Case Example 9 (Multiple Primary, Histology and Primary Site)
Submandibular gland excision: involvement by follicular lymphoma, WHO grades 2-3A w/ focal diffuse areas consistent with diffuse large B-cell lymphoma (see note). Scans show cervical lymphadenopathy, no other areas involved
| Involvement | Comments |
|---|---|
| Lymph nodes | Cervical |
| Organ involvement | Submandibular gland |
| Common metastatic sites | N/A |
Coding of the case (Lymphoma schema)
| Data Item | Coding |
|---|---|
| M Rule | M4-Code one primary when 2 or more non-Hodgkin lymphomas are in the same lymph node (same location, same biopsy). See Rule PH11 |
| PH Rule | PH11: Code histology to diffuse large B-cell lymphoma when one or more NHL are in the same lymph node and one of the histologies is DLBCL PH25: Code primary site to the organ when an organ and it’s regional lymph nodes are involved. Cervical lymph nodes are regional for the submandibular gland |
| Primary site | C080 (Submandibular gland) |
| Histology | 9680/3: Diffuse large B-cell lymphoma |
| Diagnostic confirmation | 1 (positive histology) |
| EOD Primary Tumor | 400 (extralymphatic organ and its regional lymph nodes involved) |
| EOD Regional Nodes | 888 (not applicable) |
| EOD Mets | 88 (not applicable) |
| Summary Stage | 2 (extralymphatic organ and its regional lymph nodes involved) |
| Mets at Dx Data Items (all 6) | 0 (no involvement) |
Updated: December 2, 2025