SEER Inquiry System - View
Source 1: Heme & Lymph Neo Manual & DB
Multiple primaries--Heme & Lymphoid Neoplasms: Patient was diagnosed with small lymphocytic lymphoma in 1996. Patient received chemo on and off for 15 years due to relapses. In September 2012 patient was found to have diffuse large B-cell lymphoma. Is this a new primary?
To find the answer in the Hematopoietic database:
1. Type in "lymphocytic". The first entry that comes up is CLL/SLL, code 9823/3. The SLL stands for small lymphocytic lymphoma. The code for SLL changed in 2010. Since your patient was first diagnosed in 1996, you probably have histology code 9670.
2. Enter 9823/3 into the heme database and scroll down to the transformation section. You'll see that this disease transforms to diffuse large B cell lymphoma (9680/3), which is the most recent diagnosis for your case.
Click on the HEMATOPOIETIC CODING MANUAL (PDF) button. Once in the manual, locate the Multiple Primary rules. The rules are intended to be reviewed in consecutive order from Rule M1-M15. Stop at the first rule that applies to the case you are processing. Stop at Rule M12, which states to code two primaries when a chronic (9823/3) disease is followed by an acute disease (9860/3) greater than 21 days apart.
First primary: SLL
Second primary: DLBCL