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

Per PH Rule22, code the primary site to C779 [lymph nodes, NOS].

Rule PH22 is a default rule for lymphomas that is used when there is no other information regarding the primary site and the Heme DB does not indicate a primary site under its Primary Site(s) section. Rule PH27, code the primary site to unknown [C809], does not apply. Only use C809 [unknown] as the primary site when there is no evidence of lymphoma in lymph nodes AND the physician documents that the lymphoma originates in an organ(s).

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.

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

This case should be accessioned as one primary. Per Rule PH26, code the primary site to bone marrow (C421) when lymphoma is present only in the bone marrow. (We assumed all available physical exams, scans, and other work-up were negative for lymph node, tissue, or organ involvement.) Histology is coded to 9680/3 [Diffuse large B-cell lymphoma (DLBCL)]. Under the Alternate Names section of the Heme DB, a synonym for DLBCL is B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt 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.

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

Per Rule M2, this is a single primary because there is a single histology mentioned. The histology is coded to 9699/3 [MALT lymphoma]. Code the primary site to C509 [breast] per Rule PH24 which states to code the primary site to the organ when lymphoma is present only in an organ.

Unless your software has edits that prevent coding laterality for lymphomas, code the laterality as bilateral. Up to half of extranodal, extragastric MALT lymphomas occur in multiple sites, particularly in paired sites (breast is an example).

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.

For cases diagnosed prior to 1/1/2010:Yes, "smoldering" multiple myeloma is reportable to SEER as multiple myeloma [9732/3].

According to our pathologist consultant, "smoldering" multiple myeloma would certainly refer to a diagnosed process. Smoldering means the process is progressing, but perhaps slowly, or even at a slower pace than might be expected.

For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

For cases diagnosed 2007 or later, start with rule H1 in the Single Tumor module. Stop at rule H4. Assign code 8263 [adenocarcinoma in tubulovillous adenoma].

Stop at the first rule that applies. Code histology based on a specimen from the primary site whenever available.

For tumors diagnosed prior to 2007:

According to SEER rules, abstract as one primary because although these sites have separate topography codes in ICD-O-3, they were coded to the same three-digit topography code in the first edition of ICD-O (SEER Program Code Manual, 3rd Edition, page 8, Exception B). Simultaneous lesions of the same histology in trachea and lung are one primary. Code the primary site to C399 [Ill-defined sites within respiratory system].

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

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

Per the Abstractor Notes in the Heme DB, primary effusion lymphoma (PEL) is unusual in that the majority of cases arise in body cavities, such as the pleural, pericardial, and peritoneal cavities. Because there are no ICD-O-3 codes for the pleural space, pericardium, or peritoneal cavity, code the primary site to pleura C384 when the neoplasm arises in the pleural cavity, to pericardium C380 when it occurs in the pericardium, and to peritoneal cavity C482 when it occurs in the peritoneum.

Typically only one body cavity is involved. However, if multiple regions are positive for PEL as in this case, code the primary site to C809 per Rule PH27. Rule PH27 indicates one is to code the to primary site C809 when there is no evidence of lymphoma in lymph nodes AND the physician in the medical record that he/she that the lymphoma in an

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.

For cases diagnosed 1/1/2003 and after: Code the Surgical Procedure of Other Site field to 3 [Non-primary surgical procedure to distant lymph nodes] for an excision of a distant lymph node because it is a surgical procedure. However, if only a fine needle aspirate of a distant lymph node is done, code this field to 0 [None].

Fine needle aspirates of regional lymph nodes are the only FNA biopsies to be coded in a surgery field (Scope of Regional Lymph Node Surgery field). In addition, FNA biopsies of regional nodes are also included in the EOD-Number of Positive Regional and Examined Lymph Nodes fields.

For cases diagnosed 1998-2003:

EOD should include all information available within four months of diagnosis in the absence of disease progression or through completion of surgery(ies) in first course of treatment, whichever is longer.

Mets known to have developed after EOD was established should be excluded.