ICD-10: C82.87

Follicular lymphoma, particularly the subtype classified under ICD-10 code C82.87, refers to other types of follicular lymphoma that primarily affect the spleen. This condition is a type of non-Hodgkin lymphoma (NHL) characterized by the proliferation of B-lymphocytes in a follicular pattern. The treatment approaches for this condition can vary based on several factors, including the stage of the disease, the patient's overall health, and specific characteristics of the lymphoma. Below is a detailed overview of standard treatment strategies.

Standard Treatment Approaches

1. Observation (Watchful Waiting)

For patients with asymptomatic follicular lymphoma, especially those with low tumor burden, a strategy of observation may be employed. This approach involves regular monitoring without immediate treatment, as many patients may not require intervention for extended periods. This is particularly relevant for indolent forms of the disease, where the lymphoma may not progress rapidly.

2. Chemotherapy

Chemotherapy remains a cornerstone of treatment for follicular lymphoma, particularly in cases where the disease is symptomatic or has progressed. Common regimens include:

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is often used for more aggressive forms of lymphoma.
• 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

Immunotherapy has become increasingly important in the treatment of follicular lymphoma. Key agents include:

• Rituximab (Rituxan®): This is commonly used in combination with chemotherapy or as a standalone treatment for relapsed disease. It can also be used in maintenance therapy after initial treatment to prolong remission.
• Obinutuzumab (Gazyva®): This is another monoclonal antibody that may be used in combination with chemotherapy for patients with advanced disease.

4. Radiation Therapy

Radiation therapy can be effective, particularly for localized disease or as a palliative measure to relieve symptoms. It may be used in conjunction with chemotherapy or as a standalone treatment for localized lymphadenopathy.

5. Stem Cell Transplantation

For patients with relapsed or refractory 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.

6. Targeted Therapies

Recent advancements have introduced targeted therapies that focus on specific pathways involved in lymphoma cell survival. These include:

• Idelalisib: A PI3K inhibitor that has shown efficacy in patients with relapsed follicular lymphoma.
• Venetoclax: A BCL-2 inhibitor that is being explored in combination with other therapies for its potential to induce remission.

7. Clinical Trials

Participation in clinical trials may provide access to novel therapies and treatment strategies that are not yet widely available. Patients are encouraged to discuss this option with their healthcare providers.

Conclusion

The treatment of follicular lymphoma, particularly the subtype classified under ICD-10 code C82.87, is multifaceted and tailored to the individual patient. A combination of observation, chemotherapy, immunotherapy, radiation, and emerging targeted therapies offers a comprehensive approach to managing this condition. As research continues to evolve, new treatment modalities may further enhance outcomes for patients with this type of lymphoma. It is essential for patients to work closely with their healthcare team to determine the most appropriate treatment plan based on their specific circumstances and disease characteristics.

ICD-10 code C82.87 refers specifically to "Other types of follicular lymphoma, spleen." Follicular lymphoma is a subtype of non-Hodgkin lymphoma (NHL), which is characterized by the proliferation of B-lymphocytes in a follicular pattern. This type of lymphoma is generally indolent, meaning it tends to grow slowly compared to other forms of lymphoma.

Clinical Description of Follicular Lymphoma

Overview

Follicular lymphoma is classified under the broader category of non-Hodgkin lymphoma and is primarily derived from germinal center B-cells. It is one of the most common types of indolent NHL, often presenting in advanced stages at diagnosis. The disease can manifest in various lymphoid tissues, including lymph nodes, bone marrow, and the spleen.

Symptoms

Patients with follicular lymphoma may experience a range of symptoms, which can include:
- Lymphadenopathy: Swelling of lymph nodes, often painless.
- Splenomegaly: Enlargement of the spleen, which can be detected during a physical examination or imaging studies.
- B-symptoms: These may include fever, night sweats, and unexplained weight loss, although they are less common in indolent forms like follicular lymphoma.

Diagnosis

Diagnosis typically involves:
- Imaging Studies: CT scans or PET scans to assess the extent of the disease.
- Biopsy: A lymph node or bone marrow biopsy is essential for histological confirmation of follicular lymphoma.
- Immunophenotyping: This helps in identifying the specific type of lymphoma based on cell surface markers.

Classification

Follicular lymphoma is classified into several subtypes based on histological features. The designation "Other types of follicular lymphoma" under code C82.87 indicates that the lymphoma may not fit neatly into the more common subtypes, such as follicular lymphoma grade 1 or 2, and may exhibit unique characteristics or behaviors.

Treatment Options

Treatment for follicular lymphoma can vary based on the stage of the disease, the presence of symptoms, and the patient's overall health. Common treatment modalities include:
- Watchful Waiting: In asymptomatic cases, especially in early-stage disease.
- Chemotherapy: Regimens such as bendamustine combined with rituximab are commonly used.
- Immunotherapy: Targeted therapies like monoclonal antibodies (e.g., rituximab) or newer agents like epcoritamab (Epkinly™) are increasingly utilized.
- Radiation Therapy: May be used in localized disease or for symptomatic relief.

Prognosis

The prognosis for patients with follicular lymphoma can vary widely. Factors influencing outcomes include the patient's age, overall health, the specific characteristics of the lymphoma, and the 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 C82.87 captures a specific category of follicular lymphoma that affects the spleen, highlighting the need for tailored diagnostic and treatment approaches. Understanding the clinical characteristics, treatment options, and prognosis associated with this condition is crucial for effective management and patient care. For healthcare providers, accurate coding is essential for appropriate billing and treatment planning, ensuring that patients receive the best possible care tailored to their specific lymphoma subtype.

Follicular lymphoma (FL) is a type of non-Hodgkin lymphoma characterized by the proliferation of B-lymphocytes in a follicular pattern. The ICD-10 code C82.87 specifically refers to "Other types of follicular lymphoma, spleen." 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 the spleen, may present with a variety of signs and symptoms, which can include:

• Lymphadenopathy: Swelling of lymph nodes is common, often presenting as painless masses in the neck, armpits, or groin.
• Splenomegaly: Enlargement of the spleen is a hallmark of this condition, which may lead to abdominal discomfort or fullness.
• Fatigue: Many patients report persistent fatigue, which can be attributed to the disease itself or anemia.
• Weight Loss: Unintentional weight loss may occur, often due to the metabolic demands of the lymphoma.
• Night Sweats: Patients may experience drenching night sweats, which are often associated with lymphoproliferative disorders.
• Fever: Low-grade fevers can be present, contributing to the overall feeling of malaise.

Patient Characteristics

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

• Age: The median age at diagnosis is around 60 years, although it can occur in younger individuals.
• Gender: There is a slight male predominance in the incidence of follicular lymphoma.
• Ethnicity: The condition is more prevalent in certain populations, with variations in incidence rates across different ethnic groups.
• Comorbidities: Patients may have other health conditions, such as autoimmune diseases, which can complicate the clinical picture.

Diagnosis and Evaluation

The diagnosis of follicular lymphoma, including the variant coded as C82.87, typically involves:

• Histopathological Examination: A biopsy of affected lymph nodes or spleen tissue is essential for confirming the diagnosis. The characteristic follicular architecture and the presence of neoplastic B-cells are key findings.
• Imaging Studies: CT scans or PET scans may be utilized to assess the extent of disease involvement, particularly in the spleen and lymph nodes.
• Bone Marrow Biopsy: This may be performed to evaluate for bone marrow involvement, which can influence treatment decisions.

Conclusion

Follicular lymphoma, particularly the variant classified under ICD-10 code C82.87, presents with a range of clinical signs and symptoms, including lymphadenopathy, splenomegaly, and systemic symptoms like fatigue and weight loss. Understanding these characteristics is vital for healthcare providers to ensure timely diagnosis and appropriate management of the disease. Regular follow-up and monitoring are essential, as follicular lymphoma can exhibit a variable clinical course, necessitating individualized treatment strategies.

ICD-10 code C82.87 refers to "Other types of follicular lymphoma, spleen." Follicular lymphoma is a type of non-Hodgkin lymphoma that originates in the lymphatic system, specifically from B-cells. Below are alternative names and related terms associated with this specific code:

Alternative Names for Follicular Lymphoma

1. Follicular Lymphoma, Splenic Type: This term emphasizes the specific location of the lymphoma within the spleen.
2. Splenic Follicular Lymphoma: Similar to the above, this term highlights the spleen as the primary site of the disease.
3. B-cell Follicular Lymphoma: Since follicular lymphoma arises from B-cells, this term is often used in clinical contexts.
4. Indolent Follicular Lymphoma: Follicular lymphoma is typically classified as indolent, meaning it tends to grow slowly.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): Follicular lymphoma is a subtype of non-Hodgkin lymphoma, which encompasses a variety of lymphatic cancers.
2. Lymphoproliferative Disorders: This broader category includes various conditions where lymphocytes proliferate abnormally, including follicular lymphoma.
3. B-cell Neoplasms: This term refers to cancers that arise from B-cells, including follicular lymphoma.
4. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas.

Clinical Context

Follicular lymphoma is characterized by the presence of follicle-like structures in lymphoid tissue and can vary in its clinical presentation and behavior. The spleen can be involved in the disease process, leading to splenomegaly (enlargement of the spleen) and other systemic symptoms.

Understanding these alternative names and related terms can be crucial for healthcare professionals when diagnosing, coding, and discussing treatment options for patients with this condition.

In summary, ICD-10 code C82.87 encompasses various terminologies that reflect the nature and location of follicular lymphoma, particularly when it involves the spleen.

The diagnosis of follicular lymphoma, particularly the subtype classified under ICD-10 code C82.87, which refers to "Other types of follicular lymphoma, spleen," involves a comprehensive evaluation that includes clinical, laboratory, and imaging assessments. Below are the key criteria and considerations used in the diagnosis of 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 painless.
- Splenomegaly: Enlargement of the spleen, which is particularly relevant for C82.87.
- B-symptoms: These include fever, night sweats, and unexplained weight loss, which can indicate more aggressive disease.

Medical History

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

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.

Bone Marrow Biopsy

A bone marrow biopsy may be performed to evaluate for the presence of lymphoma cells in the bone marrow, which is crucial for staging and determining the extent of the disease.

Imaging Studies

CT or PET Scans

• Computed Tomography (CT) Scan: Used to assess lymph node involvement and organomegaly, particularly the spleen.
• Positron Emission Tomography (PET) Scan: Helps in evaluating metabolic activity of the lymphoma and can assist in staging.

Histopathological Examination

Biopsy

A definitive diagnosis of follicular lymphoma requires a biopsy of the affected lymph node or spleen tissue. 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, such as CD10, CD19, CD20, and BCL2, which are characteristic of follicular lymphoma.

Genetic Studies

• Cytogenetic Analysis: Detection of the t(14;18) translocation, which is common in follicular lymphoma, can support the diagnosis.

Differential Diagnosis

It is important to differentiate follicular lymphoma from other types of lymphomas and reactive lymphadenopathy. This may involve:
- Evaluating the morphology of the lymphoid cells.
- Assessing the immunophenotype and genetic markers.

Conclusion

The diagnosis of follicular lymphoma, particularly the subtype classified under ICD-10 code C82.87, involves a multifaceted approach that includes clinical evaluation, laboratory tests, imaging studies, and histopathological examination. 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!