffuse large B-cell lymphoma in 2012?

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

Per Rule M10, this case should be accessioned as two primaries. According to Rule M10, one is to abstract as multiple primaries when a neoplasm is originally diagnosed as a chronic neoplasm AND there is a second diagnosis of an acute neoplasm more than 21 days after the chronic diagnosis.

The histology for the 1996 chronic neoplasm is coded to 9670/3 [small lymphocytic lymphoma]. The histology for the 2012 acute neoplasm is 9680/3 [diffuse large B-cell 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
20130002

Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned, and what is the year of diagnosis, when the patient was initially diagnosed with poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell [9591/3] in 1991, followed by multiple recurrences and transformations? See Discussion.

5/1991 Left groin biopsy: Poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell [9591/3].

Subsequently, the patient had multiple recurrences.

7/1/08 Left axillary biopsy: Disease transformed to malignant lymphoma, large B-cell and a small focus of follicular lymphoma.

Patient was followed until there was no evidence of disease.

4/22/10 Left axillary biopsy: Recurrence of follicular lymphoma, grade 1. No large cell component was found. The bone marrow biopsy was negative for lymphoma. The patient was on observation.

11/02/10 MD note indicates the disease progressed to follicular lymphoma, grade 3. No large cell component was identified. The patient clinically has no evidence of disease on maintenance Rituxan.

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

This case should be accessioned as a single primary, non-Hodgkin lymphoma (previously called poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell) [9591/3] diagnosed in 1991.

Determining the number of primaries is based on the rules in effect at the time of each diagnosis. The original lymphoma was diagnosed in 1991 and the first transformation to follicular lymphoma in 2008. The pre-2010 rules for coding histology and determining multiple primaries must be applied first because the rules changed for diagnoses occurring 2010 or later. Per the Single Versus Subsequent Primaries Table, poorly differentiated, diffuse lymphocytic lymphoma, small cleaved cell [9591/3] is the same primary as follicular lymphoma [9690].

The Heme DB and Manual are used to confirm that the 2010 recurrences of follicular lymphoma, grade 1 [9695/3], and follicular lymphoma, grade 3 [9698/3], are the same primary according to the Heme Calculator check required per Rule M15. Per the Heme DB page, the diagnoses follicular lymphoma, grade 3 [9698/3] and follicular lymphoma, grade 1 [9695/3] are comparable to follicular lymphoma [9690] as stated in the section.

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
20130088 Grade--Heme & Lymphoid Neoplasms: Should Grade be coded to 5 [T-cell] or 9 [cell type not determined, not stated, not applicable] for anaplastic large cell lymphoma, NOS [9714/3]? See Discussion.

Under the Grade section in the Heme DB for anaplastic large cell lymphoma, NOS it indicates the following:

"Grade - Code grade specified by pathologist. If no grade specified, code 9."

There is no reference in the Grade section that we should look at the Abstractor Notes or a specific Module in the Heme DB for additional information. However, in the Abstractor Notes section it states, "Grade is T-cell (5) unless pathologist specifically designates as a B-cell (see G2 rule)." These two statements are conflicting. Which is the correct grade?

Assign code 5 [T-cell] for anaplastic large cell lymphoma [9714/3] unless the pathologist specifies that the histology is a B-cell disease process. See Grade rule G2, Note 2.

In the Heme DB, there is a default value in the Grade field for histologies that do not have a grade specified. However, this particular histology does not default to code 9. There was an error in the Grade section of the 2010 and 2012 versions of Heme DB that has now been corrected in the latest release.

2013
20130015 Reportability--Heme & Lymphoid Neoplasms: Is essential thrombocytopenia reportable? See Discussion. Many times essential thrombocytopenia has been coded based on blood counts. Sometimes the discharge summary states thrombocytosis (NOS), and the case is coded to essential thrombocytopenia. Are these cases reportable?

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

The following are not alternative names for any reportable disease process:

  • Essential thrombocytopenia

  • Reactive thrombocytosis

  • Thrombocythemia

  • Thrombocytopenia

  • Thrombocytosis

    • The diagnosis of essential thrombocythemia is based on blood counts, but is usually a diagnosis made by excluding other myelodysplastic disorders. The following are reportable disease processes:

    • Essential thrombocythemia (9962/3)

  • Essential thrombocytosis (9962/3)

  • Refractory thrombocytopenia (9992/3)

    • 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
    		20130125 Reportability--Heme & Lymphoid Neoplasms: Is self-healing Langerhans cell histiocytosis (LCH) of the skin reportable?

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

    This is a reportable primary. Langerhans cell histiocytosis (LCH) [9751/3] is a reportable neoplasm.

    The term "self-healing" means that the neoplasm regressed without treatment. This is a known phenomenon.

    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