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Question: 20170042 Status
Final

References
Source 1:   Heme & Lymph Manual & DB
pgs:  
Notes:   manual published Jan. 2015
Source 2:  
pgs:  
Notes:  


Question

Reportability--Heme & Lymphoid Neoplasms: Is a diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with large cell transformation equivalent to a diagnosis of diffuse large B-cell lymphoma (DLBCL) without mention of Richter transformation or Richter Syndrome?  See Discussion.



Discussion

The patient has a history of CLL/SLL dating back to 2007, but has had progressive disease with development of a new left frontal brain tumor. The brain tumor resection proved CLL/SLL with large cell transformation, but neither the pathologist nor the managing physician called this a Richter transformation, Richter syndrome or provided a diagnosis of DLBCL. However, a large cell transformation of CLL/SLL is a Richter transformation. Can this be accessioned as a new acute neoplasm per Rule M10?



Answer

Accession as multiple primaries according to Hematopoietic and Lymphoid Neoplasm Coding Manual Rule M10.  Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) followed by CLL/SLL with large cell transformation is multiple primaries because it is a chronic neoplasm followed by an acute neoplasm, more than 21 days in this case.



History


Last Updated
06/30/2017

Date Finalized
08/22/2017