SEER Inquiry System - View
Source 1: 2012 Heme & Lymph 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 either 9670 or 9823 into the heme database and scroll down to the transformation section. You'll see that this disease transforms to diffuse large B cell lymphoma, which is the most recent diagnosis for your case.
For this case, you have a chronic neoplasm (the SLL) diagnosed in 1996 and an acute neoplasm (DLBCL) diagnosed greater than 21 days later. Go to the Heme Manual. Rules M10-M15 handle the chronic and acute neoplasms. Rule M12 applies in this situation. Go back to the database and check the multiple primaries calculator, which confirms that the DLBCL is a new primary.
First primary: SLL
Second primary: DLBCL