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SEER Inquiry System - Report
Produced: 04/26/2025 5:28 AM
Question 20100083
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Discussion:
Patient has a history of follicular cell non-Hodgkin lymphoma dating back to the 1990s. The patient was treated with chemotherapy and bone marrow transplantation, radiation and rituximab. The patient had no evidence of recurrence. In April 2010 a lesion appeared on the side of the scalp above the left ear with a diagnosis of "B-cell lymphoma with prominent large cell component, compatible with primary cutaneous follicle center cell lymphoma." The oncology diagnosis is "primary cutaneous follicle center lymphoma."
Would the Multiple Primaries Calculator be used in this case?
Answer:
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Accession two primaries per Rule M15. Per the Multiple Primaries Calculator, primary cutaneous follicle center lymphoma [9597/3] following a diagnosis of follicular lymphoma, NOS [9690/3] is a new primary.
While the pathologic diagnosis was B-cell lymphoma "compatible with" primary cutaneous follicle center cell lymphoma and ambiguous terms cannot be used to identify a more specific histology, the physician confirmed the more specific diagnosis without ambiguous terminology. Therefore, this diagnosis should be coded.
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.
History:
This SINQ question has been updated to the Hematopoietic & Lymphoid Neoplasm Manual & Database published January 2014.
The original answer below was written based on the rules in 2010
Take the following steps to determine the number of hematopoietic primaries that should be accessioned:
Look up the historic and current diagnoses in the 2010 Hematopoietic Database to get provisional ICD-O-3 codes and also to see if the new neoplasm is a transformation of the initial diagnosis. Start by entering the known ICD-O-3 code for the follicular lymphoma [9690/3]. Next, click the Display button and scroll down to look at the transformation information. The DB says follicular lymphoma transforms to diffuse large B-cell lymphoma.
Next look up the newly diagnosed neoplasm. Do NOT enter the entire term, do a "smart search" by entering only the term or terms that are unique in this disease name. In this case, the unique word in "primary cutaneous follicle center lymphoma" is follicle. Enter ONLY the word follicle in the search mechanism. The display shows primary cutaneous follicle center lymphoma [9597/3] and its definition. Click on the Display button and then the Display Abstractor Notes button to see that the description fits the disease you are assessing.
Go to the reportability rules. Both ICD-O-3 codes fall into the reportable range.
Use rule M13 because none of the previous rules fit this case. M13 tells you to use the Multiple Primaries calculator to determine the number of primaries. Enter both histologies 9690/3 and 9597/3. The result is "new primary." Abstract the primary cutaneous follicle center lymphoma [9597/3] as a new primary.
The answers for SINQ questions with 2010 ID numbers were written using the 2010 Heme & Lymph Manual & DB. The instructions for using the 2010 Hematopoietic Database were written for the version of the software in use as of 5/24/2011. The user interface of the web-based 2010 Hematopoietic Database available from the SEER website varies slightly from the 5/24/2011 version in that the web-based version provides all the disease information in one scrollable window.
For cases diagnosed 2010-2011, access the 2010 Hematopoietic Database at http://seer.cancer.gov/tools/heme/. Click on Hematopoietic Project. Click on Hematopoietic and Lymphoid Database. For 2010-2011 diagnoses, click on the "use the 2010 database" label in the upper right corner of the screen. The 2010 Hematopoietic Coding Manual (PDF) button will appear to indicate the correct version of the program is available now for query.
