ICD-10: C82.90

ICD-10 code C82.90 refers to Follicular lymphoma, unspecified, unspecified site. This classification falls under the broader category of non-Hodgkin lymphoma (NHL), which encompasses a diverse group of blood cancers that originate in the lymphatic system. Below is a detailed overview of this condition, including its clinical description, characteristics, and relevant coding information.

Clinical Description of Follicular Lymphoma

Overview

Follicular lymphoma is a type of indolent (slow-growing) non-Hodgkin lymphoma that arises from B-lymphocytes, specifically from the germinal centers of lymphoid follicles. It is characterized by the proliferation of neoplastic follicle center (germinal center) cells, which can lead to the formation of lymph nodes and other lymphoid tissues.

Symptoms

Patients with follicular lymphoma may present with a variety of symptoms, which can include:
- Lymphadenopathy: Swelling of lymph nodes, often painless, which can occur in various regions of the body.
- B symptoms: These may include fever, night sweats, and unexplained weight loss.
- Fatigue: Generalized tiredness and lack of energy.
- Splenomegaly: Enlargement of the spleen, which may be detected during a physical examination.

Diagnosis

Diagnosis typically involves:
- Histopathological examination: A biopsy of the affected lymph node or tissue is essential for confirming the diagnosis. The presence of follicle center cells is a key indicator.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to identify specific markers (e.g., CD10, CD19, CD20) that characterize follicular lymphoma.
- Imaging studies: CT scans or PET scans may be utilized to assess the extent of disease and involvement of lymph nodes or other organs.

Staging

Follicular lymphoma is staged using the Ann Arbor system, which considers the number of lymph node regions involved and whether the disease has spread to other organs. The staging helps guide treatment decisions.

Coding Information

ICD-10 Code C82.90

• Code Description: Follicular lymphoma, unspecified, unspecified site.
• Classification: This code is part of the C82 category, which specifically covers follicular lymphoma. The "unspecified" designation indicates that the specific site of the lymphoma is not documented or is not clearly defined in the medical record.

Importance of Accurate Coding

Accurate coding is crucial for:
- Reimbursement: Ensuring that healthcare providers receive appropriate payment for services rendered.
- Epidemiological tracking: Assisting in the collection of data for research and public health monitoring.
- Treatment planning: Providing a clear understanding of the patient's diagnosis for effective management and treatment strategies.

Conclusion

ICD-10 code C82.90 is essential for identifying cases of follicular lymphoma that do not specify the site of involvement. Understanding the clinical characteristics, symptoms, and diagnostic criteria of this condition is vital for healthcare providers in delivering appropriate care and ensuring accurate coding for billing and treatment purposes. If further details or specific case studies are needed, consulting hematology-oncology resources or clinical guidelines may provide additional insights.

Follicular lymphoma, classified under ICD-10 code C82.90, is a type of non-Hodgkin lymphoma (NHL) that primarily affects the lymphatic system. This condition is characterized by the proliferation of follicle center (germinal center) B-cells, leading to a range of clinical presentations, signs, symptoms, and patient characteristics. Below is a detailed overview of these aspects.

Clinical Presentation

General Overview

Follicular lymphoma typically presents as a slow-growing (indolent) form of lymphoma, which can lead to a variety of clinical manifestations. Patients may remain asymptomatic for extended periods, and the disease is often diagnosed incidentally during imaging studies or routine examinations.

Common Signs and Symptoms

1. Lymphadenopathy: The most common clinical finding is painless swelling of lymph nodes, which may occur in various regions, including the neck, armpits, and groin. These lymph nodes may be firm but are usually not tender.

2. B Symptoms: Some patients may experience systemic symptoms known as "B symptoms," which include:
   - Unexplained fever
   - Night sweats
   - Significant weight loss (more than 10% of body weight over six months)

3. Fatigue: Many patients report a general sense of fatigue or malaise, which can be attributed to the underlying disease process.

4. Abdominal Symptoms: In cases where lymph nodes in the abdomen are involved, patients may experience abdominal pain, fullness, or discomfort due to lymphadenopathy or splenomegaly (enlargement of the spleen).

5. Skin Involvement: Although less common, some patients may develop skin lesions or rashes associated with follicular lymphoma.

Patient Characteristics

Demographics

• Age: Follicular lymphoma is more commonly diagnosed in adults, particularly those aged 50 and older. The median age at diagnosis is around 60 years.
• Gender: There is a slight male predominance, with men being more frequently affected than women.

Risk Factors

• Family History: A family history of lymphoma or other hematologic malignancies may increase the risk.
• Immune System Status: Patients with compromised immune systems, such as those with HIV/AIDS or those who have undergone organ transplantation, are at higher risk for developing lymphomas, including follicular lymphoma.
• Environmental Exposures: Certain environmental factors, such as exposure to pesticides or solvents, have been suggested as potential risk factors, although the evidence is not definitive.

Comorbidities

Patients with follicular lymphoma may have other health conditions that can complicate their management, including cardiovascular diseases, diabetes, or other malignancies. The presence of these comorbidities can influence treatment decisions and overall prognosis.

Conclusion

Follicular lymphoma, classified under ICD-10 code C82.90, presents with a range of clinical signs and symptoms, primarily characterized by painless lymphadenopathy and potential systemic symptoms. Understanding the patient demographics and risk factors is crucial for early diagnosis and management. Given its indolent nature, many patients may live for years without significant symptoms, making regular monitoring and follow-up essential for optimal care. If you suspect follicular lymphoma or have concerns about symptoms, consulting a healthcare professional for further evaluation and potential diagnostic testing is advisable.

ICD-10 code C82.90 refers to "Follicular lymphoma, unspecified, unspecified site." This classification falls under the broader category of non-Hodgkin lymphoma (NHL), which encompasses various types of lymphomas that do not originate from Hodgkin's disease. Below are alternative names and related terms associated with this specific code.

Alternative Names for Follicular Lymphoma

1. Follicular Lymphoma, Grade 1: This term is often used to describe the indolent form of follicular lymphoma, which is characterized by slow growth and a better prognosis.

2. Follicular Lymphoma, Grade 2: This refers to a more aggressive form of follicular lymphoma that may require different treatment approaches.

3. Follicular Lymphoma, Grade 3: This is the most aggressive form of follicular lymphoma, often treated similarly to diffuse large B-cell lymphoma.

4. B-cell Follicular Lymphoma: This term emphasizes the B-cell origin of the lymphoma, as follicular lymphoma arises from B-lymphocytes.

5. Non-Hodgkin Follicular Lymphoma: This term is used to distinguish follicular lymphoma from Hodgkin lymphoma, highlighting its classification within non-Hodgkin lymphomas.

Related Terms

1. Lymphoproliferative Disorders: This broader category includes various conditions characterized by the proliferation of lymphocytes, including follicular lymphoma.

2. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas.

3. Indolent Lymphoma: This term describes lymphomas that grow slowly, which includes many cases of follicular lymphoma.

4. Stage IV Lymphoma: While C82.90 does not specify a stage, follicular lymphoma can progress to advanced stages, which may be referred to in clinical contexts.

5. Chronic Lymphocytic Leukemia (CLL): Although distinct, CLL can sometimes be confused with follicular lymphoma due to overlapping features in lymphocyte proliferation.

6. Diffuse Large B-cell Lymphoma (DLBCL): While not the same, DLBCL can arise from follicular lymphoma and is often discussed in relation to it, especially in cases of transformation.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.90 is essential for accurate diagnosis, treatment planning, and communication among healthcare professionals. Follicular lymphoma, while classified under a specific code, encompasses a range of grades and characteristics that can influence patient management and outcomes. If you need further details or specific information regarding treatment protocols or prognosis, feel free to ask!

Follicular lymphoma, classified under ICD-10 code C82.90, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. The diagnosis of follicular lymphoma, particularly when unspecified and at an unspecified site, involves several criteria that healthcare professionals utilize to ensure accurate identification and classification of the disease.

Diagnostic Criteria for Follicular Lymphoma

Clinical Evaluation

1. Symptoms: Patients may present with symptoms such as painless lymphadenopathy (swelling of lymph nodes), fatigue, fever, night sweats, and weight loss. These symptoms can vary widely among individuals, and some may be asymptomatic at diagnosis[1].

2. Physical Examination: A thorough physical examination is essential to identify swollen lymph nodes, spleen, or liver, which may indicate lymphatic involvement[1].

Laboratory Tests

1. Blood Tests: Routine blood tests may reveal anemia, thrombocytopenia, or elevated lactate dehydrogenase (LDH) levels, which can indicate the presence of lymphoma[1].

2. Immunophenotyping: Flow cytometry is often used to analyze the surface markers on lymphocytes. Follicular lymphoma typically expresses CD19, CD20, and CD10, while lacking CD5[1][2].

3. Genetic Testing: The presence of the t(14;18) chromosomal translocation, which results in the BCL2 gene rearrangement, is a hallmark of follicular lymphoma. This can be detected through techniques such as fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR)[2].

Imaging Studies

1. CT Scans and PET Scans: Imaging studies are crucial for staging the disease and assessing the extent of lymph node involvement. A CT scan of the chest, abdomen, and pelvis can help visualize enlarged lymph nodes and any organ involvement[1].

2. Bone Marrow Biopsy: A bone marrow biopsy may be performed to determine if the lymphoma has spread to the bone marrow, which is common in advanced stages of the disease[1].

Histopathological Examination

1. Lymph Node Biopsy: A definitive diagnosis of follicular lymphoma is made through a biopsy of an affected lymph node. Histological examination reveals a characteristic follicular pattern with neoplastic follicles composed of small cleaved and large non-cleaved cells[2].

2. Grading: Follicular lymphoma is graded based on the proportion of large cells present. The grading can influence treatment decisions and prognosis[1].

Conclusion

The diagnosis of follicular lymphoma (ICD-10 code C82.90) is a multifaceted process that combines clinical evaluation, laboratory tests, imaging studies, and histopathological examination. Accurate diagnosis is crucial for determining the appropriate treatment plan and managing the disease effectively. If you have further questions or need more specific information regarding treatment options or prognosis, feel free to ask!

Follicular lymphoma, classified under ICD-10 code C82.90, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. This indolent form of lymphoma typically presents with painless lymphadenopathy and can vary in its clinical course. The treatment approaches for follicular lymphoma depend on several factors, including the stage of the disease, the presence of symptoms, and the patient's overall health. Below is a detailed overview of standard treatment strategies for this condition.

Initial Assessment and Staging

Before initiating treatment, a thorough assessment is essential. This includes:

• Physical Examination: Evaluating lymph nodes and spleen size.
• Imaging Studies: CT scans or PET scans to determine the extent of the disease.
• Bone Marrow Biopsy: To assess for bone marrow involvement.
• Laboratory Tests: Blood tests to evaluate overall health and organ function.

Treatment Approaches

1. Watchful Waiting (Active Surveillance)

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.

2. First-Line Treatment Options

When treatment is indicated, the following first-line therapies are commonly used:

a. Immunotherapy

• Rituximab (Rituxan): A monoclonal antibody targeting CD20 on B-cells. It is often used in combination with chemotherapy or as a single agent in patients who are not symptomatic or have early-stage disease.

b. Chemotherapy

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is typically used in combination with rituximab (R-CHOP) for more aggressive treatment.
• Bendamustine: Often combined with rituximab (BR) for patients who may not tolerate CHOP.

c. Radioimmunotherapy

• Ibritumomab tiuxetan (Zevalin): This combines a monoclonal antibody with a radioactive isotope, targeting CD20 and delivering localized radiation to the lymphoma cells.

3. Second-Line and Subsequent Treatments

If the disease relapses or does not respond to initial treatment, several options are available:

a. Targeted Therapies

• Idelalisib: A PI3K inhibitor used in combination with rituximab for relapsed follicular lymphoma.
• Copanlisib (Aliqopa): Another PI3K inhibitor that has shown efficacy in relapsed cases.

b. Stem Cell Transplantation

• Autologous Stem Cell Transplant: Considered for younger patients or those with more aggressive disease after achieving remission with chemotherapy.

4. Palliative Care

For patients with advanced disease or those who experience significant symptoms, palliative care is essential. This approach focuses on improving quality of life and managing symptoms, which may include pain management and psychological support.

Conclusion

The management of follicular lymphoma (ICD-10 code C82.90) is multifaceted and tailored to the individual patient. While many patients may live for years without treatment, those requiring intervention have a variety of effective options, including immunotherapy, chemotherapy, and targeted therapies. Continuous advancements in treatment strategies and ongoing clinical trials are enhancing the outlook for patients with this indolent form of lymphoma. Regular follow-up and monitoring are crucial to adapt treatment plans as needed and to manage any potential relapses effectively.