ICD-10: C82.88

ICD-10 code C82.88 refers to "Other types of follicular lymphoma, lymph nodes of multiple sites." This classification falls under the broader category of non-Hodgkin lymphoma (NHL), specifically focusing on follicular lymphoma, which is a type of cancer that originates in the lymphatic system.

Clinical Description of Follicular Lymphoma

Overview

Follicular lymphoma is a slow-growing (indolent) form of non-Hodgkin lymphoma that arises from B-lymphocytes, a type of white blood cell. It is characterized by the proliferation of follicle center (germinal center) B-cells, which can lead to the formation of lymph node masses. The disease is often diagnosed in its advanced stages, as it may not present with significant symptoms initially.

Symptoms

Patients with follicular lymphoma may experience a variety of symptoms, including:
- Swollen lymph nodes: Painless swelling in the neck, armpits, or groin.
- Fatigue: General tiredness that does not improve with rest.
- Weight loss: Unexplained weight loss over a short period.
- Night sweats: Excessive sweating during the night.
- Fever: Low-grade fevers that may come and go.

Diagnosis

Diagnosis typically involves:
- Physical examination: Assessment of swollen lymph nodes.
- Imaging studies: CT scans or PET scans to evaluate the extent of the disease.
- Biopsy: A tissue sample from the lymph node is examined to confirm the presence of lymphoma cells.
- Blood tests: To assess overall health and organ function.

Specifics of C82.88

Classification

The code C82.88 specifically denotes cases of follicular lymphoma that do not fit into the more common subtypes, such as follicular lymphoma grade 1 or 2. It indicates that the lymphoma is present in multiple lymph nodes, which can complicate treatment and prognosis.

Treatment Options

Treatment for follicular lymphoma may vary based on the stage of the disease and the patient's overall health. Common approaches include:
- Watchful waiting: In cases where the lymphoma is asymptomatic and slow-growing.
- Chemotherapy: Often used in combination with immunotherapy agents, such as monoclonal antibodies (e.g., rituximab).
- Radiation therapy: Targeted radiation may be used for localized disease.
- Stem cell transplant: Considered for younger patients or those with aggressive disease.

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 how well the disease responds to treatment. Generally, follicular lymphoma is considered manageable, with many patients living for years with the disease.

Conclusion

ICD-10 code C82.88 captures a specific subset of follicular lymphoma characterized by its presence in multiple lymph nodes. Understanding the clinical features, diagnostic methods, treatment options, and prognosis associated with this condition is crucial for effective management and care. As research continues, new therapies and treatment strategies are being developed, offering hope for improved outcomes for patients diagnosed with this type of lymphoma.

Follicular lymphoma (FL) is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. The ICD-10 code C82.88 specifically refers to "Other types of follicular lymphoma, lymph nodes of multiple sites." 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 classified under C82.88, may present with a variety of signs and symptoms, which can vary significantly among individuals. Common manifestations include:

• Lymphadenopathy: The most prominent feature is painless swelling of lymph nodes, which may occur in multiple regions of the body, including the neck, axilla, and groin. This can be generalized or localized depending on the extent of the disease[1].
• B Symptoms: Some patients may experience systemic symptoms known as B symptoms, which include:
• Fever
• Night sweats
• Unexplained weight loss
• Fatigue: Many patients report a general sense of fatigue or malaise, which can be debilitating and affect daily activities[1].
• Abdominal Symptoms: If lymph nodes in the abdomen are involved, patients may experience abdominal pain, fullness, or discomfort due to lymphadenopathy or splenomegaly[1].

Patient Characteristics

Follicular lymphoma typically presents in adults, with a median age of diagnosis around 60 years. However, it can occur in younger individuals as well. Key patient characteristics include:

• Demographics: There is a slight male predominance in follicular lymphoma cases. The disease is more common in Caucasian populations compared to other ethnic groups[1][2].
• Risk Factors: Certain risk factors have been associated with an increased likelihood of developing follicular lymphoma, including:
• Family history of lymphoma or other hematologic malignancies
• Exposure to certain chemicals (e.g., pesticides)
• Autoimmune diseases (e.g., rheumatoid arthritis, Sjögren's syndrome) may also increase risk[2].
• Histological Variants: The classification of follicular lymphoma includes various histological grades, with grade 1 and grade 2 being the most common. The presence of higher-grade variants may influence clinical behavior and prognosis[1].

Diagnosis and Management

Diagnosis of follicular lymphoma 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 assess prognostic factors.

Management strategies for follicular lymphoma can vary based on the stage of the disease, patient symptoms, and overall health. Treatment options may include:

• Watchful Waiting: In asymptomatic patients with early-stage disease, a watchful waiting approach may be adopted.
• Chemotherapy and Immunotherapy: For symptomatic or advanced cases, treatment may involve chemotherapy regimens, often combined with monoclonal antibodies like rituximab[2].
• Radiation Therapy: Localized radiation may be used for patients with limited disease or specific symptomatic lymphadenopathy.

Conclusion

Follicular lymphoma, particularly the subtype classified under ICD-10 code C82.88, presents with a range of clinical features primarily characterized by lymphadenopathy and systemic symptoms. Understanding the signs, symptoms, and patient demographics is essential for timely diagnosis and effective management. As research continues to evolve, treatment strategies are becoming increasingly personalized, improving outcomes for patients with this type of lymphoma.

For further information on follicular lymphoma and its management, healthcare professionals should refer to the latest clinical guidelines and research literature.

ICD-10 code C82.88 refers to "Other types of follicular lymphoma, lymph nodes of multiple sites." This classification falls under the broader category of non-Hodgkin lymphoma (NHL), specifically within the follicular lymphoma subtype. Below are alternative names and related terms associated with this code:

Alternative Names

1. Follicular Lymphoma, Unspecified: This term is often used to describe follicular lymphoma cases that do not fit neatly into more specific categories.
2. Follicular Lymphoma, Multiple Sites: This name emphasizes the involvement of lymph nodes at various locations in the body.
3. Non-Hodgkin Follicular Lymphoma: A broader term that includes all types of follicular lymphoma, distinguishing it from Hodgkin lymphoma.

Related Terms

1. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas.
2. Non-Hodgkin Lymphoma (NHL): This encompasses a diverse group of blood cancers that includes follicular lymphoma as one of its subtypes.
3. Lymphadenopathy: Refers to the enlargement of lymph nodes, which is a common symptom in patients with follicular lymphoma.
4. B-cell Lymphoma: Follicular lymphoma is a type of B-cell lymphoma, indicating that it originates from B lymphocytes, a type of white blood cell.
5. Stage IV Lymphoma: In cases where follicular lymphoma has spread to multiple lymph nodes, it may be classified as stage IV, indicating advanced disease.

Clinical Context

Follicular lymphoma is characterized by the proliferation of follicle center (germinal center) B-cells. The "other types" designation in C82.88 may refer to variants of follicular lymphoma that do not conform to the typical presentation or histological features of the more common forms. This code is crucial for accurate billing and coding in healthcare settings, ensuring that patients receive appropriate treatment and that healthcare providers are reimbursed correctly for their services.

In summary, understanding the alternative names and related terms for ICD-10 code C82.88 is essential for healthcare professionals involved in the diagnosis, treatment, and coding of lymphoma cases. This knowledge aids in effective communication and documentation within the medical community.

The diagnosis of follicular lymphoma, particularly under the ICD-10 code C82.88, which refers to "Other types of follicular lymphoma, lymph nodes of multiple sites," involves a combination of clinical evaluation, imaging studies, and histopathological examination. Below is a detailed overview of the criteria typically used for diagnosing this condition.

Clinical Presentation

Symptoms

Patients with follicular lymphoma may present with:
- Painless lymphadenopathy: Swelling of lymph nodes, often in multiple regions.
- B symptoms: These include fever, night sweats, and unexplained weight loss, which may indicate more aggressive disease.
- Fatigue: Generalized tiredness that is not relieved by rest.

Medical History

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

Diagnostic Criteria

Imaging Studies

Imaging techniques are crucial for assessing the extent of the disease:
- CT scans: Often used to evaluate lymph node involvement and to check for splenic or hepatic enlargement.
- PET scans: Useful for assessing metabolic activity of lymph nodes and distinguishing between active disease and residual masses post-treatment.

Laboratory Tests

• Complete blood count (CBC): To check for anemia, thrombocytopenia, or leukopenia, which may indicate bone marrow involvement.
• Lactate dehydrogenase (LDH): Elevated levels can suggest a more aggressive disease.

Histopathological Examination

The definitive diagnosis of follicular lymphoma is made through:
- Biopsy: A lymph node biopsy is performed to obtain tissue samples. The histological examination typically reveals:
- Follicular architecture: The presence of neoplastic follicles.
- Cellularity: Increased number of follicle center cells (centrocytes and centroblasts).
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to identify specific markers, such as:
- CD10: Positive in follicular lymphoma.
- BCL2: Overexpression is a hallmark of follicular lymphoma.
- CD19 and CD20: B-cell markers that are typically positive.

Genetic Testing

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

Staging

Once diagnosed, the disease is staged using the Ann Arbor classification, which considers the number of lymph node regions involved and the presence of systemic symptoms. This staging is crucial for determining the appropriate treatment approach.

Conclusion

The diagnosis of follicular lymphoma, particularly under the ICD-10 code C82.88, relies on a comprehensive approach that includes clinical evaluation, imaging studies, laboratory tests, and histopathological examination. Accurate diagnosis is essential for effective management and treatment planning, as it helps to determine the disease's stage and potential aggressiveness. If you have further questions or need more specific information, feel free to ask!

Follicular lymphoma, particularly the subtype classified under ICD-10 code C82.88, refers to other types of follicular lymphoma affecting lymph nodes at multiple sites. This indolent form of non-Hodgkin lymphoma (NHL) is characterized by a slow progression and can often be managed effectively with various treatment strategies. Below, we explore the standard treatment approaches for this condition.

Overview of Follicular Lymphoma

Follicular lymphoma is a type of B-cell lymphoma that arises from follicle center (germinal center) B-cells. It is typically classified as low-grade or indolent, meaning it tends to grow slowly and may not require immediate treatment upon diagnosis. However, treatment is necessary when symptoms arise or the disease progresses.

Standard Treatment Approaches

1. Watchful Waiting (Active Surveillance)

For patients diagnosed with asymptomatic follicular lymphoma, especially those with early-stage disease, a common approach is watchful waiting. This strategy involves regular monitoring without immediate treatment, allowing patients to avoid the side effects of therapy until the disease shows signs of progression or symptoms develop.

2. Chemotherapy

When treatment is indicated, chemotherapy is often the first-line approach. Common regimens include:

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is effective for many patients and can be combined with other therapies.
• Bendamustine: This is another chemotherapy option that has shown efficacy in treating follicular lymphoma, often used in combination with monoclonal antibodies.

3. Immunotherapy

Monoclonal antibodies play a significant role in the treatment of follicular lymphoma. Key agents include:

• Rituximab (Rituxan): This anti-CD20 monoclonal antibody is commonly used in combination with chemotherapy. It targets B-cells and has been shown to improve outcomes significantly.
• Obinutuzumab (Gazyva): Another anti-CD20 monoclonal antibody that may be used in combination with chemotherapy or as a single agent in relapsed cases[4].

4. Radioimmunotherapy

This approach combines radiation therapy with immunotherapy. Agents like Ibritumomab tiuxetan deliver targeted radiation to B-cells, providing a dual mechanism of action that can be particularly effective in treating follicular lymphoma[8].

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 features.

6. Targeted Therapies

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

• Copanlisib (Aliqopa): An inhibitor of the PI3K pathway, used for patients who have received at least two prior therapies[10].
• Mosunetuzumab (Lunsumio): A bispecific T-cell engager that has shown promise in treating relapsed or refractory follicular lymphoma[5].

Conclusion

The treatment of follicular lymphoma, particularly the subtype classified under ICD-10 code C82.88, involves a multifaceted approach tailored to the individual patient's disease characteristics and overall health. While watchful waiting may be appropriate for asymptomatic patients, various treatment modalities, including chemotherapy, immunotherapy, radioimmunotherapy, and targeted therapies, are available for those requiring intervention. As research continues to evolve, new therapies and combinations are likely to enhance the management of this indolent yet complex disease. Regular follow-up and monitoring are essential to adapt treatment strategies as needed.