ICD-10: C82.95

Clinical Description of ICD-10 Code C82.95

ICD-10 Code C82.95 refers to Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb. Follicular lymphoma is a type of non-Hodgkin lymphoma (NHL) that originates in the lymphatic system, specifically from B-lymphocytes. This particular code indicates that the lymphoma is located in the lymph nodes of the inguinal region (the groin area) and the lower limb, but does not specify the exact characteristics or subtype of the follicular lymphoma.

Characteristics of Follicular Lymphoma

• Type: Follicular lymphoma is classified as a low-grade (indolent) lymphoma, which means it typically grows slowly compared to aggressive forms of lymphoma.
• Histology: It is characterized by the proliferation of follicle center (germinal center) B-cells. The histological appearance often shows a nodular pattern, which can be confirmed through biopsy and immunohistochemical staining.
• Symptoms: Patients may present with painless lymphadenopathy (swelling of lymph nodes), which can occur in various regions, including the inguinal area. Other symptoms may include fever, night sweats, weight loss, and fatigue, although many patients remain asymptomatic for extended periods.

Diagnosis and Staging

• Diagnosis: Diagnosis typically involves a combination of physical examination, imaging studies (such as CT scans), and biopsy of the affected lymph nodes. Flow cytometry and molecular studies may also be employed to confirm the diagnosis and assess the presence of specific genetic markers.
• Staging: The staging of follicular lymphoma is crucial for determining the appropriate treatment approach. The Ann Arbor staging system is commonly used, which considers the number of lymph node regions involved and whether the disease has spread to other organs.

Treatment Options

Treatment for follicular lymphoma can vary based on the stage of the disease, the patient's overall health, and the presence of symptoms. Common treatment modalities include:

• Watchful Waiting: In asymptomatic patients with early-stage disease, a "watch and wait" approach may be adopted.
• Chemotherapy: Regimens such as R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) are often used for more advanced disease.
• Immunotherapy: Rituximab, a monoclonal antibody targeting CD20 on B-cells, is frequently used either alone or in combination with chemotherapy.
• Radiation Therapy: This may be used for localized disease or as palliative treatment for symptomatic lymphadenopathy.

Prognosis

The prognosis for patients with follicular lymphoma can vary widely. Factors influencing outcomes include the patient's age, overall health, the extent of disease at diagnosis, and the specific characteristics of the lymphoma. Follicular lymphoma is generally considered manageable, with many patients living for years with the disease, although it is often not curable.

Conclusion

ICD-10 code C82.95 captures a specific presentation of follicular lymphoma affecting the lymph nodes in the inguinal region and lower limb. Understanding the clinical characteristics, diagnostic processes, treatment options, and prognosis associated with this condition is essential for effective management and care of affected patients. For healthcare providers, accurate coding is crucial for appropriate treatment planning and reimbursement processes.

Follicular lymphoma, classified under ICD-10 code C82.95, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. This specific code refers to follicular lymphoma that is unspecified and localized to the lymph nodes of the inguinal region and lower limb. 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 may present with a variety of signs and symptoms, which can vary in severity and may not be immediately apparent. Common clinical features include:

• Lymphadenopathy: The most prominent sign is the enlargement of lymph nodes, particularly in the inguinal region (groin) and lower limbs. These lymph nodes may be painless and can be detected during a physical examination.
• B Symptoms: Some patients may experience systemic symptoms known as "B symptoms," which 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.
• Fatigue: Patients often report a general sense of fatigue or malaise, which can be debilitating.
• Abdominal Symptoms: In some cases, if lymph nodes in the abdomen are involved, patients may experience abdominal pain or discomfort.

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, with men being more frequently diagnosed than women.
• 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 lymphoproliferative disorders may also be noted in some patients, suggesting a potential genetic predisposition.

Diagnosis and Evaluation

The diagnosis of follicular lymphoma involves a combination of clinical evaluation, imaging studies, and histopathological examination:

• Imaging Studies: CT scans or PET scans may be utilized to assess the extent of lymphadenopathy and to evaluate for any involvement of other regions.
• Biopsy: A definitive diagnosis is made through a lymph node biopsy, where histological examination reveals the characteristic follicular architecture and the presence of neoplastic B-cells.
• Immunophenotyping: Flow cytometry or immunohistochemistry is used to confirm the B-cell lineage and to assess specific markers, such as CD10, CD19, and CD20.

Conclusion

Follicular lymphoma, particularly when localized to the inguinal region and lower limb, presents with specific clinical features that are essential for diagnosis and management. Recognizing the signs and symptoms, along with understanding patient characteristics, can aid healthcare providers in identifying this condition early and implementing appropriate treatment strategies. Regular follow-up and monitoring are crucial, as follicular lymphoma can exhibit a variable clinical course, ranging from indolent to more aggressive forms.

ICD-10 code C82.95 refers to "Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb." This specific classification falls under the broader category of non-Hodgkin lymphoma, particularly follicular lymphoma, which is a type of cancer that originates in the lymphatic system.

Alternative Names for Follicular Lymphoma

1. Follicular Lymphoma, Grade 1: This term is often used to describe the less aggressive form of follicular lymphoma.
2. Follicular Lymphoma, Grade 2: This refers to a more aggressive variant of the disease.
3. Follicular Lymphoma, Grade 3: This is the most aggressive form and may be treated differently than lower-grade variants.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): A broader category that includes various types of lymphomas, including follicular lymphoma.
2. Lymphoma: A general term for cancers that affect the lymphatic system.
3. Lymphadenopathy: Refers to the enlargement of lymph nodes, which can be a symptom of follicular lymphoma.
4. B-cell Lymphoma: Since follicular lymphoma arises from B-cells, this term is often used interchangeably in discussions about the disease.
5. Chronic Lymphocytic Leukemia (CLL): While distinct, CLL can sometimes be confused with follicular lymphoma due to overlapping characteristics.

Clinical Context

Follicular lymphoma is characterized by the proliferation of follicle center (germinal center) B-cells. The unspecified nature of C82.95 indicates that the specific grade or subtype of the lymphoma has not been determined, which can affect treatment decisions and prognosis. The involvement of lymph nodes in the inguinal region and lower limb suggests a specific anatomical focus, which may influence the clinical approach to management and treatment.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.95 is crucial for healthcare professionals involved in the diagnosis and treatment of lymphomas. This knowledge aids in accurate coding, effective communication among medical teams, and appropriate patient management strategies. If you need further details on treatment options or prognosis related to follicular lymphoma, feel free to ask!

Diagnosing follicular lymphoma, particularly under the ICD-10 code C82.95, which specifies "Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb," involves a comprehensive evaluation that includes clinical assessment, imaging studies, and histopathological examination. Below is a detailed overview of the criteria and processes typically used in the diagnosis of this condition.

Clinical Presentation

Symptoms

Patients with follicular lymphoma may present with:
- Painless lymphadenopathy: Swelling of lymph nodes, particularly in the inguinal region and lower limbs, is a common initial symptom.
- B symptoms: These may include fever, night sweats, and unexplained weight loss, which can indicate more aggressive disease or transformation.
- Fatigue: Generalized fatigue is often reported by patients.

Medical History

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

Diagnostic Tests

Imaging Studies

Imaging plays a crucial role in the diagnosis and staging of follicular lymphoma:
- CT Scans: Computed tomography scans of the abdomen, pelvis, and chest can help identify enlarged lymph nodes and assess the extent of disease.
- PET Scans: Positron emission tomography scans may be used to evaluate metabolic activity in lymph nodes and detect any potential transformation to a more aggressive form of lymphoma.

Laboratory Tests

• Blood Tests: Complete blood count (CBC) and other blood tests can help assess overall health and detect any abnormalities.
• Lactate Dehydrogenase (LDH): Elevated levels may indicate a higher tumor burden.

Histopathological Examination

The definitive diagnosis of follicular lymphoma is made through:
- Lymph Node Biopsy: A biopsy of the affected lymph nodes is critical. The tissue is examined microscopically to identify characteristic features of follicular lymphoma, such as:
- Follicular architecture: The presence of neoplastic follicles.
- Cellularity: Increased number of B-cells.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to confirm the presence of CD10, CD19, and CD20 markers, which are typical for 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 aid in diagnosis.

Staging

Once diagnosed, staging is performed according to the Ann Arbor classification, which assesses the extent of lymph node involvement and any extranodal disease. This is crucial for determining the appropriate treatment approach.

Conclusion

The diagnosis of follicular lymphoma, particularly for the ICD-10 code C82.95, involves a multifaceted approach that includes clinical evaluation, imaging studies, laboratory tests, and histopathological confirmation. Each of these components is essential for accurate diagnosis and effective management of the disease. If you have further questions or need more specific information, feel free to ask!

Follicular lymphoma, classified under ICD-10 code C82.95, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. This specific code refers to follicular lymphoma that is unspecified and located in the lymph nodes of the inguinal region and lower limb. 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 approaches for follicular lymphoma.

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

Chemotherapy remains a cornerstone of treatment for symptomatic follicular lymphoma. Common regimens include:

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is often used in combination with monoclonal antibodies.
• R-CHOP: The addition of Rituximab (a monoclonal antibody targeting CD20) to the CHOP regimen has significantly improved outcomes for patients with follicular lymphoma.

3. Immunotherapy

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

• Rituximab: This monoclonal antibody is frequently used alone or in combination with chemotherapy. It targets CD20 on B-cells and has been shown to improve response rates and overall survival.
• Obinutuzumab: Another anti-CD20 monoclonal antibody that may be used in combination with chemotherapy or as a single agent.

4. Targeted Therapy

Targeted therapies are designed to attack specific cancer cell characteristics. In follicular lymphoma, options include:

• PI3K Inhibitors: Such as Copanlisib (Aliqopa®) and Duvelisib, which target the PI3K pathway involved in cell growth and survival.
• BCL-2 Inhibitors: Venetoclax is an example that has shown promise in treating relapsed or refractory follicular lymphoma.

5. Radiation Therapy

Radiation therapy may be used in specific situations, such as localized disease or to relieve symptoms. It is often combined with other treatments, especially in cases where the lymphoma is confined to a limited area.

6. 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 aggressive disease features.

7. Radioimmunotherapy

This treatment combines radiation therapy with immunotherapy. Agents like Ibritumomab tiuxetan (Zevalin) deliver targeted radiation to lymphoma cells and can be effective in treating follicular lymphoma, particularly in relapsed cases.

Conclusion

The treatment of follicular lymphoma, particularly in the inguinal region and lower limb, is multifaceted and tailored to the individual patient. The choice of therapy depends on various factors, including disease stage, symptoms, and patient preferences. Ongoing research continues to refine these approaches, with new therapies emerging that may further improve outcomes for patients with this type of lymphoma. Regular follow-up and monitoring are essential to adapt treatment plans as needed and to manage any potential side effects effectively.