ICD-10: C83.38

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma characterized by the rapid proliferation of large B lymphocytes. It is one of the most common forms of lymphoma, accounting for a significant percentage of all non-Hodgkin lymphoma cases. The ICD-10 code C83.38 specifically refers to DLBCL affecting lymph nodes at multiple sites.

Clinical Description of Diffuse Large B-Cell Lymphoma

Pathophysiology

DLBCL arises from the transformation of B cells, which are a type of white blood cell involved in the immune response. The disease is marked by the presence of large, atypical lymphoid cells in lymphoid tissues, particularly lymph nodes. The exact cause of DLBCL is not fully understood, but it is associated with various risk factors, including age, immunosuppression, and certain infections, such as Epstein-Barr virus (EBV) and hepatitis C virus (HCV) [1].

Symptoms

Patients with DLBCL may present with a range of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, which may be painless and can occur in multiple regions of the body.
- B symptoms: These include fever, night sweats, and unexplained weight loss, which are indicative of systemic involvement.
- Fatigue: A common complaint among patients due to the disease's impact on overall health.
- Abdominal discomfort: If lymph nodes in the abdomen are affected, patients may experience pain or fullness.

Diagnosis

Diagnosis of DLBCL typically involves:
- Histopathological examination: A biopsy of the affected lymph nodes is essential for confirming the diagnosis. The tissue is examined microscopically to identify the characteristic large B cells.
- Immunophenotyping: This process helps determine the specific type of lymphoma by analyzing the proteins expressed on the surface of the cells.
- Imaging studies: CT scans or PET scans are often used to assess the extent of the disease and to identify affected lymph nodes in multiple sites.

ICD-10 Code C83.38 Details

Code Definition

The ICD-10 code C83.38 is defined as "Diffuse large B-cell lymphoma, lymph nodes of multiple sites." This classification indicates that the lymphoma is not localized to a single lymph node but rather involves multiple lymphatic regions, which can complicate treatment and prognosis [2].

Treatment Options

Treatment for DLBCL typically involves:
- Chemotherapy: The most common regimen is R-CHOP, which includes rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone.
- Radiation therapy: This may be used in conjunction with chemotherapy, especially if there are localized areas of disease.
- Stem cell transplant: In cases of relapsed or refractory DLBCL, high-dose chemotherapy followed by autologous stem cell transplantation may be considered.

Prognosis

The prognosis for patients with DLBCL can vary widely 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 C83.38 captures the complexity of diffuse large B-cell lymphoma affecting multiple lymph node sites. Understanding the clinical presentation, diagnostic criteria, and treatment options is crucial for effective management of this aggressive lymphoma. Early diagnosis and appropriate treatment can significantly improve patient outcomes, making awareness of the symptoms and risk factors essential for timely intervention [3].

References

1. Pathophysiology of DLBCL and associated risk factors.
2. ICD-10 classification and definitions for lymphoma types.
3. Treatment protocols and prognosis for DLBCL patients.

Diffuse Large B-Cell Lymphoma (DLBCL) is a common and aggressive form of non-Hodgkin lymphoma characterized by the proliferation of large B lymphocytes. The ICD-10 code C83.38 specifically refers to DLBCL affecting lymph nodes at multiple sites. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and management.

Clinical Presentation

Signs and Symptoms

Patients with DLBCL often present with a variety of symptoms, which can vary based on the extent of the disease and the specific sites involved. Common signs and symptoms include:

• Lymphadenopathy: The most prominent feature is the enlargement of lymph nodes, which may be painless and can occur in multiple regions, including the neck, axilla, and groin[1].
• B Symptoms: These systemic symptoms include:
• Fever: Often intermittent and may be associated with night sweats.
• Weight Loss: Unintentional weight loss exceeding 10% of body weight over six months.
• Night Sweats: Profuse sweating during the night that may soak clothing and bedding[1][2].
• Fatigue: Patients frequently report a general sense of tiredness or lack of energy, which can be debilitating[1].
• Abdominal Symptoms: If lymph nodes in the abdomen are involved, patients may experience abdominal pain, fullness, or discomfort due to organ compression[2].
• Respiratory Symptoms: Involvement of mediastinal lymph nodes can lead to cough, shortness of breath, or chest pain[1].

Patient Characteristics

DLBCL can affect individuals of any age, but certain demographic factors are associated with its incidence:

• Age: The median age at diagnosis is around 65 years, with a higher prevalence in older adults. However, it can also occur in younger individuals[2].
• Gender: There is a slight male predominance, with men being more frequently diagnosed than women[1].
• Comorbidities: Patients with immunocompromised states, such as those with HIV/AIDS or those undergoing immunosuppressive therapy, are at increased risk for developing DLBCL[2].
• Ethnicity: Some studies suggest variations in incidence based on ethnicity, with higher rates observed in certain populations[1].

Diagnosis and Evaluation

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[2].
• 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[1].
• Staging: The Ann Arbor staging system is commonly used to determine the extent of the disease, which is crucial for treatment planning[2].

Conclusion

Diffuse Large B-Cell Lymphoma, particularly when affecting multiple lymph node sites, presents with a range of clinical symptoms that can significantly impact a patient's quality of life. Early recognition of the signs and symptoms, along with an understanding of patient characteristics, is essential for effective management. Given the aggressive nature of DLBCL, timely diagnosis and initiation of treatment are critical to improving patient outcomes. If you suspect DLBCL based on these clinical features, further evaluation and referral to a specialist are recommended for comprehensive care.

Diffuse large B-cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma characterized by the rapid growth of large B-cells in lymph nodes and other tissues. The ICD-10 code C83.38 specifically refers to DLBCL affecting lymph nodes at multiple sites. Here are some alternative names and related terms associated with this condition:

Alternative Names

1. Large Cell Lymphoma: A general term that can refer to various types of lymphomas characterized by large cells, including DLBCL.
2. Diffuse B-cell Lymphoma: A more specific term that emphasizes the diffuse nature of the lymphoma and its B-cell origin.
3. High-Grade B-cell Lymphoma: This term is often used to describe aggressive forms of B-cell lymphomas, including DLBCL.
4. B-cell Non-Hodgkin Lymphoma: A broader category that includes DLBCL and other types of B-cell lymphomas.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): DLBCL is a subtype of non-Hodgkin lymphoma, which encompasses a diverse group of blood cancers.
2. Lymphadenopathy: 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, including both Hodgkin and non-Hodgkin lymphomas.
4. Stage IV Lymphoma: DLBCL can be classified as stage IV when it has spread to multiple lymph node regions or other organs.
5. Chemotherapy Regimens: Treatments for DLBCL often include specific chemotherapy regimens, such as R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone).

Conclusion

Understanding the alternative names and related terms for ICD-10 code C83.38 is essential for healthcare professionals, researchers, and patients alike. These terms help in accurately identifying and discussing the condition, facilitating better communication and treatment planning. If you need further information on treatment options or prognosis related to DLBCL, feel free to ask!

Diffuse large B-cell lymphoma (DLBCL), classified under ICD-10 code C83.38, is a type of non-Hodgkin lymphoma characterized by the rapid proliferation of large B-cells. Diagnosing DLBCL involves a combination of clinical evaluation, imaging studies, and histopathological examination. Below are the key criteria and steps typically used in the diagnosis of DLBCL.

Clinical Presentation

Symptoms

Patients with DLBCL may present with a variety of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, often in multiple regions (cervical, axillary, or inguinal).
- B symptoms: These include fever, night sweats, and unexplained weight loss, which can indicate more aggressive disease.
- Fatigue: Generalized weakness or fatigue is common.
- Abdominal symptoms: If lymph nodes in the abdomen are involved, patients may experience abdominal pain or fullness.

Diagnostic Criteria

1. Histopathological Examination

The definitive diagnosis of DLBCL is made through a biopsy of the affected lymph node or tissue. The following histological features are typically assessed:
- Cell Size and Morphology: The presence of large atypical B-cells.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to identify specific markers, such as CD19, CD20, CD22, and CD79a, which are characteristic of B-cell lineage.
- Genetic Studies: Molecular tests may be performed to identify chromosomal abnormalities, such as the presence of the BCL2 or BCL6 gene rearrangements, which are associated with DLBCL.

2. Imaging Studies

Imaging techniques are crucial for staging and assessing the extent of the disease:
- CT Scans: Computed tomography scans of the chest, abdomen, and pelvis help identify enlarged lymph nodes and any extranodal involvement.
- PET Scans: Positron emission tomography scans can assess metabolic activity and help differentiate between active disease and residual masses post-treatment.

3. Laboratory Tests

• Blood Tests: Complete blood count (CBC) may reveal anemia or thrombocytopenia. Lactate dehydrogenase (LDH) levels can be elevated in cases of aggressive lymphoma and are used as a prognostic indicator.
• Bone Marrow Biopsy: This may be performed to assess for bone marrow involvement, which can influence treatment decisions.

Staging

The Ann Arbor staging system is commonly used to classify the extent of DLBCL:
- Stage I: Involvement of a single lymph node region.
- Stage II: Involvement of two or more lymph node regions on the same side of the diaphragm.
- Stage III: Involvement of lymph node regions on both sides of the diaphragm.
- Stage IV: Disseminated involvement of one or more extranodal sites.

Conclusion

The diagnosis of diffuse large B-cell lymphoma (ICD-10 code C83.38) is a multifaceted process that relies on clinical evaluation, histopathological confirmation, imaging studies, and laboratory tests. Accurate diagnosis is essential for determining the appropriate treatment strategy and prognosis. If you suspect DLBCL or have further questions about the diagnostic process, consulting a healthcare professional or a hematologist is advisable for personalized guidance and management.

Diffuse Large B-Cell Lymphoma (DLBCL), classified under ICD-10 code C83.38, is a common and aggressive form of non-Hodgkin lymphoma that primarily affects B lymphocytes. The treatment for DLBCL typically involves a combination of chemotherapy, immunotherapy, and sometimes radiation therapy, depending on the stage of the disease and the patient's overall health. Below is a detailed overview of the standard treatment approaches for this condition.

Standard Treatment Approaches

1. Chemotherapy

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

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

This regimen is typically administered in cycles over several months, with the exact number of cycles depending on the patient's response and specific clinical factors[1][2].

2. Immunotherapy

In addition to chemotherapy, immunotherapy plays a crucial role in the treatment of DLBCL. Rituximab is often used in conjunction with chemotherapy, enhancing the effectiveness of the treatment by targeting malignant B cells directly. For patients with relapsed or refractory DLBCL, other immunotherapeutic agents such as Monjuvi (tafasitamab-cxix) may be considered. Tafasitamab is a monoclonal antibody that targets CD19, another protein found on B cells, and is used in combination with lenalidomide for patients who have not responded to prior therapies[3][4].

3. Radiation Therapy

Radiation therapy may be utilized in specific scenarios, particularly for localized disease or as a consolidation treatment after chemotherapy. It is generally not the primary treatment for DLBCL but can be effective in managing localized disease or residual masses following chemotherapy[5].

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 own 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 a good performance status[6].

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 may involve novel agents, combination therapies, or different treatment protocols aimed at improving outcomes for patients with DLBCL[7].

Conclusion

The treatment of Diffuse Large B-Cell Lymphoma (ICD-10 code C83.38) is multifaceted, involving chemotherapy, immunotherapy, and potentially radiation therapy or stem cell transplantation. The choice of treatment is tailored to the individual patient based on various factors, including the stage of the disease, the presence of specific biomarkers, and the patient's overall health. Ongoing research and clinical trials continue to evolve the treatment landscape, offering hope for improved outcomes in this aggressive lymphoma subtype.

For patients and healthcare providers, staying informed about the latest treatment options and clinical trials is essential for optimizing care and improving survival rates in DLBCL[8].