SEER Inquiry System - View
Source 1: 2012 Heme & Lymph Manual & DB
Histology/Primary site--Heme & Lymphoid Neoplasms: How are the histology and primary site coded if the patient has monomorphic B-cell post-transplant lymphoproliferative disorder with features of diffuse large B-cell lymphoma involving the intramuscular chest wall and right frontal lobe of the brain?
The patient is a 12 year old with a history of Fanconi anemia, status post stem cell transplant. In May, 2012 the patient was diagnosed with monomorphic B-cell PTLD with features of diffuse large B-cell lymphoma.
For cases diagnosed 2012 and later, access the Hematopoietic Database at http://seer.cancer.gov/tools/heme/.
Click on Hematopoietic Project. Click on Hematopoietic and Lymphoid Database. The 2012 Hematopoietic Coding Manual (PDF) button will appear to indicate the correct version of the program is available now for query.
Code the primary site to C809 [unknown primary site] and the histology as diffuse large B-cell lymphoma [9680/3]. The steps used to arrive at this decision are:
Step 1: Enter in the Heme DB to find the histology. Click on the SEARCH button. Ensure that the term "post-transplant lymphoproliferative disorder" [9971/3] is highlighted on the screen. PTLD
Step 2: Scroll down to the ALTERNATIVE NAMES section. Note that “monomorphic B-cell post-transplant lymphoproliferative disorder” is not a synonym for PTLD. Continue to scroll down to the ABSTRACTOR NOTE section which indicates there are two types of PTLD, monomorphic and polymorphic. Monomorphic PTLD is a PTLD that has an accompanying B-cell lymphoma, T-cell lymphoma, Classical Hodgkin lymphoma, or a Plasmacytoma. When there is both a PTLD and a lymphoma or plasmacytoma, the histology is coded to the lymphoma or plasmacytoma – in this case a diffuse large B-cell lymphoma.
Step 3: Enter in the Heme DB to find the correct histology. Click on the SEARCH button. Ensure that the term “diffuse large B-cell lymphoma (DLBCL)” [9680/3] is highlighted on the screen. diffuse large B-cell lymphoma
Step 4: Determine the primary site. No primary site is given per the Heme DB, but the PRIMARY SITE(S) information states Module 7 applies to DLBCL. Click on the 2012 HEMATOPOIETIC CODING MANUAL (PDF) button. Once in the manual scroll to Module 7 to check the Primary Site and Histology Rules. The rules within the Module are intended to be reviewed in consecutive order. Start at Rule PH25 and stop at the first rule that applies to the case you are processing. Code the primary site to C809 [unknown primary site] as there is no lymph node involvement, but there is involvement of two extranodal sites. Stop at Rule PH37.