ICD-10: C82.92

ICD-10 code C82.92 refers to Follicular lymphoma, unspecified, intrathoracic lymph nodes. This classification falls under the broader category of non-Hodgkin lymphoma (NHL), specifically within the follicular lymphoma subtype. Below is a detailed clinical description and relevant information regarding this condition.

Overview of Follicular Lymphoma

Follicular lymphoma is a type of indolent (slow-growing) non-Hodgkin lymphoma that originates from B-lymphocytes, which are a type of white blood cell involved in the immune response. It is characterized by the proliferation of neoplastic follicle center (germinal center) cells. This lymphoma typically presents in a nodular pattern and can involve lymph nodes and extranodal sites.

Clinical Features

• Symptoms: Patients with follicular lymphoma may present with painless lymphadenopathy (swelling of lymph nodes), which can occur in various regions of the body, including the neck, axilla, and groin. In cases where the lymphoma involves intrathoracic lymph nodes, patients may experience symptoms related to respiratory distress, cough, or chest pain due to the mass effect on surrounding structures.
• Diagnosis: Diagnosis is typically confirmed through a combination of imaging studies (such as CT scans) and histopathological examination of lymph node biopsies. Immunophenotyping and genetic studies may also be performed to characterize the lymphoma further.

Specifics of C82.92

Definition

The code C82.92 specifically denotes follicular lymphoma that is unspecified and localized to the intrathoracic lymph nodes. This means that while the lymphoma is identified as follicular in nature, the precise characteristics or subtype may not be fully defined at the time of coding.

Intrathoracic Involvement

• Location: The intrathoracic lymph nodes include those located in the mediastinum and hilum of the lungs. Involvement of these nodes can lead to complications such as compression of the airways or major blood vessels, which may necessitate urgent medical intervention.
• Prognosis: Follicular lymphoma generally has a favorable prognosis, especially in its early stages. However, the prognosis can vary based on factors such as the extent of disease, patient age, and overall health.

Treatment Options

Treatment for follicular lymphoma may include:

• Watchful Waiting: In asymptomatic patients with early-stage disease, a strategy of observation may be employed.
• Chemotherapy: Common regimens include combinations of agents such as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP).
• Immunotherapy: Monoclonal antibodies like rituximab are often used in conjunction with chemotherapy.
• Radiation Therapy: This may be considered for localized disease or for symptomatic relief.

Conclusion

ICD-10 code C82.92 captures the essence of follicular lymphoma localized to the intrathoracic lymph nodes, highlighting the need for careful clinical evaluation and management. Understanding the characteristics of this lymphoma subtype is crucial for effective treatment planning and improving patient outcomes. Regular follow-up and monitoring are essential to manage potential complications and assess treatment response.

Follicular lymphoma, classified under ICD-10 code C82.92, is a type of non-Hodgkin lymphoma that primarily affects the lymphatic system. This specific code refers to follicular lymphoma that is unspecified and localized in the intrathoracic lymph nodes. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for diagnosis and management.

Clinical Presentation

Overview of Follicular Lymphoma

Follicular lymphoma is characterized by the proliferation of B-lymphocytes in a follicular pattern. It is typically indolent, meaning it progresses slowly, but it can transform into a more aggressive form. The disease often presents in advanced stages, and patients may be asymptomatic at the time of diagnosis.

Signs and Symptoms

The clinical manifestations of follicular lymphoma can vary widely among patients. Common signs and symptoms include:

• Lymphadenopathy: The most common presentation is painless swelling of lymph nodes, particularly in the neck, axilla, or groin. In the case of C82.92, lymphadenopathy is specifically noted in the intrathoracic region, which may involve mediastinal or hilar lymph nodes.
• B Symptoms: These are systemic symptoms that may indicate more advanced disease and include:
• Fever: Unexplained fevers that may be intermittent.
• Night Sweats: Profuse sweating during the night that can soak clothing and bedding.
• Weight Loss: Unintentional weight loss of more than 10% of body weight over six months.
• Respiratory Symptoms: If the intrathoracic lymph nodes are significantly enlarged, patients may experience:
• Cough: Persistent cough due to compression of the airways.
• Dyspnea: Shortness of breath, especially during exertion.
• Chest Pain: Discomfort or pain in the chest area, which may be related to lymph node enlargement.

Patient Characteristics

Certain demographic and clinical characteristics are often associated with follicular lymphoma:

• Age: Follicular lymphoma is more common in adults, typically diagnosed in individuals aged 50 and older.
• Gender: There is a slight male predominance in the incidence of follicular lymphoma.
• Ethnicity: The condition is observed across various ethnic groups, but incidence rates may vary.
• Comorbidities: Patients may have other health conditions that can complicate the management of lymphoma, such as autoimmune diseases or previous cancers.

Diagnosis and Evaluation

Diagnosis of follicular lymphoma typically involves a combination of clinical evaluation, imaging studies, and histopathological examination:

• Imaging: CT scans or PET scans are often used to assess the extent of lymphadenopathy and to evaluate the involvement of intrathoracic lymph nodes.
• Biopsy: A definitive diagnosis is made through a biopsy of the affected lymph node, which reveals the characteristic follicular pattern of neoplastic B-cells.
• Laboratory Tests: Blood tests may be performed to assess overall health and to check for anemia or other abnormalities.

Conclusion

Follicular lymphoma, particularly when localized to intrathoracic lymph nodes as indicated by ICD-10 code C82.92, presents with a range of clinical signs and symptoms, primarily lymphadenopathy and systemic B symptoms. Understanding these characteristics is essential for timely diagnosis and effective management. If you suspect follicular lymphoma or have concerns about symptoms, it is crucial to consult a healthcare professional for further evaluation and potential diagnostic testing.

ICD-10 code C82.92 refers to "Follicular lymphoma, unspecified, intrathoracic lymph nodes." This specific code is part of the broader classification of non-Hodgkin lymphoma, particularly 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 condition. It is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells.

2. Non-Hodgkin Lymphoma (NHL): Follicular lymphoma is classified under the umbrella of non-Hodgkin lymphomas, which are a diverse group of blood cancers that include any lymphoma except Hodgkin's lymphoma.

3. Lymphoma, Follicular Type: This term emphasizes the specific histological type of lymphoma, indicating that it arises from follicle center cells.

4. Intrathoracic Lymph Nodes Involvement: This phrase highlights the anatomical location of the lymphoma, indicating that the lymph nodes affected are located within the thoracic cavity.

5. Stage IV Follicular Lymphoma: If the lymphoma has spread to the intrathoracic lymph nodes, it may be classified as stage IV, which indicates advanced disease.

6. B-cell Lymphoma: Since follicular lymphoma is derived from B-cells, this term is often used in broader discussions about lymphomas.

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

8. Chronic Lymphocytic Leukemia (CLL): While distinct, there can be some overlap in terminology and classification, particularly in cases where lymphoid tissue is involved.

Related Codes and Classifications

• ICD-10 Codes for Other Lymphomas: Other related codes include C82.90 (Follicular lymphoma, unspecified, unspecified site) and C83.9 (Non-Hodgkin lymphoma, unspecified site), which may be relevant in differential diagnosis.

• NCI Thesaurus Terms: The National Cancer Institute (NCI) provides a thesaurus that includes various terms related to follicular lymphoma, which can be useful for research and clinical documentation.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.92 is essential for accurate diagnosis, treatment planning, and coding in medical records. These terms not only facilitate communication among healthcare providers but also enhance the clarity of patient records and billing processes. If you need further details or specific information about treatment options or prognosis related to follicular lymphoma, feel free to ask!

Follicular lymphoma, classified under ICD-10 code C82.92, 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 it involves unspecified intrathoracic lymph nodes, follows specific clinical and pathological criteria. Below is a detailed overview of the criteria used for diagnosis.

Clinical Presentation

Symptoms

Patients with follicular lymphoma may present with a variety of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, which may be painless and can occur in the neck, armpits, or groin.
- B Symptoms: These include fever, night sweats, and unexplained weight loss, which may indicate more aggressive disease.
- Fatigue: Generalized tiredness is common among patients.

Physical Examination

During a physical examination, healthcare providers will assess for:
- Enlarged lymph nodes, particularly in the intrathoracic region (mediastinal or hilar lymph nodes).
- Splenomegaly or hepatomegaly, which may indicate systemic involvement.

Diagnostic Imaging

Imaging Studies

Imaging techniques are crucial for identifying the extent of lymph node involvement:
- CT Scans: Chest CT scans are often used to visualize intrathoracic lymph nodes and assess their size and distribution.
- PET Scans: Positron emission tomography (PET) scans can help determine metabolic activity in lymph nodes, aiding in the differentiation between benign and malignant processes.

Laboratory Tests

Biopsy

A definitive diagnosis of follicular lymphoma typically requires a biopsy of the affected lymph nodes. The following are key aspects of the biopsy:
- Histopathological Examination: The biopsy sample is examined microscopically to identify characteristic follicular structures and the presence of neoplastic B-cells.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to assess the expression of specific markers (e.g., CD10, CD19, CD20, and BCL2) that are indicative of follicular lymphoma.

Molecular Studies

• Genetic Testing: Detection of the t(14;18) chromosomal translocation, which involves the BCL2 gene, is a hallmark of follicular lymphoma and can be confirmed through molecular techniques.

Staging and Classification

Ann Arbor Staging System

The Ann Arbor staging system is used to classify the extent of lymphoma:
- Stage I: Involvement of a single lymph node region.
- Stage II: Involvement of two or more lymph node regions on the same side of the diaphragm.
- Stage III: Involvement of lymph nodes on both sides of the diaphragm, which may include intrathoracic lymph nodes.
- Stage IV: Disseminated involvement of one or more extralymphatic organs.

Conclusion

The diagnosis of follicular lymphoma, particularly with involvement of unspecified intrathoracic lymph nodes (ICD-10 code C82.92), relies on a combination of clinical evaluation, imaging studies, histopathological examination, and molecular testing. Accurate diagnosis is essential for determining the appropriate treatment strategy and prognosis for patients. If you have further questions or need more specific information, feel free to ask!

Follicular lymphoma, classified under ICD-10 code C82.92, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. This specific code indicates that the lymphoma is unspecified and located in the intrathoracic lymph nodes. Treatment approaches for follicular lymphoma 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 an overview of standard treatment strategies.

Standard Treatment Approaches

1. Watchful Waiting (Active Surveillance)

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 years. This approach is particularly suitable for indolent (slow-growing) forms of the disease.

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 regimen includes the addition of rituximab, a monoclonal antibody that targets CD20 on B-cells, enhancing the effectiveness of chemotherapy.

Chemotherapy can be used alone or in combination with other therapies, depending on the patient's specific situation and response to treatment.

3. Immunotherapy

Rituximab is a cornerstone of treatment for follicular lymphoma. It can be used in combination with chemotherapy (as mentioned above) or as a standalone treatment for patients who are not candidates for chemotherapy. Other newer immunotherapies, such as:

• Obinutuzumab: Another anti-CD20 monoclonal antibody that may be used in combination with chemotherapy.
• Mosunetuzumab (Lunsumio): A bispecific T-cell engager that has shown promise in treating relapsed or refractory follicular lymphoma.

4. Radiation Therapy

Radiation therapy may be employed in specific cases, particularly for localized disease or to alleviate symptoms. It is often used in conjunction with other treatments, especially in cases where lymph nodes are involved in a limited area.

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. Clinical Trials

Participation in clinical trials may be an option for patients seeking access to cutting-edge therapies or novel treatment combinations. These trials can provide opportunities to receive treatments that are not yet widely available.

Conclusion

The treatment of follicular lymphoma, particularly when it involves intrathoracic lymph nodes, is multifaceted and tailored to the individual patient. The choice of treatment depends on various factors, including the disease's stage, the patient's health status, and the presence of symptoms. Ongoing research and clinical trials continue to evolve the landscape of treatment options, offering hope for improved outcomes in patients with this type of lymphoma. For the most effective management, patients should consult with a hematologist or oncologist specializing in lymphomas to determine the best course of action based on their specific circumstances.