ICD-10: C82.82

ICD-10 code C82.82 refers to "Other types of follicular lymphoma, intrathoracic lymph nodes." This classification falls under the broader category of follicular lymphoma, which is a type of non-Hodgkin lymphoma (NHL) characterized by the proliferation of follicle center (germinal center) B-cells. Below is a detailed clinical description and relevant information regarding this specific code.

Overview of Follicular Lymphoma

Follicular lymphoma is a slow-growing (indolent) form of non-Hodgkin lymphoma that typically arises from B-lymphocytes. It is one of the most common types of NHL and is often diagnosed in adults. The disease is characterized by the presence of neoplastic follicles in lymphoid tissue, which can lead to the enlargement of lymph nodes and other lymphatic tissues.

Types of Follicular Lymphoma

Follicular lymphoma can be classified into several grades based on histological features, with grade I being the least aggressive and grade III being more aggressive. The specific code C82.82 pertains to cases that do not fit neatly into the more common classifications and may represent atypical presentations or variants of follicular lymphoma.

Clinical Presentation

Symptoms

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

• Lymphadenopathy: Swelling of lymph nodes, particularly in the neck, armpits, or groin.
• B-symptoms: These include fever, night sweats, and unexplained weight loss.
• Fatigue: Generalized tiredness that is not relieved by rest.
• Abdominal discomfort: If lymph nodes in the abdomen are involved, patients may experience pain or fullness.

Intrathoracic Involvement

The designation "intrathoracic lymph nodes" indicates that the lymphoma has affected lymph nodes located within the thoracic cavity, which may include:

• Mediastinal lymph nodes: Located in the central part of the chest, between the lungs.
• Hilar lymph nodes: Found at the root of the lungs.

Involvement of these lymph nodes can lead to respiratory symptoms, such as cough or difficulty breathing, depending on the extent of the disease and any associated compression of surrounding structures.

Diagnosis

Diagnosis of follicular lymphoma typically involves:

• Imaging Studies: CT scans or PET scans are used to assess the extent of lymph node involvement and to identify any extranodal disease.
• Biopsy: A tissue sample from an affected lymph node is examined histologically to confirm the diagnosis and determine the grade of the lymphoma.
• Immunophenotyping: This process helps to identify specific markers on the lymphoma cells, aiding in the classification and treatment planning.

Treatment Options

Treatment for follicular lymphoma, particularly when it involves intrathoracic lymph nodes, may include:

• Watchful Waiting: In cases where the disease is asymptomatic and indolent, a "watch and wait" approach may be adopted.
• Chemotherapy: Regimens such as R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) are commonly used.
• Immunotherapy: Targeted therapies, including monoclonal antibodies like Rituximab, are effective in treating follicular lymphoma.
• Radiation Therapy: This may be used in localized disease or as palliative treatment for symptomatic relief.

Conclusion

ICD-10 code C82.82 captures a specific subset of follicular lymphoma characterized by the involvement of intrathoracic lymph nodes. Understanding the clinical presentation, diagnostic criteria, and treatment options is crucial for effective management of this condition. As with all forms of lymphoma, early diagnosis and tailored treatment strategies are essential for improving patient outcomes and quality of life.

Follicular lymphoma is a type of non-Hodgkin lymphoma characterized by the proliferation of B-lymphocytes in a follicular pattern. The ICD-10 code C82.82 specifically refers to "Other types of follicular lymphoma, intrathoracic lymph nodes." Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for diagnosis and management.

Clinical Presentation

Signs and Symptoms

Patients with follicular lymphoma, particularly those with involvement of intrathoracic lymph nodes, may present with a variety of symptoms, which can include:

• Lymphadenopathy: Swelling of lymph nodes, particularly in the chest area, which may be detected during physical examination or imaging studies.
• Respiratory Symptoms: Patients may experience cough, shortness of breath, or chest pain due to the compression of surrounding structures by enlarged lymph nodes.
• Systemic Symptoms: Common systemic symptoms include:
• Fever: Often low-grade and intermittent.
• Night Sweats: Profuse sweating during the night.
• Weight Loss: Unintentional weight loss over a short period.
• Fatigue: Persistent tiredness that does not improve with rest.

Patient Characteristics

Follicular lymphoma typically affects adults, with the following characteristics often observed in patients:

• Age: Most commonly diagnosed in individuals aged 60 years and older, although it can occur in younger adults.
• 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 lymphoma or other hematological malignancies may be present in some patients.

Diagnosis and Evaluation

Diagnostic Imaging

• CT Scans: Computed tomography (CT) scans of the chest, abdomen, and pelvis are often used to assess the extent of lymphadenopathy and to evaluate the involvement of intrathoracic lymph nodes.
• PET Scans: Positron emission tomography (PET) scans may be utilized to assess metabolic activity of the lymph nodes and to help stage the disease.

Biopsy

• Tissue Biopsy: A definitive diagnosis is made through a biopsy of the affected lymph nodes, which reveals the characteristic follicular pattern of neoplastic B-cells.

Laboratory Tests

• Blood Tests: Routine blood tests may show anemia or other abnormalities, but they are not specific for follicular lymphoma.

Conclusion

Follicular lymphoma, particularly with intrathoracic lymph node involvement (ICD-10 code C82.82), presents with a range of symptoms primarily related to lymphadenopathy and systemic effects. Understanding the clinical presentation and patient characteristics is essential for timely diagnosis and effective management. If you suspect a patient may have this condition, a thorough evaluation including imaging and biopsy is critical for confirming the diagnosis and determining the appropriate treatment plan.

ICD-10 code C82.82 refers to "Other types of follicular lymphoma, intrathoracic lymph nodes." This classification falls under the broader category of non-Hodgkin lymphoma, specifically focusing on follicular lymphoma, which is a type of cancer that originates in the lymphatic system.

Alternative Names and Related Terms

1. Follicular Lymphoma: This is the primary term used to describe the type of lymphoma that C82.82 represents. It is characterized by the proliferation of follicle center (germinal center) B-cells.

2. Non-Hodgkin Lymphoma (NHL): Follicular lymphoma is a subtype of non-Hodgkin lymphoma, which encompasses a diverse group of blood cancers that include all lymphomas except Hodgkin's lymphoma.

3. Intrathoracic Lymph Nodes: This term specifies the location of the lymphoma, indicating that the affected lymph nodes are located within the thoracic cavity, which includes the chest area.

4. Lymphoma, Follicular, Stage IV: In some contexts, this term may be used to describe advanced follicular lymphoma that has spread to intrathoracic lymph nodes.

5. B-cell Lymphoma: Since follicular lymphoma is derived from B-cells, this term is often used interchangeably in discussions about the disease.

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

7. Chronic Lymphocytic Leukemia (CLL): While distinct, CLL can sometimes be confused with follicular lymphoma due to overlapping characteristics, particularly in the context of B-cell malignancies.

8. Lymphoma, Low-Grade: Follicular lymphoma is often classified as a low-grade lymphoma, indicating a slower progression compared to high-grade lymphomas.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.82 is essential for accurate diagnosis, treatment planning, and coding in medical records. These terms help healthcare professionals communicate effectively about the condition and ensure that patients receive appropriate care based on the specific type and location of their lymphoma. If you need further details or specific information regarding treatment or management of follicular lymphoma, feel free to ask!

The diagnosis of follicular lymphoma, particularly the subtype classified under ICD-10 code C82.82, which refers to "Other types of follicular lymphoma, intrathoracic lymph nodes," involves a comprehensive evaluation that includes clinical, laboratory, and imaging assessments. Below is a detailed overview of the criteria typically used for diagnosing this condition.

Clinical Presentation

Symptoms

Patients with follicular lymphoma may present with a variety of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, which may be localized or generalized.
- B Symptoms: These include fever, night sweats, and unexplained weight loss, which can indicate more aggressive disease.
- Fatigue: A common complaint among patients, often due to the disease burden.

Medical History

A thorough medical history is essential, including:
- Previous history of lymphoma or other hematologic malignancies.
- Family history of lymphoproliferative disorders.
- Exposure to risk factors such as certain infections (e.g., HIV, Hepatitis C) or environmental toxins.

Laboratory Tests

Blood Tests

• Complete Blood Count (CBC): To assess for anemia, thrombocytopenia, or leukopenia, which may indicate bone marrow involvement.
• Lactate Dehydrogenase (LDH): Elevated levels can suggest a higher tumor burden and correlate with prognosis.

Bone Marrow Biopsy

A bone marrow biopsy may be performed to evaluate for the presence of lymphoma cells, which can help confirm the diagnosis and assess the extent of disease involvement.

Imaging Studies

CT Scans

• Chest CT Scan: This is crucial for identifying enlarged intrathoracic lymph nodes, which are characteristic of C82.82. The scan helps in assessing the size, number, and distribution of lymph nodes.

PET Scans

• Positron Emission Tomography (PET): Often used in conjunction with CT scans, PET scans can help determine metabolic activity in lymph nodes, aiding in the differentiation between benign and malignant processes.

Histopathological Examination

Lymph Node Biopsy

A definitive diagnosis of follicular lymphoma requires a biopsy of the affected lymph nodes. The histopathological examination typically reveals:
- Follicular Architecture: The presence of neoplastic follicles composed of small to medium-sized lymphoid cells.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to identify specific markers (e.g., CD10, CD19, CD20, and BCL2) that confirm the diagnosis of follicular lymphoma.

Genetic Studies

• Cytogenetic Analysis: Detection of the t(14;18) translocation, which is commonly associated with follicular lymphoma, can provide additional confirmation of the diagnosis.

Conclusion

The diagnosis of follicular lymphoma, particularly the subtype represented by ICD-10 code C82.82, involves a multifaceted approach that includes clinical evaluation, laboratory tests, imaging studies, and histopathological confirmation. Each of these components plays a critical role in establishing an accurate diagnosis and guiding treatment decisions. If you have further questions or need more specific information regarding treatment options or prognosis, feel free to ask!

Follicular lymphoma, particularly the subtype classified under ICD-10 code C82.82, refers to a type of non-Hodgkin lymphoma that primarily affects the lymph nodes in the thoracic region. This condition is characterized by the proliferation of follicle center (germinal center) B-cells and is known for its indolent nature, although it can transform into a more aggressive form. The treatment approaches for this specific type of lymphoma 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. Observation (Watchful Waiting)

For patients with asymptomatic follicular lymphoma, 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 extended periods. This approach is particularly suitable for older patients or those with comorbidities who may not tolerate aggressive treatments well[1].

2. Chemotherapy

When treatment is necessary, chemotherapy is often the first-line option. Common regimens include:
- CHOP: Cyclophosphamide, doxorubicin, vincristine, and prednisone.
- R-CHOP: This is a variation that includes rituximab, a monoclonal antibody that targets CD20 on B-cells, enhancing the effectiveness of chemotherapy[2].

3. Immunotherapy

Rituximab is a cornerstone in the treatment of follicular lymphoma. It can be used alone or in combination with chemotherapy. In cases of relapsed or refractory disease, other monoclonal antibodies, such as obinutuzumab, may be considered[3].

4. Radiation Therapy

Radiation therapy can be effective, particularly for localized disease or as a palliative measure to relieve symptoms. It is often used in conjunction with other treatments, especially in cases where lymph nodes are significantly enlarged or symptomatic[4].

5. Targeted Therapy

Recent advancements have introduced targeted therapies that focus on specific pathways involved in the growth of lymphoma cells. For instance:
- PI3K inhibitors (e.g., copanlisib) have shown promise in treating relapsed follicular lymphoma, particularly in patients who have received prior therapies[5].
- BCL-2 inhibitors (e.g., venetoclax) are also being explored for their efficacy in this type of lymphoma, especially in combination with other agents[6].

6. Stem Cell Transplantation

For patients with relapsed or refractory follicular lymphoma, autologous stem cell transplantation may be considered, particularly after achieving a complete response to initial therapy. This approach is more common in younger patients or those with aggressive disease features[7].

7. Clinical Trials

Participation in clinical trials can provide access to novel therapies and treatment combinations that are not yet widely available. Patients are encouraged to discuss this option with their healthcare providers, as it may offer additional benefits[8].

Conclusion

The management of follicular lymphoma, particularly the subtype affecting intrathoracic lymph nodes, involves a tailored approach based on individual patient factors and disease characteristics. While watchful waiting may be appropriate for some, others may require a combination of chemotherapy, immunotherapy, and targeted treatments. Ongoing research and clinical trials continue to evolve the treatment landscape, offering hope for improved outcomes in patients with this condition. It is essential for patients to work closely with their healthcare team to determine the most suitable treatment plan for their specific situation.