Case Example 11 (Multiple Primary, Histology and Primary Site)

Mantle cell lymphoma diagnosed 11/23. Lymph nodes above and below the diaphragm involved. No other involvement noted. Remission 5/24. Imaging 9/24 shows increasing uptake in lymph nodes recently stated to be in remission. In 10/24 biopsy done which shows DLBCL.

Involvement Comments
Lymph nodes 11/23 diagnosis above and below the diaphragm
9/24 uptake in lymph nodes recently stated to be in remission (same lymph nodes from 11/23)
Organ involvement None
Common metastatic sites None

Coding of the case (Lymphoma schema)

Data Item-Primary #1 Coding
M Rule M2-Single histology, single primary
PH Rule PH21: Multiple lymph nodes
Primary site C778: Multiple lymph node regions
Histology 9673/3: Mantle cell lymphoma
Diagnostic confirmation 1 (positive histology)
EOD Primary Tumor 575 (lymph nodes above and below the diaphragm)
EOD Regional Nodes 888 (not applicable)
EOD Mets 88 (not applicable)
Summary Stage 7 (lymph nodes above and below the diaphragm)
Mets at Dx Data Items (all 6) Mets at Dx-Distant lymph nodes: 8, remaining Mets at Dx data items 0
Data Item-Primary #2 Coding
M Rule M10: Acute neoplasm following a chronic
Per the Heme DB, mantle cell lymphoma transforms to DLBCL
PH Rule PH21: Multiple lymph nodes
Primary site C778: Multiple lymph node regions
Histology 9680/3: Diffuse large B-cell lymphoma
Diagnostic confirmation 1 (positive histology)
EOD Primary Tumor 575 (lymph nodes above and below the diaphragm)
EOD Regional Nodes 888 (not applicable)
EOD Mets 88 (not applicable)
Summary Stage 7 (lymph nodes above and below the diaphragm)
Mets at Dx Data Items (all 6) Mets at Dx-Distant lymph nodes: 8, remaining Mets at Dx data items 0

Updated: December 2, 2025