ICD-10: C82.02

ICD-10 code C82.02 refers specifically to Follicular lymphoma grade I that is located in the intrathoracic lymph nodes. This classification is part of the broader category of non-Hodgkin lymphoma, which encompasses a variety of lymphoid malignancies characterized by the proliferation of lymphocytes.

Clinical Description of Follicular Lymphoma Grade I

Overview

Follicular lymphoma is a type of indolent (slow-growing) non-Hodgkin lymphoma that arises from B-lymphocytes. It is characterized by the formation of follicle-like structures in lymphoid tissue. Grade I follicular lymphoma indicates a low proliferation rate, typically defined by the presence of a low number of large cells (centroblasts) in the tumor tissue.

Symptoms

Patients with follicular lymphoma may present with:
- Lymphadenopathy: Swelling of lymph nodes, which can be painless and may occur in various regions, including the neck, armpits, and groin.
- B-symptoms: These include fever, night sweats, and unexplained weight loss, although they are less common in grade I cases.
- Fatigue: General tiredness and lack of energy are frequently reported.

Diagnosis

Diagnosis of follicular lymphoma typically involves:
- Histopathological Examination: A biopsy of the affected lymph nodes is essential for confirming the diagnosis. The tissue is examined under a microscope to identify the characteristic follicular architecture and the presence of centroblasts.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to determine the specific markers on the lymphoma cells, confirming their B-cell lineage.
- Imaging Studies: CT scans or PET scans may be utilized to assess the extent of the disease, particularly to identify intrathoracic lymph node involvement.

Intrathoracic Involvement

The designation of intrathoracic lymph nodes indicates that the lymphoma has affected lymph nodes located within the thoracic cavity, which may include:
- Mediastinal Lymph Nodes: Located in the central part of the chest, between the lungs.
- Hilar Lymph Nodes: Found at the root of the lungs.

Treatment Options

Treatment for follicular lymphoma grade I may vary based on the stage of the disease and the patient's overall health. Common approaches include:
- Watchful Waiting: In cases where the lymphoma is asymptomatic and not causing significant problems, a "watch and wait" approach may be adopted.
- Chemotherapy: Regimens such as R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) may be used for symptomatic patients.
- Radiation Therapy: This may be employed for localized disease, particularly if the lymphoma is confined to a limited number of lymph nodes.
- Targeted Therapy: Newer agents, such as monoclonal antibodies (e.g., Rituximab), may be used in combination with chemotherapy or as standalone treatments.

Prognosis

The prognosis for patients with follicular lymphoma grade I is generally favorable, especially when diagnosed early. The indolent nature of the disease often allows for long-term management, although it is important to note that follicular lymphoma can transform into a more aggressive form over time.

Conclusion

ICD-10 code C82.02 captures the essential details of follicular lymphoma grade I affecting intrathoracic lymph nodes. Understanding the clinical presentation, diagnostic methods, treatment options, and prognosis is crucial for effective management of this lymphoma subtype. Regular follow-up and monitoring are essential to address any changes in the disease status and to adapt treatment strategies accordingly.

Follicular lymphoma, particularly classified under ICD-10 code C82.02, refers to a specific type of non-Hodgkin lymphoma characterized by its indolent nature and follicular growth pattern. The diagnosis of follicular lymphoma, including grade I, involves a combination of clinical evaluation, imaging studies, and histopathological examination. Below are the key criteria used for diagnosis:

Clinical Presentation

• Symptoms: Patients may present with painless lymphadenopathy, which can be localized or generalized. Other symptoms may include fever, night sweats, and weight loss, although these are less common in early-stage follicular lymphoma.
• Physical Examination: A thorough physical examination is essential to identify lymph node enlargement, particularly in the intrathoracic region, which is pertinent for C82.02.

Imaging Studies

• CT Scans: Computed tomography (CT) scans of the chest, abdomen, and pelvis are commonly used to assess the extent of lymphadenopathy and to identify any intrathoracic lymph nodes involved.
• PET Scans: Positron emission tomography (PET) scans may be utilized to evaluate metabolic activity in lymph nodes and to help differentiate between active disease and benign conditions.

Histopathological Criteria

• Biopsy: A definitive diagnosis requires a biopsy of the affected lymph node. The histological examination will reveal the characteristic follicular architecture.
• Grading: Follicular lymphoma is graded based on the number of large cells present in the tissue sample. Grade I indicates a predominance of small cleaved cells with fewer than 5 large cells per high-power field.
• Immunophenotyping: Immunohistochemical staining is performed to confirm the diagnosis. Follicular lymphoma typically expresses CD10, CD19, CD20, and BCL2, while lacking CD5.

Molecular and Genetic Testing

• Cytogenetic Analysis: The presence of the t(14;18) chromosomal translocation, which results in the overexpression of the BCL2 gene, is a hallmark of follicular lymphoma and is often assessed through fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR) techniques.

Staging

• Ann Arbor Staging System: The staging of follicular lymphoma is crucial for treatment planning. The Ann Arbor system classifies the disease based on the number of lymph node regions involved and the presence of systemic symptoms.

Conclusion

The diagnosis of follicular lymphoma grade I, particularly involving intrathoracic lymph nodes (ICD-10 code C82.02), relies on a comprehensive approach that includes clinical assessment, imaging studies, histopathological evaluation, and molecular testing. Accurate diagnosis is essential for determining the appropriate management and treatment strategies for patients with this type of lymphoma.

Follicular lymphoma, particularly classified under ICD-10 code C82.02, refers to a type of non-Hodgkin lymphoma that is characterized by a slow-growing nature and typically arises in the lymphatic system. When it specifically involves intrathoracic lymph nodes, treatment approaches can vary based on several factors, including the stage of the disease, the patient's overall health, and specific characteristics of the lymphoma.

Standard Treatment Approaches

1. Observation (Watchful Waiting)

For patients with asymptomatic follicular lymphoma, especially those with grade I disease, a common initial approach is "watchful waiting." This strategy involves closely monitoring the patient without immediate treatment, as many patients may not require intervention for extended periods. Regular follow-ups and imaging studies are conducted to assess any changes in the disease status.

2. Chemotherapy

When treatment is necessary, chemotherapy is often the first-line option. Common regimens include:

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is a standard treatment for various types of non-Hodgkin lymphoma.
• R-CHOP: This is a variation of the CHOP regimen that includes Rituximab, a monoclonal antibody that targets CD20 on B-cells, enhancing the effectiveness of chemotherapy.

3. Immunotherapy

Rituximab is frequently used in combination with chemotherapy for follicular lymphoma. It can also be used as a standalone treatment in cases where the disease is not immediately life-threatening. Other newer immunotherapies, such as Obinutuzumab, may also be considered.

4. Radiation Therapy

Radiation therapy can be effective, particularly for localized disease or in cases where the lymphoma is confined to a specific area, such as intrathoracic lymph nodes. It may be used as a primary treatment or as an adjunct to chemotherapy.

5. Targeted Therapy

Targeted therapies, such as PI3K inhibitors (e.g., Copanlisib), are increasingly being utilized for follicular lymphoma. These drugs specifically target pathways involved in the growth and survival of cancer cells, offering a more tailored approach to treatment.

6. Stem Cell Transplantation

In certain cases, particularly for relapsed or refractory disease, high-dose chemotherapy followed by autologous stem cell transplantation may be considered. This approach is more common in younger patients or those with aggressive disease features.

7. Clinical Trials

Participation in clinical trials may be an option for patients seeking access to cutting-edge therapies or novel treatment combinations. These trials can provide opportunities for patients to receive treatments that are not yet widely available.

Conclusion

The treatment of follicular lymphoma grade I, particularly when involving intrathoracic lymph nodes, is multifaceted and tailored to the individual patient. The choice of treatment depends on various factors, including the patient's symptoms, overall health, and specific disease characteristics. Regular follow-up and monitoring are crucial, as the disease can often be managed effectively over time. For patients and healthcare providers, staying informed about the latest treatment options and clinical trials is essential for optimizing care.

Follicular lymphoma, particularly classified under ICD-10 code C82.02, refers to a specific type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. This subtype is typically indolent, meaning it often progresses slowly, and it can present with a variety of clinical features. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with follicular lymphoma grade I, particularly when it involves intrathoracic lymph nodes.

Clinical Presentation

General Characteristics

Follicular lymphoma grade I is often diagnosed in adults, with a median age of diagnosis around 60 years. It is more common in women than in men, with a ratio of approximately 2:1. The disease is characterized by the presence of small, cleaved lymphoid cells that typically form follicle-like structures in lymphoid tissue.

Signs and Symptoms

The clinical presentation of follicular lymphoma can vary significantly among patients, but common signs and symptoms include:

• Lymphadenopathy: The most common presentation is painless swelling of lymph nodes, which may be localized or generalized. In the case of C82.02, there is specific involvement of intrathoracic lymph nodes, which may lead to mediastinal or hilar lymphadenopathy.

• B Symptoms: Some patients may experience systemic symptoms known as "B symptoms," which include:

• Unexplained fever
• Night sweats

• Unintentional weight loss (more than 10% of body weight over six months)

• Respiratory Symptoms: If intrathoracic lymph nodes are significantly enlarged, patients may present with respiratory symptoms such as:

• Cough
• Shortness of breath

• Chest pain or discomfort

• Abdominal Symptoms: In some cases, patients may also experience abdominal discomfort or fullness if lymph nodes in the abdomen are involved.

Patient Characteristics

Patients with follicular lymphoma grade I often share certain characteristics:

• Age: Most commonly diagnosed in older adults, particularly those over 60 years of age.

• Gender: There is a higher prevalence in females compared to males.

• History of Autoimmune Disorders: Some studies suggest a link between autoimmune diseases (such as rheumatoid arthritis or lupus) and an increased risk of developing follicular lymphoma.

• Family History: A family history of lymphoproliferative disorders may also be a risk factor.

• Ethnicity: The incidence of follicular lymphoma can vary by ethnicity, with higher rates observed in Caucasian populations compared to African American populations.

Conclusion

Follicular lymphoma grade I, particularly with intrathoracic lymph node involvement (ICD-10 code C82.02), presents with a range of clinical features, primarily characterized by painless lymphadenopathy and potential respiratory symptoms due to lymph node enlargement. Understanding these signs and symptoms is crucial for timely diagnosis and management. Given the indolent nature of this lymphoma subtype, patients often require careful monitoring and may benefit from a multidisciplinary approach to treatment, including oncologists and hematologists.

ICD-10 code C82.02 refers specifically to Follicular lymphoma grade I located in the intrathoracic lymph nodes. This classification falls under the broader category of non-Hodgkin lymphoma, which encompasses various types of lymphatic cancers. Below are alternative names and related terms associated with this specific diagnosis.

Alternative Names for Follicular Lymphoma Grade I

1. Follicular Lymphoma, Low-Grade: This term emphasizes the indolent nature of grade I follicular lymphoma, which typically has a slower progression compared to higher-grade lymphomas.

2. Grade I Follicular Lymphoma: This is a direct reference to the grading system used to classify the aggressiveness of the lymphoma, with grade I indicating a less aggressive form.

3. Indolent Follicular Lymphoma: This term highlights the slow-growing characteristic of grade I follicular lymphoma, distinguishing it from more aggressive forms of lymphoma.

4. Follicular Lymphoma, Stage I: While not a direct synonym, this term may be used in clinical contexts to describe early-stage follicular lymphoma, which can include grade I cases.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): Follicular lymphoma is a subtype of non-Hodgkin lymphoma, which is a broader category of lymphatic cancers.

2. Lymphadenopathy: This term refers to the enlargement of lymph nodes, which is a common symptom in patients with follicular lymphoma.

3. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas.

4. Intrathoracic Lymph Nodes: This term specifies the location of the lymphoma, indicating that the affected lymph nodes are within the thoracic cavity.

5. B-cell Lymphoma: Follicular lymphoma is classified as a B-cell lymphoma, as it originates from B lymphocytes, a type of white blood cell.

6. Chronic Lymphocytic Leukemia (CLL): While distinct, CLL can sometimes be confused with follicular lymphoma due to overlapping characteristics, particularly in terms of B-cell involvement.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.02 is essential for accurate diagnosis, treatment planning, and communication among healthcare professionals. These terms help clarify the specific type of lymphoma and its characteristics, aiding in the management of the disease. If you need further information on treatment options or prognosis related to follicular lymphoma, feel free to ask!