ICD-10: C83.30

Diffuse large B-cell lymphoma (DLBCL), classified under ICD-10 code C83.30, is a type of non-Hodgkin lymphoma characterized by the rapid growth of large B-cells. This condition is often referred to by various alternative names and related terms that reflect its clinical and pathological features. Below are some of the most common alternative names and related terms associated with DLBCL:

Alternative Names

1. Diffuse Large B-Cell Lymphoma (DLBCL): This is the most widely used term and is often abbreviated as DLBCL.
2. Large Cell Lymphoma: A general term that can refer to various types of lymphomas characterized by large cells, including DLBCL.
3. Non-Hodgkin Lymphoma, Diffuse Large B-Cell Type: This term emphasizes that DLBCL is a subtype of non-Hodgkin lymphoma.
4. B-Cell Lymphoma, Diffuse Large Cell Type: This name highlights the B-cell origin of the lymphoma.

Related Terms

1. B-Cell Lymphoma: A broader category that includes various types of lymphomas originating from B-cells, including DLBCL.
2. Aggressive Non-Hodgkin Lymphoma: DLBCL is often classified as an aggressive form of non-Hodgkin lymphoma due to its rapid progression.
3. Unspecified Site: This term indicates that the lymphoma is not localized to a specific anatomical site, which is a characteristic of the unspecified variant of DLBCL.
4. Lymphoma, Diffuse Large B-Cell, NOS (Not Otherwise Specified): This term is used in some contexts to denote cases that do not fit into more specific categories of DLBCL.

Clinical Context

DLBCL is the most common subtype of non-Hodgkin lymphoma, accounting for approximately 30% of all cases. It can arise in lymph nodes or extranodal sites, and its presentation can vary significantly among patients. The unspecified site designation in the ICD-10 code indicates that the lymphoma has not been localized to a specific area, which can complicate diagnosis and treatment.

Understanding these alternative names and related terms is crucial for healthcare professionals involved in the diagnosis, treatment, and coding of this condition, as it aids in ensuring accurate communication and documentation in clinical settings.

Diffuse large B-cell lymphoma (DLBCL) is a common type of non-Hodgkin lymphoma characterized by the rapid proliferation of large B-cells. The ICD-10 code C83.30 specifically refers to DLBCL that is classified as "unspecified site," meaning that the exact location of the lymphoma is not identified. The diagnosis of DLBCL involves several criteria, which can be categorized into clinical, histopathological, and immunophenotypic assessments.

Clinical Criteria

1. Symptoms: Patients often present with symptoms such as:
   - Painless lymphadenopathy (swelling of lymph nodes)
   - Fever
   - Night sweats
   - Unexplained weight loss
   - Fatigue

2. Physical Examination: A thorough physical examination is essential to identify lymphadenopathy or splenomegaly (enlargement of the spleen).

3. Imaging Studies: Imaging techniques such as CT scans or PET scans are utilized to assess the extent of the disease and to identify any lymph node involvement or extranodal sites.

Histopathological Criteria

1. Biopsy: A definitive diagnosis of DLBCL requires a biopsy of the affected lymph node or tissue. The biopsy can be:
   - Excisional (removal of an entire lymph node)
   - Incisional (removal of a portion of the lymph node)
   - Core needle biopsy

2. Microscopic Examination: The biopsy specimen is examined under a microscope by a pathologist. Key histological features include:
   - Presence of large atypical B-cells
   - A diffuse pattern of growth
   - High mitotic activity

3. Grading: DLBCL is typically classified as high-grade lymphoma due to its aggressive nature.

Immunophenotypic Criteria

1. Immunohistochemistry: This technique is used to determine the expression of specific markers on the surface of the lymphoma cells. Common markers include:
   - CD19
   - CD20
   - CD22
   - CD79a
   - BCL2 and BCL6 (to assess the presence of certain genetic alterations)

2. Genetic Testing: Additional tests, such as fluorescence in situ hybridization (FISH), may be performed to identify chromosomal abnormalities, such as the MYC gene rearrangement, which can influence prognosis and treatment decisions.

Conclusion

The diagnosis of diffuse large B-cell lymphoma, unspecified site (ICD-10 code C83.30), relies on a combination of clinical evaluation, histopathological examination, and immunophenotypic profiling. Accurate diagnosis is crucial for determining the appropriate treatment strategy, which may include chemotherapy, immunotherapy, or stem cell transplantation, depending on the stage and characteristics of the disease. For further information on treatment protocols and management strategies, healthcare professionals often refer to guidelines from organizations such as the National Comprehensive Cancer Network (NCCN) or the American Society of Clinical Oncology (ASCO) [1][2][3].

Diffuse Large B-Cell Lymphoma (DLBCL), classified under ICD-10 code C83.30, is a common and aggressive form of non-Hodgkin lymphoma. The treatment approaches for DLBCL are multifaceted and typically involve a combination of chemotherapy, immunotherapy, and sometimes radiation therapy. Below is a detailed overview of the standard treatment strategies for this condition.

Standard Treatment Approaches

1. Chemotherapy

The cornerstone of DLBCL treatment is chemotherapy, often administered in combination regimens. The most widely used regimen is R-CHOP, which includes:

• Rituximab: A monoclonal antibody targeting CD20 on B-cells.
• Cyclophosphamide: An alkylating agent that interferes with DNA replication.
• Doxorubicin (Adriamycin): An anthracycline antibiotic that disrupts DNA synthesis.
• Vincristine: A vinca alkaloid that inhibits cell division.
• Prednisone: A corticosteroid that helps reduce inflammation and suppress the immune response.

This regimen is typically administered every 21 days for six to eight cycles, depending on the patient's response and overall health status[1][2].

2. Immunotherapy

In addition to chemotherapy, immunotherapy plays a crucial role in treating DLBCL. Rituximab is a key component of the R-CHOP regimen, but other immunotherapeutic options may be considered, especially in relapsed or refractory cases. These include:

• CAR T-cell therapy: This involves modifying a patient’s T-cells to better recognize and attack lymphoma cells. It is particularly effective for patients who do not respond to standard treatments.
• Polatuzumab vedotin: An antibody-drug conjugate that targets CD79b, used in combination with other agents for relapsed DLBCL[3].

3. Radiation Therapy

Radiation therapy may be utilized in specific scenarios, particularly for localized disease or as a consolidation treatment after chemotherapy. It is less common in the initial treatment of DLBCL but can be effective in certain cases, such as when there is a bulky mass or residual disease after chemotherapy[4].

4. Stem Cell Transplantation

For patients with high-risk or relapsed DLBCL, autologous stem cell transplantation may be considered. This procedure involves harvesting the patient’s stem cells, administering high-dose chemotherapy to eradicate the lymphoma, and then reinfusing the stem cells to restore bone marrow function. This approach is typically reserved for younger patients or those with good performance status[5].

5. Clinical Trials

Patients with DLBCL may also have the option to participate in clinical trials, which can provide access to new therapies and treatment strategies that are not yet widely available. These trials often explore novel agents, combinations, or treatment approaches that may improve outcomes for patients with DLBCL[6].

Conclusion

The treatment of Diffuse Large B-Cell Lymphoma (ICD-10 code C83.30) is primarily based on a combination of chemotherapy and immunotherapy, with additional options like radiation therapy and stem cell transplantation available for specific patient populations. The choice of treatment is influenced by various factors, including the patient's age, overall health, and specific characteristics of the lymphoma. Ongoing research and clinical trials continue to evolve the treatment landscape, offering hope for improved outcomes in this aggressive disease.

For patients diagnosed with DLBCL, it is crucial to discuss treatment options with a healthcare provider to determine the most appropriate strategy tailored to their individual needs.

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma characterized by the rapid proliferation of large B-cells. The ICD-10-CM code C83.30 specifically refers to DLBCL when the site of the lymphoma is unspecified. Below is a detailed clinical description and relevant information regarding this diagnosis.

Clinical Description of Diffuse Large B-Cell Lymphoma

Overview

Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma, accounting for approximately 30% of all cases. It typically presents as an aggressive disease, often requiring prompt diagnosis and treatment. DLBCL can arise in lymph nodes or extranodal sites, including the gastrointestinal tract, skin, and central nervous system.

Symptoms

Patients with DLBCL may exhibit a variety of symptoms, which can include:
- Lymphadenopathy: Swelling of lymph nodes, often painless.
- B symptoms: These include fever, night sweats, and unexplained weight loss.
- Fatigue: Generalized weakness and tiredness.
- Extranodal involvement: Symptoms may vary depending on the site of involvement, such as abdominal pain for gastrointestinal DLBCL or neurological symptoms for central nervous system involvement.

Diagnosis

The diagnosis of DLBCL typically involves:
- Histopathological examination: A biopsy of the affected tissue is essential for confirming the diagnosis. The tissue is examined microscopically to identify the presence of large B-cells.
- Immunophenotyping: This process helps to classify the lymphoma based on the specific markers present on the surface of the cancer cells.
- Imaging studies: CT scans, PET scans, or MRI may be used to assess the extent of the disease and to identify any extranodal involvement.

Treatment

Treatment for DLBCL often includes:
- Chemotherapy: The standard treatment regimen is R-CHOP, which combines rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone.
- Radiation therapy: This may be used in localized cases or as a consolidation treatment after chemotherapy.
- Stem cell transplant: In cases of relapsed or refractory DLBCL, high-dose chemotherapy followed by autologous stem cell transplant may be considered.

Prognosis

The prognosis for patients with DLBCL varies based on several factors, including the stage of the disease at diagnosis, the patient's age, and overall health. The International Prognostic Index (IPI) is often used to assess risk and guide treatment decisions.

Conclusion

ICD-10 code C83.30 is designated for diffuse large B-cell lymphoma when the specific site of the lymphoma is not specified. Understanding the clinical features, diagnostic criteria, and treatment options for DLBCL is crucial for effective management and improving patient outcomes. Early detection and appropriate treatment are key to enhancing survival rates in patients diagnosed with this aggressive form of lymphoma.

Diffuse large B-cell lymphoma (DLBCL), classified under ICD-10 code C83.30, is a common and aggressive form of non-Hodgkin lymphoma. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for timely diagnosis and management.

Clinical Presentation

Overview of DLBCL

DLBCL is characterized by the proliferation of large B-cells in lymphoid tissues, leading to a variety of clinical manifestations. It can arise in lymph nodes or extranodal sites, and its presentation can vary significantly among patients. The disease is often aggressive, necessitating prompt diagnosis and treatment.

Common Signs and Symptoms

Patients with DLBCL may present with a range of symptoms, which can be broadly categorized into local and systemic manifestations:

Local Symptoms

• Lymphadenopathy: The most common presentation is painless swelling of lymph nodes, particularly in the neck, axilla, or groin. This can be unilateral or bilateral[1].
• Extranodal Involvement: DLBCL can also present in extranodal sites such as the gastrointestinal tract, skin, or central nervous system, leading to site-specific symptoms (e.g., abdominal pain, skin lesions, neurological deficits) depending on the location of the lymphoma[2].

Systemic Symptoms

• B Symptoms: These include fever, night sweats, and unexplained weight loss (typically more than 10% of body weight over six months). The presence of B symptoms is associated with a poorer prognosis[3].
• Fatigue: Many patients report significant fatigue, which can be debilitating and affect quality of life[4].
• Anemia: Patients may also present with anemia, which can contribute to fatigue and weakness[5].

Patient Characteristics

Demographics

• Age: DLBCL can occur at any age but is most commonly diagnosed in adults, particularly those aged 60 and older. The incidence increases with age, making it a significant concern in the geriatric population[6].
• Gender: There is a slight male predominance in DLBCL cases, with men being more frequently affected than women[7].

Risk Factors

Several risk factors have been identified that may increase the likelihood of developing DLBCL:
- Immunosuppression: Patients with compromised immune systems, such as those with HIV/AIDS or those undergoing immunosuppressive therapy, are at higher risk[8].
- Autoimmune Diseases: Conditions like rheumatoid arthritis or Sjögren's syndrome have been associated with an increased risk of lymphoma[9].
- Family History: A family history of lymphoma or other hematologic malignancies may also contribute to risk[10].

Comorbidities

Patients with DLBCL often present with comorbid conditions, particularly in older adults. Common comorbidities include cardiovascular diseases, diabetes, and chronic kidney disease, which can complicate treatment and affect overall prognosis[11].

Conclusion

Diffuse large B-cell lymphoma (ICD-10 code C83.30) presents with a variety of clinical signs and symptoms, primarily characterized by lymphadenopathy and systemic B symptoms. The demographic profile typically includes older adults, with a slight male predominance. Understanding these characteristics is essential for healthcare providers to facilitate early diagnosis and appropriate management of this aggressive lymphoma. Early intervention can significantly impact patient outcomes, making awareness of the clinical presentation and associated risk factors vital in clinical practice.