ICD-10: C82.96

ICD-10 code C82.96 refers to Follicular lymphoma, unspecified, intrapelvic lymph nodes. This classification falls under the broader category of non-Hodgkin lymphoma, specifically 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 neoplastic follicle center (germinal center) cells. The disease is often diagnosed in its advanced stages and can present with various symptoms depending on the extent of lymph node involvement and other factors.

Symptoms

Patients with follicular lymphoma may experience:
- Lymphadenopathy: Swelling of lymph nodes, which can be painless and may occur in various regions, including the neck, armpits, and groin.
- B-symptoms: These include fever, night sweats, and unexplained weight loss, which can indicate more aggressive disease or transformation.
- Abdominal discomfort: If the lymphoma involves intrapelvic lymph nodes, patients may experience abdominal pain or fullness due to lymph node enlargement.

Diagnosis

Diagnosis typically involves:
- Imaging studies: CT scans or PET scans to assess the extent of lymph node involvement and any potential organ involvement.
- Biopsy: A definitive diagnosis is made through a biopsy of the affected lymph nodes, which allows for histological examination and immunophenotyping to confirm the presence of follicular lymphoma.

Specifics of C82.96

Code Details

• C82.96 specifically denotes follicular lymphoma that is not otherwise specified and is localized to the intrapelvic lymph nodes. This means that while the lymphoma is identified as follicular, the precise characteristics or subtypes are not detailed in the coding.
• The intrapelvic lymph nodes refer to lymph nodes located within the pelvic cavity, which can include nodes associated with the iliac vessels and other pelvic structures.

Treatment Options

Treatment for follicular lymphoma can vary based on the stage of the disease, the patient's overall health, and specific symptoms. Common approaches include:
- Watchful waiting: In cases where the lymphoma is asymptomatic and indolent, a "watch and wait" strategy may be employed.
- Chemotherapy: Regimens such as R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) are commonly used.
- Immunotherapy: Targeted therapies, including monoclonal antibodies like Rituximab, are often utilized.
- Radiation therapy: This may be used for localized disease or to alleviate symptoms.

Prognosis

The prognosis for patients with follicular lymphoma can vary widely. Generally, it is considered a chronic condition that can be managed effectively for many years, although it may transform into a more aggressive form of lymphoma in some cases.

Conclusion

ICD-10 code C82.96 captures a specific diagnosis of follicular lymphoma localized to the intrapelvic lymph nodes. Understanding the clinical presentation, diagnostic criteria, and treatment options is crucial for effective management of this condition. Regular follow-up and monitoring are essential to address any changes in the disease status and to adapt treatment strategies accordingly.

ICD-10 code C82.96 refers to "Follicular lymphoma, unspecified, intrapelvic lymph nodes." This classification falls under the broader category of non-Hodgkin lymphoma, specifically 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

• Non-Hodgkin Lymphoma (NHL): A broader category that includes various types of lymphomas, including follicular lymphoma.
• Lymphoma: A general term for cancers that affect the lymphatic system.
• Lymphadenopathy: Refers to the enlargement of lymph nodes, which can be a symptom of follicular lymphoma.
• B-cell Lymphoma: Follicular lymphoma is classified as a B-cell lymphoma, as it originates from B lymphocytes.
• Stage IV Lymphoma: If the lymphoma has spread to the intrapelvic lymph nodes, it may be classified as stage IV, indicating advanced disease.

Clinical Context

Follicular lymphoma is characterized by its slow progression and can often be asymptomatic in the early stages. The involvement of intrapelvic lymph nodes indicates a specific location of lymphatic spread, which can influence treatment decisions and prognosis.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.96 is crucial for accurate diagnosis, treatment planning, and communication among healthcare providers. This knowledge aids in the classification and management of follicular lymphoma, particularly when it presents in specific anatomical locations such as the intrapelvic lymph nodes.

Follicular lymphoma, classified under ICD-10 code C82.96, is a type of non-Hodgkin lymphoma that primarily affects the lymphatic system. The diagnosis of follicular lymphoma, particularly when it involves unspecified intrapelvic lymph nodes, is based on a combination of clinical evaluation, imaging studies, and histopathological examination. Below are the key criteria and steps involved in the diagnosis of this condition.

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 help guide the clinician towards further investigation.

2. Physical Examination: A thorough physical examination is essential to identify enlarged lymph nodes, particularly in the cervical, axillary, and inguinal regions, as well as in the abdominal and pelvic areas.

Imaging Studies

1. Ultrasound: This imaging modality can help visualize lymphadenopathy in the pelvic region and assess the characteristics of the lymph nodes.

2. CT Scan: A computed tomography (CT) scan of the abdomen and pelvis is often performed to evaluate the extent of lymphadenopathy and to identify any other involved areas.

3. PET Scan: Positron emission tomography (PET) scans may be used to assess metabolic activity in lymph nodes and to differentiate between benign and malignant processes.

Histopathological Examination

1. Biopsy: A definitive diagnosis of follicular lymphoma requires a biopsy of the affected lymph node. This can be done through:
   - Excisional Biopsy: Removal of an entire lymph node for examination.
   - Core Needle Biopsy: A less invasive method that removes a small cylinder of tissue.

2. Immunophenotyping: The biopsy sample is analyzed using immunohistochemistry to identify specific markers. Follicular lymphoma typically expresses CD10, CD19, CD20, and BCL2 proteins, which are indicative of B-cell lineage.

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

Staging

Once diagnosed, the lymphoma is staged using the Ann Arbor staging system, which considers the number of lymph node regions involved, the presence of systemic symptoms, and whether the disease has spread to other organs.

Conclusion

The diagnosis of follicular lymphoma, particularly when it involves unspecified intrapelvic lymph nodes (ICD-10 code C82.96), relies on a combination of clinical assessment, imaging studies, and histopathological confirmation. Early and accurate diagnosis is crucial for determining the appropriate treatment strategy and improving patient outcomes. If you have further questions or need more specific information, feel free to ask!

Follicular lymphoma, classified under ICD-10 code C82.96, 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 located in the intrapelvic lymph nodes and is unspecified, meaning that the exact characteristics of the lymphoma may not be detailed. The 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 itself.

Standard Treatment Approaches

1. Watchful Waiting (Active Surveillance)

For patients with asymptomatic follicular lymphoma, especially those with low tumor burden, 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 older patients or those with other significant health issues.

2. Chemotherapy

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

• CHOP: Cyclophosphamide, doxorubicin, vincristine, and prednisone.
• R-CHOP: This is a variation that includes rituximab, a monoclonal antibody that targets CD20 on B-cells, enhancing the effectiveness of chemotherapy.

These regimens are often used in combination with rituximab to improve outcomes.

3. Immunotherapy

Rituximab is a key component in the treatment of follicular lymphoma. It can be used alone or in combination with chemotherapy. Other immunotherapeutic agents, such as obinutuzumab, may also be considered depending on the patient's specific situation.

4. Radiation Therapy

Radiation therapy can be effective for localized disease, particularly in cases where the lymphoma is confined to a specific area, such as the intrapelvic lymph nodes. It may be used as a primary treatment or as a consolidation therapy after chemotherapy.

5. Targeted Therapy

Targeted therapies, such as PI3K inhibitors (e.g., copanlisib) and BTK inhibitors, are increasingly being used for follicular lymphoma, especially in relapsed or refractory cases. These therapies work by specifically targeting pathways involved in the growth and survival of cancer cells.

6. Stem Cell Transplantation

For patients with relapsed or refractory follicular lymphoma, autologous stem cell transplantation may be considered. This approach is typically reserved for younger patients or those with aggressive disease features.

7. Radioimmunotherapy

Radioimmunotherapy combines radiation therapy with immunotherapy. Agents like ibritumomab tiuxetan deliver targeted radiation to lymphoma cells, providing a dual mechanism of action.

Conclusion

The treatment of follicular lymphoma, particularly when it involves intrapelvic lymph nodes, is multifaceted and tailored to the individual patient. The choice of treatment depends on various factors, including the stage of the disease, symptoms, and patient preferences. Ongoing research continues to refine these approaches, with a focus on improving outcomes and minimizing side effects. For patients diagnosed with C82.96, a multidisciplinary team approach is essential to determine the most appropriate treatment plan. Regular follow-up and monitoring are crucial to assess treatment effectiveness and manage any potential relapses.

Follicular lymphoma, classified under ICD-10 code C82.96, 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 to the intrapelvic 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, typically presenting as a slow-growing tumor. It is often diagnosed in later stages due to its indolent nature. The disease can manifest in various lymph node regions, including the intrapelvic area, which encompasses lymph nodes located in the pelvis.

Signs and Symptoms

Patients with follicular lymphoma may exhibit a range of signs and symptoms, which can vary based on the extent of the disease and the specific lymph node involvement:

• Lymphadenopathy: The most common presentation is painless swelling of lymph nodes. In the case of C82.96, this would specifically involve the intrapelvic lymph nodes, which may lead to abdominal or pelvic discomfort.
• B Symptoms: These include systemic symptoms such as:
• Fever: Unexplained fevers that may be intermittent.
• Night Sweats: Profuse sweating during the night, often soaking bedclothes.
• Weight Loss: Unintentional weight loss exceeding 10% of body weight over six months.
• Abdominal or Pelvic Pain: Patients may experience discomfort or pain in the lower abdomen due to the enlargement of lymph nodes in the pelvic region.
• Fatigue: A common symptom in many cancer patients, fatigue can be significant and debilitating.

Patient Characteristics

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

• Age: Follicular lymphoma typically occurs in adults, with a median age of diagnosis around 60 years. It is relatively rare in younger individuals.
• Gender: There is a slight male predominance in the incidence of follicular lymphoma.
• History of Autoimmune Disorders: Some patients may have a history of autoimmune diseases, which have been linked to an increased risk of developing lymphomas.
• Family History: A family history of lymphoproliferative disorders may also be a risk factor.

Diagnostic Considerations

Diagnosis of follicular lymphoma involves a combination of clinical evaluation, imaging studies, and histopathological examination. Key diagnostic tools include:

• Imaging Studies: CT scans or PET scans may be utilized to assess the extent of lymphadenopathy and to identify the involvement of intrapelvic lymph nodes.
• Biopsy: A definitive diagnosis is made through a lymph node biopsy, which reveals the characteristic follicular pattern of neoplastic B-cells.

Conclusion

Follicular lymphoma, particularly when localized to the intrapelvic lymph nodes as indicated by ICD-10 code C82.96, presents with specific clinical features and patient characteristics. Recognizing the signs and symptoms, such as lymphadenopathy, systemic B symptoms, and abdominal discomfort, is essential for timely diagnosis and management. Understanding these aspects can aid healthcare providers in developing effective treatment plans tailored to the individual needs of patients.