ICD-10: C82.97

Follicular lymphoma, classified under ICD-10 code C82.97, is a type of non-Hodgkin lymphoma that primarily affects the lymphatic system, particularly the spleen in this case. 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 strategies for follicular lymphoma, particularly when it is unspecified and involves the spleen.

Overview of Follicular Lymphoma

Follicular lymphoma is characterized by the proliferation of B-lymphocytes and is typically indolent, meaning it tends to grow slowly. It can present with symptoms such as swollen lymph nodes, fever, night sweats, and weight loss. The involvement of the spleen can indicate a more advanced stage of the disease, necessitating a tailored treatment approach.

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 older patients or those with other significant health issues.

2. Chemotherapy

When treatment is necessary, chemotherapy is often the first-line option. 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.
• R-CHOP: This is a variation of the CHOP regimen that includes Rituximab, a monoclonal antibody that targets CD20 on B-cells, enhancing the effectiveness of chemotherapy.

3. Immunotherapy

Rituximab is a cornerstone in the treatment of follicular lymphoma. It can be used alone or in combination with chemotherapy. In cases where the lymphoma is more advanced or has relapsed, other immunotherapies may be considered, such as:

• Obinutuzumab: Another anti-CD20 monoclonal antibody that may be used in combination with chemotherapy.
• Lenalidomide: An oral immunomodulatory drug that can be used in relapsed cases.

4. Radioimmunotherapy

This approach combines radiation therapy with immunotherapy. Agents like Ibritumomab tiuxetan deliver targeted radiation to lymphoma cells, which can be particularly effective for localized disease or in cases where the lymphoma has not responded to other treatments.

5. Stem Cell Transplantation

For patients with relapsed or refractory follicular lymphoma, especially those who have undergone multiple lines of therapy, autologous stem cell transplantation may be considered. This involves harvesting the patient’s own stem cells, administering high-dose chemotherapy, and then reinfusing the stem cells to restore bone marrow function.

6. Targeted Therapy

Recent advancements have introduced targeted therapies that focus on specific pathways involved in lymphoma cell growth. For example:

• PI3K Inhibitors: Such as copanlisib, which target the PI3K pathway involved in cell survival and proliferation.
• BCL-2 Inhibitors: Like Venetoclax, which can induce apoptosis in lymphoma cells.

Conclusion

The treatment of follicular lymphoma, particularly when it involves the spleen, is multifaceted and should be personalized based on the individual patient's condition and preferences. Regular follow-ups and monitoring are crucial, as the disease can be indolent and may not require immediate intervention. As research continues to evolve, new therapies and combinations are being explored, offering hope for improved outcomes in patients with this type of lymphoma. For the most effective management, patients should work closely with their healthcare team to determine the best treatment strategy tailored to their specific situation.

ICD-10 code C82.97 refers to Follicular lymphoma, unspecified, spleen. This classification falls under the broader category of non-Hodgkin lymphoma, 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 non-Hodgkin lymphoma that originates from B-lymphocytes, which are a part of the immune system. It is characterized by the proliferation of neoplastic follicle center (germinal center) cells. This lymphoma is typically indolent, meaning it tends to grow slowly, but it can transform into a more aggressive form over time.

Clinical Presentation

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.
• Splenomegaly: Enlargement of the spleen, which is specifically noted in the case of C82.97. This can lead to discomfort or a feeling of fullness in the abdomen.
• B Symptoms: These may include fever, night sweats, and unexplained weight loss, although they are less common in early stages of follicular lymphoma.

Diagnosis

Diagnosis of follicular lymphoma typically involves:

• Histopathological Examination: A biopsy of affected lymph nodes or spleen is essential for confirming the diagnosis. The presence of follicular structures and specific markers (such as CD10, BCL2) is indicative of this lymphoma type.
• Imaging Studies: CT scans or PET scans may be utilized to assess the extent of the disease and to evaluate lymph node involvement and splenic enlargement.
• Bone Marrow Biopsy: This may be performed to determine if the lymphoma has spread to the bone marrow.

Staging and Classification

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 presence of splenic involvement, as indicated by C82.97, suggests at least stage III disease, where lymph nodes on both sides of the diaphragm and the spleen are affected.

Treatment Options

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

• Watchful Waiting: In asymptomatic cases, especially in early-stage disease, a "watch and wait" approach may be adopted.
• Chemotherapy: Regimens such as R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) are commonly used.
• Immunotherapy: Monoclonal antibodies like Rituximab are often employed, either alone or in combination with chemotherapy.
• Radiation Therapy: This may be used for localized disease or to alleviate symptoms from bulky 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 a chronic condition, with many patients living for years with the disease, although it can transform into a more aggressive form.

Conclusion

ICD-10 code C82.97 captures the clinical essence of follicular lymphoma with splenic involvement, highlighting the need for careful diagnosis and management. Understanding the characteristics, treatment options, and prognosis of this condition is crucial for healthcare providers in delivering effective care to affected patients. Regular follow-up and monitoring are essential to manage this indolent yet potentially complex disease effectively.

Follicular lymphoma, classified under ICD-10 code C82.97, is a type of non-Hodgkin lymphoma that primarily affects the spleen. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for diagnosis and management. Below is a detailed overview of these aspects.

Clinical Presentation

Follicular lymphoma is characterized by the proliferation of B-lymphocytes, which can lead to various clinical manifestations. The disease often presents insidiously, and patients may remain asymptomatic for extended periods. When symptoms do occur, they can vary widely among individuals.

Signs and Symptoms

1. Lymphadenopathy:
   - Patients may present with painless swelling of lymph nodes, particularly in the cervical, axillary, or inguinal regions. In cases where the spleen is involved, splenomegaly (enlargement of the spleen) is common[1].

2. Splenomegaly:
   - As indicated by the ICD-10 code C82.97, involvement of the spleen is a hallmark of this lymphoma type. Patients may experience a feeling of fullness or discomfort in the abdomen due to splenic enlargement[1][2].

3. B Symptoms:
   - These include fever, night sweats, and unexplained weight loss. The presence of B symptoms can indicate a more aggressive disease course and may influence treatment decisions[2].

4. Fatigue:
   - Many patients report significant fatigue, which can be attributed to the disease itself or the body’s response to the malignancy[1].

5. Abdominal Pain or Discomfort:
   - Patients may experience abdominal pain or discomfort due to splenomegaly or lymphadenopathy affecting abdominal organs[2].

6. Cytopenias:
   - In some cases, patients may develop cytopenias (low blood cell counts) due to bone marrow infiltration, leading to symptoms such as easy bruising, bleeding, or increased susceptibility to infections[1].

Patient Characteristics

Demographics

• Age: Follicular lymphoma typically occurs in adults, with a median age of diagnosis around 60 years. It is relatively rare in younger populations[2].
• Gender: There is a slight male predominance in the incidence of follicular lymphoma, although it can affect individuals of any gender[1].

Risk Factors

• Family History: A family history of lymphoma or other hematologic malignancies may increase risk.
• Immune System Status: Patients with compromised immune systems, such as those with HIV/AIDS or those on immunosuppressive therapy, are at higher risk for developing lymphomas, including follicular lymphoma[2].
• Environmental Exposures: Certain environmental factors, such as exposure to pesticides or solvents, have been suggested as potential risk factors, although evidence is not definitive[1].

Comorbidities

Patients with follicular lymphoma may have other health conditions that can complicate management, including cardiovascular disease, diabetes, or other malignancies. These comorbidities can influence treatment choices and overall prognosis[2].

Conclusion

Follicular lymphoma, particularly when involving the spleen as indicated by ICD-10 code C82.97, presents with a range of clinical signs and symptoms, including lymphadenopathy, splenomegaly, and systemic B symptoms. Understanding the patient characteristics, including age, gender, and risk factors, is essential for effective diagnosis and treatment planning. Early recognition and management of symptoms can significantly impact patient outcomes and quality of life. For further evaluation and management, healthcare providers should consider a comprehensive approach that includes imaging studies and possibly biopsy to confirm the diagnosis and assess the extent of the disease.

ICD-10 code C82.97 refers to "Follicular lymphoma, unspecified, spleen." 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. Below are alternative names and related terms associated with this diagnosis.

Alternative Names for Follicular Lymphoma

1. Follicular Lymphoma, Unspecified: This is the direct alternative name for C82.97, indicating that the specific characteristics of the lymphoma are not detailed.
2. Follicular Lymphoma, Spleen Involvement: This term emphasizes the involvement of the spleen in the lymphoma process.
3. Indolent Non-Hodgkin Lymphoma: Follicular lymphoma is often classified as an indolent (slow-growing) form of non-Hodgkin lymphoma.
4. Low-Grade Lymphoma: Follicular lymphoma is sometimes referred to as low-grade lymphoma due to its typically slow progression.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): A broader category that includes various types of lymphomas, including follicular lymphoma.
2. Lymphoproliferative Disorders: This term encompasses a range of conditions, including lymphomas, where there is an abnormal proliferation of lymphocytes.
3. B-cell Lymphoma: Follicular lymphoma is a type of B-cell lymphoma, as it originates from B-lymphocytes.
4. Stage IV Lymphoma: If the follicular lymphoma has spread to the spleen, it may be classified as stage IV, indicating advanced disease.
5. Lymphoma with Splenic Involvement: This term is used to describe cases where the lymphoma has affected the spleen specifically.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82.97 is crucial for accurate diagnosis, treatment planning, and communication among healthcare professionals. These terms help in identifying the specific nature of the lymphoma and its implications for patient care. If you need further details or specific information regarding treatment or management of follicular lymphoma, feel free to ask!

Follicular lymphoma, classified under ICD-10 code C82.97, is a type of non-Hodgkin lymphoma that primarily affects the lymphatic system, particularly the follicles of lymph nodes. When diagnosing this condition, healthcare professionals utilize a combination of clinical evaluation, imaging studies, and laboratory tests. Below are the key criteria and methods used for diagnosis:

Clinical Evaluation

1. Patient History: A thorough medical history is essential. Physicians will inquire about symptoms such as:
   - Painless swelling of lymph nodes
   - Fatigue
   - Unexplained weight loss
   - Night sweats
   - Fever

2. Physical Examination: A physical exam will focus on the lymphatic system, checking for swollen lymph nodes in areas such as the neck, armpits, and groin, as well as examining the spleen and liver for enlargement.

Imaging Studies

1. CT Scans: Computed tomography (CT) scans of the chest, abdomen, and pelvis are commonly used to identify enlarged lymph nodes and assess the extent of the disease.

2. PET Scans: Positron emission tomography (PET) scans can help determine the metabolic activity of lymph nodes and distinguish between active lymphoma and other conditions.

3. Ultrasound: This imaging technique may be used to evaluate the spleen and other abdominal organs for enlargement or abnormalities.

Laboratory Tests

1. Biopsy: A definitive diagnosis of follicular lymphoma typically requires a biopsy of the affected lymph node or spleen. The biopsy can be:
   - 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. Histopathological Examination: The biopsy sample is examined under a microscope by a pathologist to identify characteristic features of follicular lymphoma, such as:
   - The presence of follicle-like structures
   - The predominance of small cleaved cells (centrocytes) and large cells (centroblasts)

3. Immunophenotyping: This test uses antibodies to identify specific markers on the surface of the lymphoma cells, confirming the diagnosis. Follicular lymphoma typically expresses CD10, CD19, and BCL2 proteins.

4. Cytogenetic Analysis: Testing for chromosomal abnormalities, particularly the t(14;18) translocation, is crucial as it is commonly associated with follicular lymphoma.

Staging

Once diagnosed, staging is performed to determine the extent of the disease, which is essential for treatment planning. 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.

Conclusion

The diagnosis of follicular lymphoma, unspecified, spleen (ICD-10 code C82.97), involves a comprehensive approach that includes clinical assessment, imaging studies, laboratory tests, and histopathological evaluation. Accurate diagnosis is critical for effective treatment and management of the disease, which may include options such as chemotherapy, radiation therapy, or targeted therapies. If you have further questions or need more specific information, feel free to ask!