SEER Inquiry System - View
Source 1: 2012 Heme & Lymph Manual & DB
Multiple primaries--Heme & Lymphoid Neoplasms: For this case presentation should I follow these Hematopoietic Rules? M5 Single Primary; Module 6, PH16. See discussion.
1/27/12 R neck mass FNA: Suspicious for B-cell Non-Hodgkin lymphoma.
2/17/12 Cervical node Bx: In situ involvement by follicular lymphoma-like B cells of uncertain significance +CD10. Two other cervical bxs show infarcted, extensively necrotic lymphoid tissue highly suspicious for B-cell lymphoma.
3/20/12 Bone marrow: Low grade B-cell lymphoproliferative disorder with plasmacytic differential.
4/18/12 Medical Oncology treats for Stage III follicular lymphoma.
10/16/12 Cervical LN core bx: CD10+ large B-cell lymphoma.
There are two primaries, first is follicular lymphoma and the second is Diffuse Large B Cell Lymphoma.
The first primary is follicular lymphoma. Date of diagnosis is 1/27/12 because "suspicious" is an ambiguous term we use to collect cases. When the physician confirms FL on 4/12, change the histology from B-cell lymphoma (NOS) to follicular lymphoma. Not only is this case one that would be put into the registry DB based on ambiguous terminology, that DX was followed by a physician DX and treatment for FL. All of these (ambiguous terminology, physician diagnosis, and treatment for the disease) make this case reportable.
The diagnosis of DLBCL was made 9 months after the DX of FL. Do not use M5 to make this a single primary - M5 specifically says the FL and DLBCL are SIMULTANEOUSLY present. These were not simultaneous diagnoses, there were 9 months between them.
Use Rule M12, Abstract multiple primaries when a neoplasm is originally diagnosed as a chronic (FL) and there is a second diagnosis of an acute neoplasm (DLBCL) MORE THAN 21 DAYS AFTER THE CHRONIC DIAGNOSIS.