ICD-10: C82.08

ICD-10 code C82.08 refers to Follicular lymphoma grade I, specifically affecting the lymph nodes of multiple sites. This classification falls under the broader category of non-Hodgkin lymphoma (NHL), which encompasses a diverse group of blood cancers that originate in the lymphatic system.

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, a type of white blood cell. It is characterized by the formation of follicle-like structures in lymphoid tissue, which can lead to the enlargement of lymph nodes. Grade I indicates a low level of malignancy, meaning that the cancer cells are relatively well-differentiated and tend to grow slowly compared to higher-grade lymphomas.

Symptoms

Patients with follicular lymphoma may present with:
- Painless lymphadenopathy: Swelling of lymph nodes, often in the neck, armpits, or groin.
- Fatigue: General tiredness that does not improve with rest.
- Weight loss: Unintentional loss of weight over a short period.
- Night sweats: Episodes of excessive sweating during the night.
- Fever: Low-grade fevers that may come and go.

Diagnosis

Diagnosis typically involves:
- Physical examination: Assessment of swollen lymph nodes.
- Imaging studies: CT scans or PET scans to evaluate the extent of the disease and identify affected lymph nodes.
- Biopsy: A definitive diagnosis is made through a biopsy of the lymph node, where histological examination reveals the characteristic follicular architecture and the presence of neoplastic B-cells.

Staging

Follicular lymphoma is staged using the Ann Arbor system, which considers the number of lymph node regions involved and whether the disease has spread to other organs. The presence of multiple sites of lymph node involvement, as indicated by the C82.08 code, suggests a more extensive disease process.

Treatment Options

Treatment for follicular lymphoma grade I may vary based on the stage of the disease, the patient's overall health, and symptoms. 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) are commonly used.
- Immunotherapy: Rituximab, a monoclonal antibody, is often used either alone or in combination with chemotherapy.
- Radiation therapy: May be used for localized disease or to alleviate symptoms.

Prognosis

The prognosis for patients with follicular lymphoma grade I is generally favorable, especially when diagnosed early. The indolent nature of the disease allows for long-term management, and many patients can live for years with effective treatment and monitoring.

Conclusion

ICD-10 code C82.08 captures the clinical essence of follicular lymphoma grade I affecting multiple lymph node sites. Understanding the characteristics, symptoms, and treatment options for this condition is crucial for healthcare providers in managing patient care effectively. Regular follow-ups and monitoring are essential to address any changes in the disease status and to adapt treatment plans accordingly.

Follicular lymphoma, particularly classified under ICD-10 code C82.08, refers to a specific type of non-Hodgkin lymphoma (NHL) characterized by the proliferation of follicle center (germinal center) B-cells. This condition is typically indolent, meaning it progresses slowly, and is often diagnosed at an advanced stage. Below, we explore the clinical presentation, signs, symptoms, and patient characteristics associated with follicular lymphoma grade I affecting multiple lymph node sites.

Clinical Presentation

General Overview

Follicular lymphoma grade I is a subtype of follicular lymphoma that is generally associated with a favorable prognosis compared to higher-grade lymphomas. It is characterized by the presence of small, well-differentiated neoplastic follicles in the lymph nodes, which can lead to a variety of clinical manifestations depending on the extent of the disease.

Signs and Symptoms

Patients with follicular lymphoma grade I may present with a range of signs and symptoms, which can include:

• Lymphadenopathy: The most common presentation is painless swelling of lymph nodes, often in multiple regions such as the neck, axilla, and groin. Patients may notice enlarged lymph nodes during routine examinations or while feeling for lumps.
• B Symptoms: Some patients may experience systemic symptoms known as "B symptoms," which include:
• Unexplained fever
• Night sweats
• Unintentional weight loss (typically more than 10% of body weight over six months)
• Fatigue: Many patients report a general sense of fatigue or malaise, which can be attributed to the underlying disease process.
• Abdominal Symptoms: If the lymphoma involves abdominal lymph nodes, patients may experience abdominal discomfort, fullness, or even bowel obstruction in advanced cases.
• Splenomegaly: Enlargement of the spleen may occur, leading to discomfort or a feeling of fullness in the abdomen.

Patient Characteristics

The demographic and clinical characteristics of patients diagnosed with follicular lymphoma grade I can vary, but common features include:

• Age: Follicular lymphoma typically occurs in adults, with a median age of diagnosis around 60 years. It is relatively rare in younger individuals.
• Gender: There is a slight male predominance in the incidence of follicular lymphoma, although it can affect both genders.
• Comorbidities: Patients may have other health conditions, which can influence treatment decisions and overall prognosis. Common comorbidities include cardiovascular diseases and diabetes.
• Family History: A family history of lymphoproliferative disorders may be noted in some patients, suggesting a potential genetic predisposition.

Diagnosis and Staging

Diagnosis of follicular lymphoma grade I typically involves a combination of clinical evaluation, imaging studies (such as CT scans), and histopathological examination of lymph node biopsies. The staging of the disease is crucial for determining the appropriate management strategy and may involve the use of the Ann Arbor staging system.

Conclusion

Follicular lymphoma grade I, particularly affecting multiple lymph node sites, presents with a range of clinical features primarily characterized by painless lymphadenopathy and potential systemic symptoms. Understanding the signs, symptoms, and patient demographics is essential for timely diagnosis and management. Given its indolent nature, many patients may live for years with the disease, often requiring careful monitoring rather than immediate aggressive treatment. Regular follow-ups and imaging studies are critical in managing this condition effectively.

ICD-10 code C82.08 refers specifically to "Follicular lymphoma grade I, lymph nodes of multiple sites." 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 progresses slowly compared to higher-grade lymphomas.

2. Follicular Lymphoma, Grade 1: A direct reference to the grading system used to classify the aggressiveness of the lymphoma.

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

4. Chronic Follicular Lymphoma: While not commonly used, this term may be employed to describe the long-term nature of the disease.

Related Terms

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

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

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

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

5. Stage I Follicular Lymphoma: While C82.08 specifically refers to grade I, staging is also an important aspect of lymphoma classification, indicating the extent of disease spread.

6. Lymphoma Grade I: A broader term that may refer to any lymphoma classified as grade I, not limited to follicular types.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.08 is essential for accurate communication among healthcare professionals and for patient education. These terms help clarify the nature of the disease, its classification, and its implications for treatment and prognosis. If you need further information on treatment options or management strategies for follicular lymphoma, feel free to ask!

Follicular lymphoma, particularly classified under ICD-10 code C82.08, refers to a specific type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. The diagnosis of follicular lymphoma, especially grade I affecting lymph nodes at multiple sites, 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 is the swelling of lymph nodes. Other symptoms can include fever, night sweats, and unexplained weight loss, although these are less common in early-stage follicular lymphoma.
• Physical Examination: A thorough physical examination is essential to identify lymphadenopathy in multiple regions, including cervical, axillary, and inguinal lymph nodes.

Imaging Studies

• CT Scans: Computed tomography (CT) scans of the chest, abdomen, and pelvis are often performed to assess the extent of lymphadenopathy and to identify any additional sites of disease involvement.
• 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 biopsy specimen is examined microscopically to identify the characteristic features of follicular lymphoma.
• Histological Classification: Follicular lymphoma is graded based on the number of centroblasts per high-power field (HPF):
• Grade I: 0-5 centroblasts per HPF.
• Grade II: 6-15 centroblasts per HPF.
• Grade III: More than 15 centroblasts per HPF, which is further divided into IIIA and IIIB based on the presence of follicular structures.

Immunophenotyping

• Flow Cytometry: This technique is used to analyze the surface markers on the lymphoma cells. Follicular lymphoma typically expresses CD19, CD20, and CD10, while lacking CD5 and CD23, which helps in distinguishing it from other types of lymphomas.
• Genetic Testing: The presence of the t(14;18) chromosomal translocation, which results in the BCL2 gene rearrangement, is a hallmark of follicular lymphoma and can be confirmed through molecular techniques.

Staging

• Ann Arbor Staging System: The disease is staged based on the extent of lymph node involvement and the presence of systemic symptoms. Stage II indicates involvement of two or more lymph node regions on the same side of the diaphragm, which is relevant for grade I follicular lymphoma affecting multiple sites.

Conclusion

The diagnosis of follicular lymphoma grade I (ICD-10 code C82.08) involves a comprehensive approach that includes clinical assessment, imaging studies, histopathological evaluation, and immunophenotyping. Accurate diagnosis is crucial for determining the appropriate treatment strategy and for prognostic evaluation. If you have further questions or need more specific details, feel free to ask!

Follicular lymphoma, particularly classified under ICD-10 code C82.08, refers to a type of non-Hodgkin lymphoma that is characterized by the proliferation of follicle center (germinal center) B-cells. This specific grade I variant typically indicates a slow-growing form of the disease, often presenting in lymph nodes at multiple sites. The treatment approaches for this condition can vary based on several factors, including the stage of the disease, the patient's overall health, and specific symptoms. Below is a detailed overview of standard treatment strategies for follicular lymphoma grade I.

Standard Treatment Approaches

1. Watchful Waiting (Active Surveillance)

For patients with asymptomatic follicular lymphoma grade I, especially those with early-stage disease, a common approach is watchful waiting. This strategy involves regular monitoring without immediate treatment, as many patients may not require intervention for years. This approach is particularly suitable for patients who are older or have other significant health issues.

2. Chemotherapy

When treatment is necessary, chemotherapy is often the first line of defense. 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 or as a standalone treatment for patients who are not candidates for chemotherapy. It can help to reduce tumor burden and prolong remission.

4. Radiation Therapy

Localized radiation therapy may be employed, particularly for patients with limited-stage disease or those with bulky disease in specific lymph node regions. Radiation can be effective in controlling localized symptoms and reducing tumor size.

5. Targeted Therapy

Recent advancements have introduced targeted therapies that focus on specific pathways involved in the growth of lymphoma cells. For instance, agents like Idelalisib and Copanlisib target the PI3K pathway, which is often activated in follicular lymphoma.

6. Stem Cell Transplantation

In cases of relapsed or refractory follicular lymphoma, high-dose chemotherapy followed by autologous stem cell transplantation may be considered. This approach is generally reserved for younger patients or those with aggressive disease features.

7. Clinical Trials

Patients may also consider enrolling in clinical trials, which can provide access to new therapies and treatment strategies that are not yet widely available. These trials often explore novel agents or combinations that may improve outcomes for patients with follicular lymphoma.

Conclusion

The management of follicular lymphoma grade I, particularly with multiple lymph node involvement, is multifaceted and tailored to the individual patient. While watchful waiting may be appropriate for some, others may require a combination of chemotherapy, immunotherapy, and possibly radiation. As research continues to evolve, new treatment modalities and clinical trials may offer additional options for patients. It is essential for patients to discuss their specific case with their healthcare provider to determine the most appropriate treatment plan based on their unique circumstances and preferences.