ICD-10: C82.55

Diffuse follicle center lymphoma (DFCL), classified under ICD-10 code C82.55, is a subtype of non-Hodgkin lymphoma (NHL) that primarily affects the lymphatic system. This specific code indicates that the lymphoma is located in the lymph nodes of the inguinal region and lower limb. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Diffuse Follicle Center Lymphoma

Definition and Characteristics

Diffuse follicle center lymphoma is characterized by the proliferation of B-lymphocytes that arise from the germinal centers of lymphoid follicles. It is classified as a type of follicular lymphoma, which is a common form of NHL. DFCL is noted for its aggressive behavior compared to other follicular lymphomas, often presenting with a more diffuse pattern of growth.

Epidemiology

DFCL is more prevalent in adults, with a higher incidence in individuals over the age of 60. It is slightly more common in males than females. The exact etiology remains unclear, but factors such as genetic predisposition, environmental exposures, and immune system status may contribute to its development.

Symptoms

Patients with DFCL may present with various symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, particularly in the inguinal region and lower limbs, which may be painless.
- B Symptoms: These include fever, night sweats, and unexplained weight loss, which can indicate more advanced disease.
- Fatigue: Generalized fatigue is common among patients.
- Abdominal Symptoms: If lymph nodes in the abdomen are involved, patients may experience discomfort or fullness.

Diagnosis

Diagnosis of DFCL typically involves:
- Physical Examination: Assessment of lymph node enlargement.
- Imaging Studies: CT scans or PET scans to evaluate the extent of lymphadenopathy and any involvement of other organs.
- Biopsy: A definitive diagnosis is made through a lymph node biopsy, where histological examination reveals the characteristic diffuse growth pattern of neoplastic follicles.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to identify specific markers (e.g., CD10, BCL2) that confirm the diagnosis.

Staging

Staging of DFCL follows the Ann Arbor classification, which assesses the extent of disease based on the number of lymph node regions involved and the presence of systemic symptoms. This staging is crucial for determining the appropriate treatment approach.

Treatment Options

Treatment for diffuse follicle center lymphoma may include:
- Chemotherapy: Common regimens include combinations of agents such as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP).
- Immunotherapy: Monoclonal antibodies like rituximab are often used in conjunction with chemotherapy.
- Radiation Therapy: May be employed for localized disease or as palliative care.
- Stem Cell Transplantation: In cases of relapsed or refractory disease, autologous or allogeneic stem cell transplantation may be considered.

Prognosis

The prognosis for patients with DFCL varies based on several factors, including the stage at diagnosis, patient age, and overall health. Generally, the prognosis is better for localized disease compared to advanced stages. Regular follow-up and monitoring for recurrence are essential components of post-treatment care.

Conclusion

ICD-10 code C82.55 specifically denotes diffuse follicle center lymphoma affecting the lymph nodes in the inguinal region and lower limb. Understanding the clinical characteristics, diagnostic methods, treatment options, and prognosis is crucial for effective management of this lymphoma subtype. Early detection and tailored treatment strategies can significantly improve patient outcomes.

Diffuse follicle center lymphoma (DFCL), classified under ICD-10 code C82.55, is a subtype of non-Hodgkin lymphoma characterized by the proliferation of B-lymphoid cells in the follicle center. This condition primarily affects the lymph nodes, particularly in the inguinal region and lower limbs. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this lymphoma subtype is crucial for diagnosis and management.

Clinical Presentation

Signs and Symptoms

Patients with diffuse follicle center lymphoma may present with a variety of signs and symptoms, which can vary in severity and duration:

• Lymphadenopathy: The most common presentation is painless swelling of lymph nodes, particularly in the inguinal region and lower limbs. Patients may notice enlarged lymph nodes that can be palpable during a physical examination[1].
• B Symptoms: Some patients may experience systemic symptoms known as "B symptoms," which include:
• Fever: Unexplained fevers that may be intermittent.
• Night Sweats: Profuse sweating during the night, often soaking bedclothes.
• Weight Loss: Unintentional weight loss exceeding 10% of body weight over six months[1][2].
• Fatigue: Generalized fatigue and weakness are common complaints among patients, often due to the disease's metabolic demands and systemic effects[2].
• Pruritus: Some patients may experience itching, which can be generalized or localized to areas affected by lymphadenopathy[2].

Patient Characteristics

The demographic and clinical characteristics of patients diagnosed with diffuse follicle center lymphoma can provide insights into the disease's epidemiology:

• Age: DFCL typically occurs in adults, with a higher incidence in individuals aged 50 years and older. However, it can also occur in younger adults[1][3].
• Gender: There is a slight male predominance in the incidence of non-Hodgkin lymphomas, including DFCL, although the difference is not as pronounced as in some other lymphoma subtypes[3].
• Comorbidities: Patients may have underlying health conditions, such as autoimmune diseases or previous infections, which can influence the disease's presentation and progression[2].
• Histological Features: On histological examination, DFCL is characterized by a diffuse pattern of growth with neoplastic follicles, often showing a mixture of small and large cells. Immunophenotyping typically reveals B-cell markers, such as CD19, CD20, and CD10[1][3].

Diagnosis and Management

Diagnosis of diffuse follicle center lymphoma involves a combination of clinical evaluation, imaging studies (such as CT scans), and histopathological examination of lymph node biopsies. Treatment options may include:

• Chemotherapy: Common regimens include CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or other targeted therapies.
• Immunotherapy: Agents like rituximab, which targets CD20 on B-cells, are often used in conjunction with chemotherapy[2][3].
• Radiation Therapy: May be considered in localized disease or as part of a combined modality approach.

Conclusion

Diffuse follicle center lymphoma, particularly affecting the lymph nodes of the inguinal region and lower limbs, presents with distinct clinical features, including lymphadenopathy, systemic B symptoms, and fatigue. Understanding the patient characteristics and clinical presentation is essential for timely diagnosis and effective management. Regular follow-up and monitoring are crucial for assessing treatment response and managing potential complications associated with the disease and its treatment.

ICD-10 code C82.55 refers specifically to Diffuse follicle center lymphoma located in the lymph nodes of the inguinal region and lower limb. 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

1. Follicular Lymphoma: This is a more general term that encompasses various subtypes of follicular lymphoma, including diffuse follicle center lymphoma.
2. Diffuse Large B-Cell Lymphoma (DLBCL): While not identical, DLBCL can sometimes be confused with follicle center lymphomas due to overlapping characteristics in histology and clinical presentation.
3. B-Cell Lymphoma: This term refers to lymphomas that originate from B lymphocytes, which includes diffuse follicle center lymphoma.
4. Inguinal Lymphoma: This term specifies the location of the lymphoma, indicating it is found in the inguinal lymph nodes.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): A broad category of lymphomas that includes diffuse follicle center lymphoma as one of its subtypes.
2. Lymphadenopathy: This term describes the enlargement of lymph nodes, which is a common symptom in patients with diffuse follicle center lymphoma.
3. Lymphoma Staging: Refers to the process of determining the extent of lymphoma, which is crucial for treatment planning.
4. Hematologic Malignancies: A broader category that includes all cancers of the blood, bone marrow, and lymph nodes, including diffuse follicle center lymphoma.
5. Lymphoma Classification: This refers to the various systems used to categorize lymphomas, such as the WHO classification, which includes diffuse follicle center lymphoma.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.55 is essential for accurate diagnosis, treatment planning, and communication among healthcare professionals. These terms help in identifying the specific type of lymphoma and its characteristics, which can significantly influence patient management and outcomes. If you need further details or specific information regarding treatment options or prognosis, feel free to ask!

Diffuse follicle center lymphoma (DFCL), classified under ICD-10 code C82.55, is a subtype of non-Hodgkin lymphoma that primarily affects the lymph nodes, particularly in the inguinal region and lower limbs. The diagnosis of DFCL 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 enlargement of lymph nodes. Other symptoms can include fever, night sweats, weight loss, and fatigue, commonly referred to as "B symptoms" of lymphoma.
• Physical Examination: A thorough physical examination is essential to identify swollen lymph nodes, particularly in the inguinal region and lower limbs, as well as any other affected areas.

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 benign and malignant processes.

Histopathological Examination

• Biopsy: A definitive diagnosis of DFCL requires a biopsy of the affected lymph node. This can be done through excisional biopsy, core needle biopsy, or fine-needle aspiration.
• Microscopic Analysis: The biopsy specimen is examined microscopically for the presence of neoplastic follicle center cells. The histological features typically include:
• Follicular Architecture: The presence of neoplastic follicles that disrupt normal lymph node architecture.
• Cellularity: Increased cellularity with a predominance of centrocytes and centroblasts.
• Immunophenotyping: Immunohistochemical staining is performed to identify specific markers. DFCL typically expresses CD10, BCL6, and may show BCL2 positivity, which helps confirm the diagnosis.

Molecular Studies

• Genetic Testing: In some cases, molecular studies may be conducted to identify chromosomal abnormalities, such as the t(14;18) translocation, which is commonly associated with follicular lymphomas.

Staging

• Ann Arbor Staging System: Once diagnosed, the disease is staged using the Ann Arbor classification, which assesses the extent of lymph node involvement and any extranodal disease.

Conclusion

The diagnosis of diffuse follicle center lymphoma, particularly in the inguinal region and lower limbs, relies on a comprehensive approach that includes clinical evaluation, imaging studies, histopathological examination, and molecular testing. Accurate diagnosis is crucial 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!

Diffuse follicle center lymphoma (DFCL), classified under ICD-10 code C82.55, is a subtype of non-Hodgkin lymphoma (NHL) that primarily affects the lymph nodes, particularly in the inguinal region and lower limbs. The treatment approaches for this condition are multifaceted and depend on various factors, including the stage of the disease, the patient's overall health, and specific characteristics of the lymphoma.

Standard Treatment Approaches

1. Chemotherapy

Chemotherapy remains a cornerstone of treatment for diffuse follicle center lymphoma. The most commonly used regimens include:

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is often the first-line treatment for aggressive forms of NHL, including DFCL.
• R-CHOP: The addition of Rituximab (a monoclonal antibody) to the CHOP regimen has significantly improved outcomes for patients with follicular lymphomas, including DFCL. Rituximab targets CD20-positive B cells, which are prevalent in this type of lymphoma[1].

2. Radiation Therapy

Radiation therapy may be employed in specific scenarios, particularly for localized disease. It can be used as:

• Adjuvant Therapy: Following chemotherapy, radiation may be used to target residual disease in the lymph nodes, especially if the lymphoma is localized to a specific area, such as the inguinal region.
• Palliative Care: In cases where the disease is advanced and symptomatic, radiation can help alleviate symptoms by reducing tumor burden[2].

3. Targeted Therapy

Recent advancements in targeted therapies have provided additional options for patients with DFCL:

• Brentuximab Vedotin: This antibody-drug conjugate targets CD30 and may be considered in relapsed or refractory cases.
• PI3K Inhibitors: Drugs like Copanlisib (Aliqopa) have shown efficacy in treating relapsed follicular lymphoma and may be considered for patients who have not responded to standard therapies[3].

4. Immunotherapy

Immunotherapy is an emerging treatment modality for lymphomas:

• CAR T-cell Therapy: Chimeric Antigen Receptor (CAR) T-cell therapy has been effective in treating various types of NHL, including those that are refractory to standard treatments. This approach involves modifying a patient's T cells to better recognize and attack lymphoma cells[4].
• Checkpoint Inhibitors: Agents that block immune checkpoints (e.g., PD-1 inhibitors) are being investigated in clinical trials for their potential benefits in treating follicular lymphomas[5].

5. Stem Cell Transplantation

For patients with relapsed or refractory diffuse follicle center lymphoma, high-dose chemotherapy followed by autologous stem cell transplantation may be considered. This approach allows for the administration of higher doses of chemotherapy than would be tolerated alone, with the goal of achieving remission[6].

Conclusion

The treatment of diffuse follicle center lymphoma, particularly in the inguinal region and lower limbs, involves a combination of chemotherapy, radiation therapy, targeted therapies, immunotherapy, and potentially stem cell transplantation. The choice of treatment is highly individualized, taking into account the specific characteristics of the lymphoma and the patient's overall health. Ongoing research and clinical trials continue to explore new therapeutic options, aiming to improve outcomes for patients with this challenging condition.

For the most effective management, it is crucial for patients to discuss their treatment options with a healthcare provider specializing in hematology or oncology, who can tailor the approach based on the latest evidence and individual patient needs.