ICD-10: C82.10

Follicular lymphoma is a type of non-Hodgkin lymphoma (NHL) that arises from B-lymphocytes, specifically from the follicle center cells. It is characterized by a slow-growing nature and is often diagnosed at an advanced stage. The ICD-10 code C82.10 specifically refers to "Follicular lymphoma grade II, unspecified site," which indicates a particular classification of this lymphoma based on its histological grade and the absence of a specified anatomical site.

Clinical Description of Follicular Lymphoma Grade II

Definition and Classification

Follicular lymphoma is classified into different grades based on the histological examination of the lymph node tissue. Grade II follicular lymphoma is characterized by a moderate number of neoplastic follicles, typically comprising 5 to 15 follicles per high-power field. This grade indicates a more aggressive behavior compared to grade I but is generally less aggressive than grade III follicular lymphoma. The World Health Organization (WHO) classifies follicular lymphoma into grades I, II, and III, with grade II being a transitional form that may exhibit both indolent and aggressive features[1][3].

Symptoms

Patients with follicular lymphoma may present with a variety of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, which may be painless and can occur in various regions of the body.
- B-symptoms: These include fever, night sweats, and unexplained weight loss, which may indicate more advanced disease.
- Fatigue: A common complaint among patients, often due to the disease's impact on overall health.
- Splenomegaly: Enlargement of the spleen may occur, leading to discomfort or a feeling of fullness[2][3].

Diagnosis

The diagnosis of follicular lymphoma grade II typically involves:
- Histopathological Examination: A biopsy of the affected lymph node is essential for diagnosis, where the tissue is examined under a microscope to assess the grade and type of lymphoma.
- Immunophenotyping: This process helps to identify specific markers on the lymphoma cells, confirming the diagnosis of follicular lymphoma.
- Imaging Studies: CT scans, PET scans, or MRI may be used to assess the extent of the disease and to identify any additional sites of involvement[1][2].

Treatment Options

Treatment for follicular lymphoma grade II may vary based on the stage of the disease and the patient's overall health. Common treatment approaches include:
- Watchful Waiting: In cases where the lymphoma is asymptomatic and not rapidly progressing, 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 in combination with chemotherapy or as a standalone treatment.
- Radiation Therapy: This may be employed in localized cases or as palliative care to relieve symptoms[2][3].

Conclusion

ICD-10 code C82.10 designates follicular lymphoma grade II, unspecified site, highlighting the need for careful clinical evaluation and management. Understanding the characteristics, symptoms, and treatment options for this type of lymphoma is crucial for effective patient care. As research continues, advancements in targeted therapies and immunotherapies may further improve outcomes for patients diagnosed with this condition.

For further information or specific case management, consulting with a hematologist or oncologist specializing in lymphomas is recommended.

Follicular lymphoma grade II, classified under ICD-10 code C82.10, is a type of non-Hodgkin lymphoma characterized by specific clinical presentations, signs, symptoms, and patient characteristics. Understanding these aspects is crucial for diagnosis and management.

Clinical Presentation

Follicular lymphoma is a slow-growing (indolent) form of lymphoma that typically arises from B-lymphocytes. The clinical presentation can vary significantly among patients, but several common features are often observed:

Signs and Symptoms

1. Lymphadenopathy:
   - The most common initial symptom is painless swelling of lymph nodes, which may occur in the neck, armpits, or groin. Patients may notice one or more enlarged lymph nodes, often described as rubbery and mobile.

2. 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)

3. Fatigue:
   - Many patients report a general sense of fatigue or weakness, which can be attributed to the disease's impact on the body and the immune system.

4. Abdominal Symptoms:
   - In cases where the lymphoma involves the abdomen, patients may experience abdominal pain, fullness, or discomfort due to enlarged lymph nodes or spleen (splenomegaly).

5. Skin Involvement:
   - Although less common, some patients may develop skin lesions or rashes associated with the lymphoma.

Patient Characteristics

1. Age:
   - Follicular lymphoma is more commonly diagnosed in adults, particularly those aged 50 and older. The median age at diagnosis is around 60 years.

2. Gender:
   - There is a slight male predominance, with men being more frequently diagnosed than women.

3. Family History:
   - A family history of lymphoma or other hematologic malignancies may increase the risk of developing follicular lymphoma.

4. Immunocompromised Status:
   - Patients with compromised immune systems, such as those with HIV/AIDS or those who have undergone organ transplantation, may have a higher risk of developing lymphomas, including follicular lymphoma.

5. Ethnicity:
   - Some studies suggest variations in incidence based on ethnicity, with higher rates observed in Caucasian populations compared to African American populations.

Conclusion

Follicular lymphoma grade II (ICD-10 code C82.10) presents with a range of clinical features, primarily characterized by painless lymphadenopathy and systemic symptoms in some cases. Understanding the signs, symptoms, and patient demographics is essential for timely diagnosis and effective management. If you suspect follicular lymphoma based on these characteristics, further diagnostic evaluation, including imaging and biopsy, is warranted to confirm the diagnosis and determine the appropriate treatment plan.

Follicular lymphoma grade II, classified under ICD-10 code C82.10, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. This condition is part of a broader category of lymphomas and has several alternative names and related terms that are commonly used in medical literature and practice. Below are some of the key alternative names and related terms associated with this diagnosis.

Alternative Names

1. Follicular Lymphoma, Grade II: This is the most straightforward alternative name, emphasizing the grade of the lymphoma.
2. Follicular Lymphoma, Grade 2: A variation in terminology that uses numerical representation instead of Roman numerals.
3. Follicular Lymphoma, NOS (Not Otherwise Specified): This term is often used when the specific characteristics of the lymphoma are not detailed, indicating a general diagnosis without further specification.
4. Follicular Lymphoma, Unspecified Site: This name highlights that the lymphoma is not localized to a specific anatomical site, which is relevant for treatment and prognosis.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): Follicular lymphoma is a subtype of non-Hodgkin lymphoma, which encompasses a wide range of lymphoid malignancies.
2. B-cell Lymphoma: Since follicular lymphoma originates from B-cells, this term is often used in discussions about its pathology and treatment.
3. Lymphoproliferative Disorder: This term refers to a group of conditions characterized by the excessive production of lymphocytes, including follicular lymphoma.
4. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes follicular lymphoma as one of its subtypes.
5. Grade II Lymphoma: This term may be used in broader discussions about lymphoma grading, indicating a specific level of aggressiveness in the disease.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.10 is essential for accurate communication among healthcare professionals and for effective patient management. These terms not only facilitate clearer discussions regarding diagnosis and treatment but also help in the classification and coding processes within healthcare systems. If you need further information on treatment options or prognosis related to follicular lymphoma, feel free to ask!

Follicular lymphoma, particularly classified under ICD-10 code C82.10, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. The diagnosis of follicular lymphoma, including grade II, 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 most common symptom. Other symptoms can include fever, night sweats, weight loss, and fatigue, often referred to as "B symptoms" in lymphoma.
• Physical Examination: A thorough physical examination is essential to identify lymph node enlargement and any splenomegaly or hepatomegaly.

Laboratory Tests

• Blood Tests: Routine blood tests may show anemia, elevated lactate dehydrogenase (LDH), and other abnormalities. However, these findings are not specific to follicular lymphoma.
• Bone Marrow Biopsy: A bone marrow biopsy may be performed to assess the extent of disease involvement and to rule out other hematological disorders.

Imaging Studies

• CT Scans: Computed tomography (CT) scans of the chest, abdomen, and pelvis are commonly used to evaluate lymph node involvement and to assess the extent of the disease.
• PET Scans: Positron emission tomography (PET) scans can help in staging the disease and assessing metabolic activity of the lymphoma.

Histopathological Examination

• Biopsy: A definitive diagnosis of follicular lymphoma requires a biopsy of an affected lymph node or tissue. The biopsy specimen is examined microscopically.
• Histological Classification: Follicular lymphoma is classified into grades 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 (further divided into IIIA and IIIB based on the presence of follicular structures).

Immunophenotyping

• Immunohistochemistry: The use of immunohistochemical stains is crucial for confirming the diagnosis. Follicular lymphoma typically expresses CD10, CD19, CD20, and BCL2, while lacking CD5 and CD23, which helps differentiate it from other types of lymphoma.

Genetic Studies

• 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 can be detected through fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR) techniques.

Conclusion

The diagnosis of follicular lymphoma grade II (ICD-10 code C82.10) is multifaceted, relying on clinical, laboratory, imaging, and histopathological criteria. Accurate diagnosis is essential for determining the appropriate treatment strategy and prognosis for the patient. If you have further questions or need more specific information, feel free to ask!

Follicular lymphoma, particularly classified under ICD-10 code C82.10 as grade II and unspecified site, is a type of non-Hodgkin lymphoma (NHL) that typically presents with a slow-growing nature. The treatment approaches for this condition can vary based on several factors, including the patient's overall health, the extent of the disease, and specific characteristics of the lymphoma. Below is a detailed overview of standard treatment strategies for follicular lymphoma grade II.

Overview of Follicular Lymphoma

Follicular lymphoma is characterized by the proliferation of B-lymphocytes and is often diagnosed at an advanced stage. Grade II indicates a moderate level of aggressiveness, which can influence treatment decisions. The management of follicular lymphoma generally aims to control symptoms, prolong survival, and improve quality of life.

Standard Treatment Approaches

1. Watchful Waiting (Active Surveillance)

For patients with asymptomatic follicular lymphoma, especially those with early-stage disease, a strategy of watchful waiting may be employed. This approach involves regular monitoring without immediate treatment, as many patients may not require intervention until symptoms develop or the disease progresses.

2. Chemotherapy

When treatment is necessary, chemotherapy is a common first-line option. The most frequently used regimens include:

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is effective for many patients and can be combined with other therapies.
• R-CHOP: The addition of Rituximab (a monoclonal antibody) to the CHOP regimen has significantly improved outcomes for patients with follicular lymphoma. Rituximab targets CD20 on B-cells, enhancing the effectiveness of chemotherapy.

3. Immunotherapy

Rituximab is a cornerstone of treatment for follicular lymphoma. It can be used alone or in combination with chemotherapy. Other immunotherapeutic agents include:

• Obinutuzumab: Another anti-CD20 monoclonal antibody that may be used in combination with chemotherapy.
• Rituxan Hycela®: A formulation of Rituximab combined with hyaluronidase, allowing for subcutaneous administration, which can improve patient convenience and comfort.

4. Targeted Therapy

Targeted therapies have emerged as effective options for follicular lymphoma. These include:

• PI3K Inhibitors: Such as Copanlisib (Aliqopa®), which target specific pathways involved in cancer cell growth and survival.
• BCL-2 Inhibitors: Like Venetoclax, which can be particularly effective in patients with certain genetic mutations.

5. Radiation Therapy

Radiation therapy may be utilized in specific scenarios, particularly for localized disease or to alleviate symptoms from bulky lymphadenopathy. It is often used in conjunction with other treatments.

6. Stem Cell Transplantation

For patients with relapsed or refractory follicular lymphoma, autologous stem cell transplantation may be considered, especially after achieving remission with chemotherapy. This approach can provide a chance for long-term remission.

7. Radioimmunotherapy

This treatment combines radiation therapy with immunotherapy, using radiolabeled antibodies to target and destroy lymphoma cells. It can be an option for patients who have not responded to other treatments.

Conclusion

The management of follicular lymphoma grade II (ICD-10 code C82.10) is multifaceted and tailored to the individual patient. Treatment strategies may range from active surveillance to a combination of chemotherapy, immunotherapy, targeted therapy, and radiation, depending on the disease's characteristics and the patient's overall health. Ongoing research continues to refine these approaches, aiming to improve outcomes and quality of life for patients with this type of lymphoma. Regular follow-up and monitoring are essential to adapt treatment plans as needed and to address any emerging symptoms or disease progression.