05-29-2026 Positive Results, But Not Your Call
Scenario: [Case Scenario from Ask a SEER Registrar and posted in Hematopoietic and Lymphoid Neoplasm Coding Manual]
- Path Report: Final diagnosis: Acute myeloid leukemia with monocytic differentiation. Note: The combined morphologic and immunophenotypic findings are consistent with involvement by an acute myeloid leukemia with monocytic differentiation.
- Cytogenetics: RUNX1, RUNX1T1 POS. NPM1+ FLT3 TKD+. No revised diagnosis available.
Question: How would you assign the histology?
- 9861/3: Acute myeloid leukemia, NOS
- 9879/3 Acute myeloid leukemia with mutated RUNX1
- 9877/3 Acute myeloid leukemia with NPM1 mutation
Answer: 9861/3: Acute myeloid leukemia, NOS *per Hematopoietic and Lymphoid Neoplasm Database Alternate Name: Acute myeloid leukemia with monocytic differentiation
References & Discussion: The Pathologist has clearly stated the diagnosis as acute myeloid leukemia with monocytic differentiation based on the pathology report. The positive genetics cannot be used to assign histology since there is no statement from the pathologist/managing physician.
Hematopoietic and Lymphoid Neoplasm Coding Manual- Histology Coding Instructions
Registrars are NOT to update the diagnosis based on positive immunophenotyping and genetics results only. The updated diagnosis based on positive genetics or immunophenotyping MUST be provided by the pathologist or the managing physician.
- Registrars are NOT to update the histology based on genetics or immunophenotyping without a pathologist’s/physician’s statement.
- Pathologist’s/physician statement can be found in the final diagnosis, synoptic report, or in the comments section
Hematopoietic and Lymphoid Neoplasm Database
