ICD-10: C83.35

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma characterized by the rapid proliferation of large B-cells. It is one of the most common forms of lymphoma and can arise in various parts of the body, including lymph nodes, spleen, liver, bone marrow, and other tissues. The ICD-10 code C83.35 specifically refers to DLBCL located in the lymph nodes of the inguinal region and lower limb.

Clinical Description of C83.35

Definition and Characteristics

Diffuse large B-cell lymphoma is classified as an aggressive lymphoma, meaning it can grow and spread quickly if not treated. The "diffuse" aspect indicates that the cancer cells are spread throughout the lymphatic tissue rather than forming a distinct mass. This type of lymphoma is often diagnosed in adults and can present with various symptoms, including:

• Swollen lymph nodes: Patients may notice enlarged lymph nodes in the inguinal region (groin area) or other parts of the body.
• Fever: Unexplained fevers may occur, often accompanied by night sweats.
• Weight loss: Significant and unexplained weight loss can be a symptom.
• Fatigue: Patients often report feeling unusually tired or weak.

Diagnosis

Diagnosis of DLBCL typically involves a combination of clinical evaluation, imaging studies (such as CT scans), and biopsy of the affected lymph nodes. The biopsy is crucial for confirming the diagnosis and determining the specific subtype of DLBCL, which can influence treatment decisions.

Staging

The staging of DLBCL is essential for treatment planning and prognosis. The Ann Arbor staging system is commonly used, which considers the number of lymph node regions involved, the presence of systemic symptoms, and whether the disease has spread to other organs.

Treatment Options

Treatment for DLBCL often includes:

• Chemotherapy: The most common 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.
• Targeted therapies: Newer treatments, such as CAR T-cell therapy or monoclonal antibodies, may be considered, especially in relapsed cases.

Prognosis

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

Conclusion

ICD-10 code C83.35 specifically identifies diffuse large B-cell 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 crucial for effective management and care. Early diagnosis and appropriate treatment can significantly improve outcomes for patients with DLBCL.

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma characterized by the rapid proliferation of large B-cells. The clinical presentation, signs, symptoms, and patient characteristics associated with DLBCL, particularly when it involves the lymph nodes of the inguinal region and lower limb, are crucial for diagnosis and management.

Clinical Presentation

Signs and Symptoms

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

1. Local Symptoms:
   - Lymphadenopathy: The most common presentation is the enlargement of lymph nodes, particularly in the inguinal region and lower limb. Patients may notice a palpable mass or swelling in these areas[11][15].
   - Pain or Discomfort: Enlarged lymph nodes can cause localized pain or discomfort, especially if they compress surrounding structures[11].

2. Systemic Symptoms:
   - B Symptoms: These include fever, night sweats, and unexplained weight loss. The presence of B symptoms is significant as it may indicate a more aggressive disease[11][14].
   - Fatigue: Patients often report a general sense of fatigue or malaise, which can be debilitating[11][14].
   - Anorexia: Loss of appetite is common and can contribute to weight loss[11].

Patient Characteristics

DLBCL can affect individuals of various ages, but certain demographic trends are noted:

• Age: It is more commonly diagnosed in older adults, typically between the ages of 60 and 80, although it can occur in younger individuals as well[11][14].
• Gender: There is a slight male predominance in the incidence of DLBCL, with men being more frequently affected than women[11][14].
• Comorbidities: Patients may have underlying health conditions, such as autoimmune diseases or previous infections (e.g., HIV), which can influence the presentation and prognosis of the disease[11][14].

Diagnostic Considerations

The diagnosis of DLBCL typically involves a combination of clinical evaluation, imaging studies, and histopathological examination:

• Imaging: CT scans or PET scans are often utilized to assess the extent of lymphadenopathy and to identify any extranodal involvement[11][14].
• Biopsy: A definitive diagnosis is made through a biopsy of the affected lymph node, which is then examined histologically to confirm the presence of large B-cells[11][14].

Conclusion

Diffuse large B-cell lymphoma, particularly when affecting the lymph nodes of the inguinal region and lower limb, presents with a range of symptoms that can significantly impact a patient's quality of life. Recognizing the signs and symptoms, along with understanding patient demographics, is essential for timely diagnosis and effective management. Early intervention can improve outcomes, making awareness of this condition critical for healthcare providers.

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma characterized by the rapid growth of large B lymphocytes. The ICD-10 code C83.35 specifically refers to DLBCL located in the lymph nodes of the inguinal region and lower limb. Here are some alternative names and related terms associated with this condition:

Alternative Names

1. Diffuse Large B-Cell Lymphoma (DLBCL): This is the primary name for the condition, emphasizing its diffuse nature and the type of cells involved.
2. Large Cell Lymphoma: A broader term that can refer to various types of lymphomas characterized by large cells, including DLBCL.
3. B-Cell Lymphoma: This term highlights the origin of the lymphoma in B lymphocytes, which are a type of white blood cell.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): DLBCL is a subtype of non-Hodgkin lymphoma, which encompasses a diverse group of blood cancers that include all lymphomas except Hodgkin's lymphoma.
2. Lymphadenopathy: This term refers to the enlargement of lymph nodes, which is a common symptom in patients with DLBCL.
3. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas.
4. Inguinal Lymphadenopathy: Specifically refers to the enlargement of lymph nodes in the inguinal region, which can be associated with DLBCL.
5. Stage II Non-Hodgkin Lymphoma: If the lymphoma is localized to the inguinal region and lower limb, it may be classified as Stage II, depending on the extent of the disease.

Clinical Context

Understanding these terms is crucial for healthcare professionals involved in the diagnosis, treatment, and coding of DLBCL. Accurate coding using ICD-10 is essential for proper billing and epidemiological tracking of the disease. The specific code C83.35 helps in identifying cases of DLBCL that are localized to the lymph nodes in the inguinal region and lower limb, which can influence treatment decisions and prognosis.

In summary, the ICD-10 code C83.35 is associated with various alternative names and related terms that reflect the nature of the disease and its classification within the broader context of lymphomas.

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma characterized by the rapid growth of large B-cells in lymphoid tissues. The ICD-10 code C83.35 specifically refers to DLBCL located in the lymph nodes of the inguinal region and lower limb. The diagnosis of DLBCL involves several criteria, which can be categorized into clinical, histopathological, and imaging assessments.

Clinical Criteria

1. Symptoms: Patients may present with symptoms such as:
   - Painless swelling of lymph nodes, particularly in the inguinal region.
   - Systemic symptoms like fever, night sweats, and unexplained weight loss (often referred to as "B symptoms").
   - Fatigue and weakness.

2. Physical Examination: A thorough physical examination is essential to identify enlarged lymph nodes and any other signs of systemic involvement.

Histopathological Criteria

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

2. Histological Examination: The biopsy specimen is examined microscopically to identify:
   - Large atypical B-cells.
   - A diffuse pattern of growth.
   - Immunophenotyping to confirm the B-cell lineage, typically showing positive markers such as CD19, CD20, and CD79a.

3. Molecular Studies: Additional tests may include:
   - Fluorescence in situ hybridization (FISH) to detect chromosomal abnormalities, such as the MYC gene rearrangement.
   - PCR for specific gene rearrangements.

Imaging Studies

1. CT or PET Scans: Imaging studies are crucial for staging the disease and assessing the extent of lymph node involvement. These scans help determine:
   - The size and number of affected lymph nodes.
   - Any extranodal involvement, which is important for treatment planning.

2. Bone Marrow Biopsy: In some cases, a bone marrow biopsy may be performed to assess for bone marrow involvement, which can influence prognosis and treatment decisions.

Staging

The Ann Arbor staging system is commonly used to classify the extent of lymphoma. DLBCL can be staged from I (localized) to IV (widespread), with the involvement of lymph nodes in the inguinal region and lower limb being considered in the staging process.

Conclusion

The diagnosis of diffuse large B-cell lymphoma, particularly with the ICD-10 code C83.35, involves a combination of clinical evaluation, histopathological confirmation through biopsy, and imaging studies to assess the extent of the disease. Accurate diagnosis is critical for determining the appropriate treatment strategy and improving patient outcomes. If you have further questions or need more specific information, feel free to ask!

Diffuse large B-cell lymphoma (DLBCL), particularly when it involves lymph nodes in the inguinal region and lower limb, is a type of non-Hodgkin lymphoma that requires a comprehensive treatment approach. The standard treatment modalities for DLBCL typically include chemotherapy, immunotherapy, radiation therapy, and stem cell transplantation, depending on the stage of the disease and the patient's overall health.

1. Chemotherapy

R-CHOP Regimen

The most common first-line treatment for DLBCL is the R-CHOP regimen, which combines:
- Rituximab: A monoclonal antibody that targets CD20 on B-cells.
- Cyclophosphamide: An alkylating agent that interferes with DNA replication.
- Doxorubicin (Adriamycin): An anthracycline that disrupts DNA and RNA synthesis.
- Vincristine (Oncovin): A vinca alkaloid that inhibits cell division.
- Prednisone: A corticosteroid that helps reduce inflammation and suppress the immune response.

This combination is typically administered in cycles over several months, with the goal of achieving complete remission[1][2].

2. Immunotherapy

Monoclonal Antibodies

In addition to chemotherapy, monoclonal antibodies like Rituximab are often used to enhance the immune response against lymphoma cells. Newer agents, such as Monjuvi (tafasitamab-cxix), have also been approved for use in certain cases of DLBCL, particularly for patients who are not candidates for intensive chemotherapy[3][4].

3. Radiation Therapy

Radiation therapy may be employed in specific situations, particularly for localized disease or as a consolidation treatment after chemotherapy. It is often used to target residual disease in the lymph nodes of the inguinal region or lower limb, especially if there is a significant mass or if the lymphoma is bulky[5].

4. Stem Cell Transplantation

For patients with high-risk DLBCL or those who experience a relapse after initial treatment, autologous stem cell transplantation (ASCT) may be considered. This procedure involves harvesting the patient's own stem cells, administering high-dose chemotherapy to eradicate the lymphoma, and then reinfusing the stem cells to restore bone marrow function[6].

5. Clinical Trials

Patients with DLBCL may also have the option to participate in clinical trials, which can provide access to novel therapies and treatment strategies that are not yet widely available. These trials often explore new combinations of existing treatments or entirely new agents[7].

Conclusion

The treatment of diffuse large B-cell lymphoma, particularly when it involves the inguinal region and lower limb, is multifaceted and tailored to the individual patient. The R-CHOP regimen remains the cornerstone of therapy, supplemented by immunotherapy, radiation, and potentially stem cell transplantation for eligible patients. Ongoing research and clinical trials continue to evolve the treatment landscape, offering hope for improved outcomes in this aggressive form of lymphoma. For patients and healthcare providers, staying informed about the latest treatment options and clinical trials is crucial for optimizing care.