This input is used for staging


**Note 1:** For cases diagnosed 1/1/2018 and later, all cases of CLL and SLL will require both the **Lugano classification, which is captured in the AJCC stage group data item, and the five components of the modified Rai staging system, which are captured in Site-Specific Data Items (adenopathy, anemia, lymphocytosis, organomegaly, and thrombocytopenia).** The terms B-cell lymphocytic leukemia/chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are different clinical presentations of the same disease, with both terms coded 9823. Traditionally the lymphoma diagnosis was staged with the Ann Arbor staging system and it is now staged with the Lugano classification. In North America, CLL was staged with the Rai system. **Note 2:** Rai stage is only applicable for CLL, in which the bone marrow and/or peripheral blood are involved (primary site C421 for bone marrow, see Hematopoietic Manual, Module 3: PH 5, 6). * If primary site is not C421, code 5 **Note 3:** Physician statement of presence or absence of adenopathy should be used to code this data item. * Physician’s statement regarding the presence of adenopathy (present or absent) takes priority. If a physician’s statement and imaging are both available and in disagreement, go with the physician’s statement * If a physician’s statement is not available, use the definition of adenopathy in Note 3 to determine if adenopathy is present or not **Note 4:** Adenopathy is defined as the presence of lymph nodes >1.5 cm on physical examination (PE) and is part of the staging criteria. **Note 5:** This data item is determined from physical exam alone. If a physical exam cannot be used to detect adenopathy due to issues related to the patient's obesity, a physician statement of peripheral adenopathy based on a CT scan can be used. * A finding of retroperitoneal or mesenteric adenopathy on CT is not used in determining adenopathy and does not affect the assigned stage **Note 6:** If there is no mention of adenopathy (present or absent), code 9. **Note 7:** The physician's stated Rai stage always takes priority when there is conflicting information


NAACCR #3804


Code Description
0 Adenopathy not identified/not present No lymph nodes > 1.5 cm Physician states Rai stage 0
1 Adenopathy present Presence of lymph nodes > 1.5 cm Physician states Rai stage I
5 Not applicable: Primary site is not C421
9 Not documented in medical record Adenopathy not assessed or unknown if assessed No Rai stage is documented in the record and there is no documentation of adenopathy Physician states Rai stage II-IV and there is no documentation of adenopathy