ICD-10: C82.13

Follicular lymphoma, particularly classified under ICD-10 code C82.13, refers to a specific type of non-Hodgkin lymphoma that primarily affects the lymphatic system. This condition is characterized by the proliferation of follicle center (germinal center) B-cells, leading to the formation of lymphoid tissue tumors. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with follicular lymphoma grade II, particularly when it involves intra-abdominal lymph nodes.

Clinical Presentation

Overview of Follicular Lymphoma

Follicular lymphoma is typically indolent, meaning it progresses slowly. Grade II indicates a moderate level of aggressiveness, with a higher proliferation rate than grade I but lower than grade III. The involvement of intra-abdominal lymph nodes suggests that the disease has spread beyond its initial site, which can influence both symptoms and treatment approaches.

Signs and Symptoms

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

• Lymphadenopathy: Swelling of lymph nodes is common, particularly in the abdomen, which may be palpable during a physical examination. Patients may notice enlarged lymph nodes in the neck, armpits, or groin as well.
• Abdominal Pain or Discomfort: As intra-abdominal lymph nodes enlarge, they can cause pain or a feeling of fullness in the abdomen. This discomfort may be due to pressure on surrounding organs.
• B Symptoms: These are systemic symptoms that may indicate more advanced disease and include:
• Fever: Unexplained fevers that may come and go.
• Night Sweats: Excessive sweating during the night that can soak clothing and bedding.
• Weight Loss: Unintentional weight loss over a short period, often more than 10% of body weight.
• Fatigue: A common complaint among patients, often due to the body’s response to cancer and its treatment.
• Itching: Some patients report generalized itching, which can be distressing and is not always associated with a rash.

Patient Characteristics

Certain demographic and clinical characteristics are often observed in patients diagnosed with follicular lymphoma:

• Age: Follicular lymphoma is more commonly diagnosed in adults, particularly those aged 60 and older. However, it can occur in younger individuals as well.
• Gender: There is a slight male predominance in the incidence of follicular lymphoma.
• History of Autoimmune Disorders: Some patients may have a history of autoimmune diseases, which has been associated with an increased risk of developing lymphomas.
• Family History: A family history of lymphoproliferative disorders may also be a risk factor.

Diagnostic Considerations

Diagnosis typically involves a combination of clinical evaluation, imaging studies (such as CT scans or PET scans), and biopsy of affected lymph nodes to confirm the presence of follicular lymphoma. Immunophenotyping and genetic studies may also be performed to determine the specific characteristics of the lymphoma cells.

Conclusion

Follicular lymphoma grade II, particularly with intra-abdominal lymph node involvement, presents with a range of symptoms that can significantly impact a patient's quality of life. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for timely diagnosis and effective management. If you suspect you or someone you know may be experiencing these symptoms, it is essential to seek medical evaluation for appropriate testing and treatment options.

ICD-10 code C82.13 refers specifically to Follicular lymphoma grade II located in the intra-abdominal 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 II

1. Follicular Lymphoma, Grade 2: This is a direct alternative name that maintains the same meaning as C82.13.
2. Follicular Lymphoma, Intermediate Grade: This term emphasizes the grade of the lymphoma, indicating it is neither low-grade nor high-grade.
3. Follicular Lymphoma, Stage II: While this is not a direct synonym, it may be used in clinical contexts to describe the extent of the disease, particularly if it involves intra-abdominal lymph nodes.

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. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes various types, including Hodgkin and non-Hodgkin lymphomas.
3. Lymphadenopathy: This term refers to the enlargement of lymph nodes, which can be a symptom of follicular lymphoma.
4. B-cell Lymphoma: Follicular lymphoma is classified as a B-cell lymphoma, as it originates from B-lymphocytes.
5. Lymphoma Grade II: This term may be used in clinical discussions to refer to the grade of the lymphoma without specifying the type.

Clinical Context

Follicular lymphoma grade II is characterized by a moderate proliferation of neoplastic follicle center cells. It is important to note that the grading of follicular lymphoma can influence treatment decisions and prognosis. The intra-abdominal involvement indicates that the lymphoma has spread beyond the lymph nodes, which may affect staging and management strategies.

In summary, while C82.13 specifically denotes follicular lymphoma grade II in intra-abdominal lymph nodes, it is associated with various alternative names and related terms that reflect its classification within the broader context of lymphatic cancers. Understanding these terms can aid in better communication among healthcare professionals and enhance patient education regarding the condition.

The diagnosis of Follicular Lymphoma, particularly for ICD-10 code C82.13, which specifies Follicular lymphoma grade II located in intra-abdominal lymph nodes, involves a combination of clinical evaluation, imaging studies, and histopathological examination. Below is a detailed overview of the criteria used for diagnosis:

Clinical Evaluation

1. Symptoms: Patients may present with nonspecific symptoms such as:
   - Lymphadenopathy (swollen lymph nodes)
   - Abdominal pain or discomfort
   - Unexplained weight loss
   - Night sweats
   - Fever

2. Physical Examination: A thorough physical examination is essential to identify enlarged lymph nodes, particularly in the abdomen, which may indicate the presence of lymphoma.

Imaging Studies

1. CT Scans: Computed Tomography (CT) scans of the abdomen and pelvis are commonly used to visualize lymphadenopathy and assess the extent of disease involvement in intra-abdominal lymph nodes.

2. PET Scans: Positron Emission Tomography (PET) scans may be utilized to evaluate metabolic activity in lymph nodes and help differentiate between benign and malignant processes.

Histopathological Examination

1. Biopsy: A definitive diagnosis of Follicular Lymphoma requires a biopsy of the affected lymph node. This can be done through:
   - Excisional biopsy (removal of an entire lymph node)
   - Core needle biopsy (removal of a small sample of tissue)

2. Microscopic Analysis: The biopsy specimen is examined under a microscope by a pathologist. Key features include:
   - Follicular Architecture: The presence of neoplastic follicles that are characteristic of follicular lymphoma.
   - Cell Type: The identification of centrocytes and centroblasts, which are indicative of grade II follicular lymphoma.
   - Immunophenotyping: Immunohistochemical staining is performed to confirm the presence of specific markers, such as CD10, CD19, CD20, and BCL2, which are associated with follicular lymphoma.

3. Grading: 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: >15 centroblasts per HPF

Additional Diagnostic Criteria

1. Cytogenetic Studies: Genetic testing may be performed to identify chromosomal abnormalities, such as the t(14;18) translocation, which is commonly associated with follicular lymphoma.

2. Staging: The Ann Arbor staging system is often used to determine the extent of the disease, which is crucial for treatment planning.

Conclusion

The diagnosis of Follicular Lymphoma grade II in intra-abdominal lymph nodes (ICD-10 code C82.13) is a multifaceted process that combines clinical assessment, imaging studies, and histopathological evaluation. 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 grade II, classified under ICD-10 code C82.13, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. This condition typically presents with a slow progression and can involve various lymphatic tissues, including intra-abdominal lymph nodes. The treatment approaches for this specific lymphoma grade are multifaceted and depend on several factors, including the patient's overall health, the extent of the disease, and the presence of symptoms.

Standard Treatment Approaches

1. Watchful Waiting

For patients with asymptomatic follicular lymphoma grade II, a common initial approach is "watchful waiting" or active surveillance. 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 disease progression.

2. Chemotherapy

When treatment is necessary, chemotherapy is often the cornerstone of therapy. Common regimens include:

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is frequently used for aggressive forms of lymphoma but can also be effective in follicular lymphoma.
• R-CHOP: The addition of Rituximab (a monoclonal antibody targeting CD20 on B-cells) to the CHOP regimen has become a standard treatment, significantly improving outcomes for many patients.

3. Immunotherapy

Rituximab is a key component in the treatment of follicular lymphoma. It can be used alone or in combination with chemotherapy. In cases where the disease relapses or is refractory, Rituximab may be administered as a single agent or in combination with other agents.

4. Radiation Therapy

Localized radiation therapy may be considered for patients with limited-stage disease or for those with localized symptoms. It can be particularly effective in managing localized lymphadenopathy or for palliative care to relieve symptoms.

5. Targeted Therapy

Newer targeted therapies, such as Bruton’s tyrosine kinase (BTK) inhibitors and PI3K inhibitors, are being explored in clinical trials and may offer additional options for patients, especially those with relapsed or refractory disease.

6. Stem Cell Transplantation

For patients with advanced disease or those who have relapsed after initial treatment, autologous stem cell transplantation may be considered. This approach is typically reserved for younger patients or those with a good performance status.

7. Clinical Trials

Participation in clinical trials may provide access to cutting-edge therapies and novel treatment combinations. Patients are encouraged to discuss this option with their healthcare providers.

Conclusion

The management of follicular lymphoma grade II, particularly involving intra-abdominal lymph nodes, is tailored to the individual patient, considering the disease's characteristics and the patient's overall health. A multidisciplinary approach involving oncologists, radiologists, and other specialists is essential for optimizing treatment outcomes. Regular follow-up and monitoring are crucial to adapt the treatment plan as needed, ensuring the best possible care for patients with this condition.

Follicular lymphoma is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. The ICD-10 code C82.13 specifically refers to Follicular lymphoma grade II that is localized in the intra-abdominal lymph nodes. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Follicular Lymphoma Grade II

Definition and Classification

Follicular lymphoma is classified as a low-grade (indolent) lymphoma, which means it typically grows slowly compared to aggressive forms of lymphoma. The World Health Organization (WHO) classifies follicular lymphoma into different grades based on histological features, with grade II indicating a moderate level of malignancy. This classification is crucial for determining prognosis and treatment strategies.

Pathophysiology

Follicular lymphoma arises from B-lymphocytes in the germinal centers of lymphoid follicles. The neoplastic cells exhibit a characteristic follicular pattern, and the grade is determined by the number of centroblasts (a type of B-cell) present in the tissue sample. In grade II, there are typically 5 to 15 centroblasts per high-power field, indicating a moderate level of aggressiveness compared to grade I (fewer centroblasts) and grade III (more centroblasts) lymphomas.

Symptoms

Patients with follicular lymphoma may present with a variety of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, particularly in the abdomen, which may be palpable.
- Abdominal Pain or Discomfort: Due to enlarged lymph nodes or organ involvement.
- B Symptoms: These include fever, night sweats, and unexplained weight loss, which may indicate more advanced disease.

Diagnosis

Diagnosis typically involves:
- Imaging Studies: CT scans or PET scans to assess the extent of lymphadenopathy and any organ involvement.
- Biopsy: A tissue sample from an affected lymph node is examined histologically to confirm the diagnosis and grade of lymphoma.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to identify specific markers on the lymphoma cells, aiding in diagnosis.

Treatment Options

Treatment for follicular lymphoma grade II may vary based on the stage of the disease and the patient's overall health. Common approaches include:
- Watchful Waiting: In asymptomatic patients, especially those with early-stage disease.
- Chemotherapy: Regimens may include agents like bendamustine or combinations with rituximab.
- Radiation Therapy: Often used for localized disease.
- Targeted Therapy: Newer agents, such as monoclonal antibodies, may be employed.

Prognosis

The prognosis for patients with follicular lymphoma grade II can vary widely. Factors influencing outcomes include the patient's age, overall health, the extent of disease at diagnosis, and response to initial treatment. Generally, follicular lymphoma is considered manageable, with many patients living for years with the disease, although it is often not curable.

Conclusion

ICD-10 code C82.13 encapsulates the clinical nuances of follicular lymphoma grade II affecting intra-abdominal lymph nodes. Understanding the characteristics, symptoms, diagnostic methods, and treatment options is essential for healthcare providers managing patients with this condition. Regular follow-up and monitoring are crucial to address any changes in disease status and to adapt treatment plans accordingly.