ICD-10: C82.8

ICD-10 code C82.8 refers to "Other types of follicular lymphoma," which is a subtype of non-Hodgkin lymphoma (NHL). Follicular lymphoma is characterized by the proliferation of B-lymphocytes in a follicular pattern, and it is typically indolent, meaning it tends to grow slowly compared to other types of lymphoma. Below is a detailed clinical description and relevant information regarding this specific code.

Clinical Description of Follicular Lymphoma

Overview

Follicular lymphoma is a type of B-cell non-Hodgkin lymphoma that arises from the follicle center (germinal center) of lymphoid tissue. It is one of the most common forms of NHL and is classified as a low-grade lymphoma, although it can transform into a more aggressive form over time. The disease is often diagnosed in middle-aged adults and is slightly more prevalent in women than in men.

Types of Follicular Lymphoma

While the ICD-10 code C82.8 specifically denotes "Other types of follicular lymphoma," it encompasses various subtypes that do not fall under the more commonly recognized categories, such as follicular lymphoma grade 1 or grade 2. These may include:

• Follicular lymphoma, grade 3: This is a more aggressive form that can be further divided into grade 3A and 3B, with grade 3B being more aggressive and often treated similarly to diffuse large B-cell lymphoma (DLBCL).
• Follicular lymphoma with mixed histology: This may involve a combination of follicular and other types of lymphoma, complicating the clinical picture and treatment approach.

Symptoms

Patients with follicular lymphoma may present with a variety of symptoms, including:

• Lymphadenopathy: Swelling of lymph nodes, often painless, which can occur in the neck, armpits, or groin.
• 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 body's response to the lymphoma.

Diagnosis

Diagnosis typically involves a combination of clinical evaluation, imaging studies (such as CT scans), and histopathological examination of lymph node biopsies. Immunophenotyping and genetic studies may also be performed to confirm the diagnosis and subtype classification.

Treatment

The treatment for follicular lymphoma varies based on the stage of the disease, the patient's overall health, and specific characteristics of the lymphoma. Options may include:

• Watchful waiting: In cases where the lymphoma is asymptomatic and indolent.
• Chemotherapy: Often combined with monoclonal antibodies (e.g., rituximab) for more advanced stages.
• Radiation therapy: May be used for localized disease.
• Stem cell transplant: Considered in relapsed or refractory cases.

Prognosis

The prognosis for patients with follicular lymphoma can vary widely. Factors influencing outcomes include the grade of the lymphoma, the presence of B symptoms, and the patient's overall health. Generally, follicular lymphoma has a good prognosis, especially in early stages, but it can be challenging to treat if it transforms into a more aggressive form.

Conclusion

ICD-10 code C82.8 captures the complexity of follicular lymphoma by categorizing it as "Other types of follicular lymphoma." This classification is essential for accurate diagnosis, treatment planning, and understanding the clinical implications of the disease. As research continues, the understanding of follicular lymphoma and its various subtypes will evolve, potentially leading to more targeted therapies and improved patient outcomes.

Follicular lymphoma (FL) is a type of non-Hodgkin lymphoma (NHL) that arises from B-lymphocytes and is characterized by a specific histological pattern. The ICD-10 code C82.8 refers to "Other types of follicular lymphoma," which encompasses various subtypes of follicular lymphoma that do not fit into the more commonly recognized categories. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this diagnosis is crucial for effective management and treatment.

Clinical Presentation

General Characteristics

Follicular lymphoma typically presents as a slow-growing (indolent) lymphoma, which can lead to a delayed diagnosis. Patients may be asymptomatic for extended periods, and the disease is often discovered incidentally during imaging studies or routine examinations.

Common Symptoms

Patients with follicular lymphoma may exhibit a range of symptoms, including:

• Lymphadenopathy: Painless swelling of lymph nodes is the most common presentation. This can occur in various regions, including the neck, armpits, and groin.
• B Symptoms: Some patients may experience systemic symptoms known as "B symptoms," which include:
• Unexplained fever
• Night sweats
• Unintentional weight loss
• Fatigue: A general sense of tiredness or lack of energy is frequently reported.
• Abdominal Symptoms: In cases where lymph nodes in the abdomen are involved, patients may experience abdominal pain or discomfort, early satiety, or changes in bowel habits.

Advanced Disease Symptoms

In more advanced stages, patients may present with additional complications, such as:

• Splenomegaly: Enlargement of the spleen can occur, leading to discomfort or a feeling of fullness.
• Hepatomegaly: Liver involvement may also be present, although it is less common.
• Cytopenias: Bone marrow involvement can lead to decreased blood cell counts, resulting in anemia, thrombocytopenia, or leukopenia.

Patient Characteristics

Demographics

Follicular lymphoma predominantly affects adults, with a higher incidence in individuals aged 50 and older. It is slightly more common in women than in men, although the gender difference is not as pronounced as in some other types of lymphoma.

Risk Factors

Several risk factors have been associated with an increased likelihood of developing follicular lymphoma, including:

• Family History: A family history of lymphoma or other hematological malignancies may increase risk.
• Immune System Disorders: Conditions that compromise the immune system, such as HIV/AIDS or autoimmune diseases, can elevate the risk of developing lymphoma.
• Environmental Exposures: Certain environmental factors, including exposure to pesticides and solvents, have been suggested as potential risk factors.

Histological Variants

The "Other types of follicular lymphoma" category (ICD-10 code C82.8) includes various histological subtypes that may exhibit different clinical behaviors and responses to treatment. These variants can include:

• Follicular Lymphoma Grade 1: Characterized by a predominance of small cleaved cells.
• Follicular Lymphoma Grade 2: A mix of small and large cells.
• Follicular Lymphoma Grade 3: More aggressive, often resembling diffuse large B-cell lymphoma.

Conclusion

Follicular lymphoma, particularly the subtypes classified under ICD-10 code C82.8, presents a unique clinical picture characterized by indolent growth and a variety of symptoms primarily related to lymphadenopathy and systemic effects. Understanding the clinical presentation, signs, symptoms, and patient characteristics is essential for healthcare providers to diagnose and manage this condition effectively. Early recognition and appropriate treatment can significantly impact patient outcomes, especially given the potential for transformation to more aggressive forms of lymphoma in some cases.

ICD-10 code C82.8 refers to "Other types of follicular lymphoma," which is a subtype of non-Hodgkin lymphoma (NHL). This classification encompasses various forms of follicular lymphoma that do not fit into the more commonly recognized categories. Below are alternative names and related terms associated with this code.

Alternative Names for C82.8

1. Follicular Lymphoma, Unspecified: This term is often used interchangeably with C82.8, particularly when the specific type of follicular lymphoma is not detailed.

2. Follicular Lymphoma, Grade 1: While this specifically refers to a low-grade variant, it may sometimes be included under the broader category of other types of follicular lymphoma, especially in clinical discussions.

3. Follicular Lymphoma, Mixed Cellularity: This term can describe a variant of follicular lymphoma that exhibits a mixture of cell types, which may fall under the C82.8 classification.

4. Follicular Lymphoma, Transformed: This refers to cases where follicular lymphoma has transformed into a more aggressive form, which may also be categorized under C82.8.

5. Non-Hodgkin Lymphoma, Follicular Type: This broader term encompasses all follicular lymphomas, including those classified under C82.8.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): A general term for a diverse group of blood cancers that includes follicular lymphoma among other types.

2. Lymphoma: A type of cancer that originates in the lymphatic system, which includes various subtypes, including follicular lymphoma.

3. B-cell Lymphoma: Since follicular lymphoma is a type of B-cell lymphoma, this term is often used in discussions about its classification and treatment.

4. Lymphoproliferative Disorders: This term encompasses a range of conditions, including follicular lymphoma, characterized by the proliferation of lymphocytes.

5. ICD-10-CM Codes: Related codes may include C82.80 (Other types of follicular lymphoma, unspecified site) and other specific codes for different subtypes of follicular lymphoma.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.8 is crucial for accurate diagnosis, treatment planning, and coding in medical records. These terms help healthcare professionals communicate effectively about the various forms of follicular lymphoma and ensure that patients receive appropriate care based on their specific condition. If you need further details or specific information about treatment options or prognosis related to these terms, feel free to ask!

The diagnosis of follicular lymphoma, particularly under the ICD-10 code C82.8, which refers to "Other types of follicular lymphoma," involves a combination of clinical evaluation, imaging studies, and histopathological examination. Below is a detailed overview of the criteria and processes typically used in diagnosing this specific type of lymphoma.

Clinical Evaluation

Symptoms

Patients may present with various symptoms that can prompt further investigation, including:
- Lymphadenopathy: Swelling of lymph nodes, which is often painless.
- B-symptoms: These include fever, night sweats, and unexplained weight loss, which can indicate more aggressive disease.
- Fatigue: Generalized tiredness that does not improve with rest.

Medical History

A thorough medical history is essential, including:
- Previous history of lymphoma or other malignancies.
- Family history of lymphoproliferative disorders.
- Exposure to certain environmental factors or chemicals.

Imaging Studies

Radiological Assessment

Imaging techniques are crucial for assessing the extent of the disease:
- CT Scans: Computed tomography scans of the chest, abdomen, and pelvis can help identify enlarged lymph nodes and organ involvement.
- PET Scans: Positron emission tomography scans may be used to evaluate metabolic activity in lymph nodes and other tissues, helping to distinguish between active disease and residual masses post-treatment.

Histopathological Examination

Biopsy

A definitive diagnosis of follicular lymphoma requires a biopsy of the affected lymph node or tissue. The following steps are involved:
- Tissue Sampling: This can be done through excisional biopsy, core needle biopsy, or fine-needle aspiration.
- Histological Analysis: The biopsy sample is examined under a microscope by a pathologist. Key features include:
- Follicular Architecture: The presence of follicle-like structures.
- Cell Type: Identification of neoplastic follicle center (germinal center) B-cells.
- Grading: Follicular lymphoma is graded based on the number of centroblasts per high-power field, which can influence prognosis and treatment decisions.

Immunophenotyping

Immunohistochemistry is used to further characterize the lymphoma:
- Surface Markers: The presence of specific markers such as CD10, CD19, CD20, and BCL2 is assessed. The co-expression of CD10 and BCL2 is particularly indicative of follicular lymphoma.
- Genetic Studies: Cytogenetic analysis may reveal the t(14;18) translocation, which is commonly associated with follicular lymphoma.

Staging

Once diagnosed, the lymphoma is staged using the Ann Arbor staging system, which considers:
- The number of lymph node regions involved.
- Whether the disease has spread to other organs.
- The presence of B-symptoms.

Conclusion

The diagnosis of follicular lymphoma, particularly under the ICD-10 code C82.8, is a multifaceted process that combines clinical assessment, imaging studies, and detailed histopathological evaluation. 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!

Follicular lymphoma, classified under ICD-10 code C82.8, encompasses various subtypes of follicular lymphoma that do not fall into the more commonly recognized categories. This type of non-Hodgkin lymphoma (NHL) is characterized by the proliferation of B-lymphocytes and is generally considered an indolent (slow-growing) form of cancer. The treatment approaches for follicular lymphoma, including the "other types" specified by C82.8, can vary based on several factors, including the specific subtype, stage of the disease, patient health, and individual preferences.

Standard Treatment Approaches

1. Watchful Waiting

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 for years due to the indolent nature of the disease[1][2].

2. Chemotherapy

Chemotherapy remains a cornerstone of treatment for symptomatic follicular lymphoma. Common regimens include:
- CHOP: Cyclophosphamide, doxorubicin, vincristine, and prednisone.
- R-CHOP: The addition of rituximab (a monoclonal antibody) to the CHOP regimen has significantly improved outcomes for many patients[3][4].

3. Immunotherapy

Rituximab, a CD20-targeting monoclonal antibody, is frequently used either alone or in combination with chemotherapy. It can be effective in both initial treatment and relapsed cases. Other immunotherapeutic agents, such as obinutuzumab, may also be considered depending on the specific characteristics of the lymphoma[5][6].

4. Targeted Therapy

Targeted therapies have emerged as important options for treating follicular lymphoma. Notable examples include:
- Lenalidomide (Revlimid): Often used in combination with rituximab for relapsed or refractory cases, this oral medication has shown promise in improving patient outcomes[7].
- Idelalisib: A PI3K inhibitor that can be used in patients with relapsed follicular lymphoma, particularly those who are not candidates for chemotherapy[8].

5. Radioimmunotherapy

This approach combines radiation therapy with immunotherapy. Agents like ibritumomab tiuxetan deliver targeted radiation to lymphoma cells, providing an effective treatment option for patients with relapsed or refractory disease[9].

6. Stem Cell Transplantation

For patients with aggressive or relapsed follicular lymphoma, high-dose chemotherapy followed by autologous stem cell transplantation may be considered. This approach is typically reserved for younger patients or those with more aggressive disease features[10].

7. Clinical Trials

Participation in clinical trials can provide access to new therapies and treatment strategies that are not yet widely available. Patients are encouraged to discuss this option with their healthcare providers, as ongoing research may lead to innovative treatments tailored to specific subtypes of follicular lymphoma[11].

Conclusion

The treatment of follicular lymphoma, particularly the "other types" classified under ICD-10 code C82.8, is multifaceted and tailored to individual patient needs. With advancements in immunotherapy, targeted therapies, and the integration of clinical trials, patients have a range of options that can lead to improved outcomes. It is essential for patients to work closely with their healthcare team to determine the most appropriate treatment strategy based on their specific circumstances and disease characteristics.