ICD-10: C83.82

ICD-10 code C83.82 refers to "Other non-follicular lymphoma, intrathoracic lymph nodes." This classification falls under the broader category of non-Hodgkin lymphoma (NHL), which encompasses a diverse group of blood cancers that originate in the lymphatic system. Below is a detailed clinical description and relevant information regarding this specific code.

Clinical Description

Definition

Non-follicular lymphoma is a type of non-Hodgkin lymphoma that does not arise from follicle center (germinal center) B-cells. Instead, it includes various subtypes of lymphomas that can exhibit different histological features and clinical behaviors. The designation "other" indicates that the lymphoma does not fit into the more commonly recognized categories, such as diffuse large B-cell lymphoma or mantle cell lymphoma.

Intrathoracic Lymph Nodes

The term "intrathoracic lymph nodes" refers to lymph nodes located within the thoracic cavity, which includes the mediastinum (the area between the lungs) and the pleural cavities. Lymphoma affecting these nodes can lead to various symptoms, including:

• Respiratory Issues: Due to compression of the airways or lungs.
• Chest Pain: Resulting from lymph node enlargement.
• Cough: Often persistent and may be associated with other respiratory symptoms.
• Systemic Symptoms: Such as fever, night sweats, and weight loss, which are common in lymphoproliferative disorders.

Diagnosis

Diagnosis of non-follicular lymphoma typically involves a combination of clinical evaluation, imaging studies (such as CT scans), and histopathological examination of lymph node biopsies. Flow cytometry and immunohistochemistry are often employed to characterize the specific type of lymphoma and guide treatment decisions.

Treatment

Treatment options for non-follicular lymphoma may include:

• Chemotherapy: Often the first line of treatment, depending on the specific subtype and stage of the disease.
• Radiation Therapy: May be used in localized cases or as a palliative measure.
• Targeted Therapy: Such as monoclonal antibodies (e.g., Rituximab) or newer agents tailored to specific lymphoma subtypes.
• Stem Cell Transplantation: Considered in cases of relapsed or refractory disease.

Coding and Documentation

When documenting cases of non-follicular lymphoma affecting intrathoracic lymph nodes, it is crucial to provide comprehensive clinical details, including:

• Histological Type: Specify the subtype of non-follicular lymphoma if known.
• Location: Clearly indicate that the involvement is in the intrathoracic lymph nodes.
• Stage of Disease: Document any relevant staging information, as this can impact treatment decisions and prognosis.

Conclusion

ICD-10 code C83.82 is essential for accurately coding and billing for cases of other non-follicular lymphoma affecting intrathoracic lymph nodes. Understanding the clinical implications, diagnostic criteria, and treatment options associated with this code is vital for healthcare providers involved in the management of patients with lymphoma. Proper documentation and coding ensure appropriate patient care and facilitate effective communication among healthcare professionals.

When addressing the standard treatment approaches for ICD-10 code C83.82, which refers to "Other non-follicular lymphoma, intrathoracic lymph nodes," it is essential to understand the nature of non-follicular lymphomas and the specific considerations for treatment based on the disease's characteristics and patient factors.

Overview of Non-Follicular Lymphoma

Non-follicular lymphomas encompass a variety of lymphoproliferative disorders that do not originate from follicle center (germinal center) B-cells. This category includes several subtypes, such as diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, and others. The treatment approach can vary significantly depending on the specific subtype, stage of the disease, and the patient's overall health.

Standard Treatment Approaches

1. Chemotherapy

Chemotherapy remains a cornerstone of treatment for many types of non-follicular lymphomas. The most commonly used regimens include:

• R-CHOP: This regimen combines Rituximab (a monoclonal antibody) with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. R-CHOP is particularly effective for DLBCL and is often the first-line treatment for patients with advanced-stage disease[1].
• Other Regimens: Depending on the specific subtype and patient factors, other chemotherapy regimens may be employed, such as EPOCH (Etoposide, Prednisone, Oncovin, Cyclophosphamide, and Doxorubicin) for aggressive lymphomas[2].

2. Targeted Therapy

Targeted therapies have become increasingly important in the management of non-follicular lymphomas. For instance:

• Ibrutinib (Imbruvica): This Bruton's tyrosine kinase inhibitor is used for certain types of non-follicular lymphomas, particularly mantle cell lymphoma. It works by disrupting the signaling pathways that promote cancer cell survival and proliferation[3].
• Other Agents: Other targeted therapies may include agents like Venetoclax, which is used in specific cases of chronic lymphocytic leukemia and some non-Hodgkin lymphomas[4].

3. Radiation Therapy

Radiation therapy can be an effective treatment modality, particularly for localized disease or as a consolidation treatment after chemotherapy. It may be used in the following scenarios:

• Localized Disease: If the lymphoma is confined to a specific area, such as intrathoracic lymph nodes, radiation therapy may be employed to target those nodes directly[5].
• Palliative Care: In cases where the disease is advanced and symptomatic, radiation can help alleviate symptoms by reducing tumor burden[6].

4. Stem Cell Transplantation

For patients with aggressive non-follicular lymphomas who do not respond adequately to initial therapy, autologous stem cell transplantation may be considered. This approach involves:

• High-Dose Chemotherapy: Patients receive high doses of chemotherapy to eradicate the lymphoma, followed by the infusion of their own previously harvested stem cells to restore bone marrow function[7].
• Allogeneic Transplantation: In some cases, a donor's stem cells may be used, particularly for patients with relapsed or refractory disease[8].

5. Clinical Trials

Participation in clinical trials can provide access to novel therapies and treatment strategies that are not yet widely available. Patients are encouraged to discuss potential clinical trial options with their healthcare providers, as these may offer promising alternatives to standard treatments[9].

Conclusion

The treatment of non-follicular lymphoma, particularly when involving intrathoracic lymph nodes, is multifaceted and tailored to the individual patient. Standard approaches typically include chemotherapy, targeted therapies, radiation, and potentially stem cell transplantation, depending on the specific characteristics of the lymphoma and the patient's overall health. Ongoing research and clinical trials continue to evolve the landscape of treatment options, providing hope for improved outcomes in this patient population. For personalized treatment plans, consultation with a hematologist or oncologist specializing in lymphomas is essential.

References

1. [Chemotherapy regimens for DLBCL]
2. [EPOCH regimen details]
3. [Ibrutinib in mantle cell lymphoma]
4. [Venetoclax usage in lymphomas]
5. [Radiation therapy for localized lymphoma]
6. [Palliative radiation therapy]
7. [Autologous stem cell transplantation]
8. [Allogeneic transplantation considerations]
9. [Clinical trials for lymphoma treatments]

The ICD-10 code C83.82 refers to "Other non-follicular lymphoma, intrathoracic lymph nodes." This classification encompasses a variety of lymphomas that do not fall under the more common follicular lymphoma category. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this diagnosis is crucial for effective management and treatment.

Clinical Presentation

Overview of Non-Follicular Lymphoma

Non-follicular lymphomas are a diverse group of hematological malignancies that can arise from various types of lymphoid tissue. They are characterized by their aggressive nature and can present in various anatomical locations, including the intrathoracic region, which includes the mediastinum and the lungs.

Intrathoracic Lymph Nodes

When lymphomas involve intrathoracic lymph nodes, they may present with specific symptoms related to the location and extent of the disease. The intrathoracic lymph nodes are critical in the immune response and can become enlarged due to malignancy, leading to various clinical manifestations.

Signs and Symptoms

Common Symptoms

Patients with C83.82 may exhibit a range of symptoms, which can vary based on the extent of the disease and the specific lymph nodes involved. Common symptoms include:

• Lymphadenopathy: Swelling of lymph nodes, particularly in the neck, armpits, or groin, may be observed. In cases of intrathoracic involvement, mediastinal lymphadenopathy can lead to respiratory symptoms.
• Respiratory Symptoms: Patients may experience cough, shortness of breath, or chest pain due to compression of the airways or lungs by enlarged lymph nodes.
• Systemic Symptoms: Fever, night sweats, and unexplained weight loss are often reported, indicating a systemic response to the malignancy.
• Fatigue: A common complaint among patients, often due to the cancer's metabolic demands and the body's response to the disease.

Specific Signs

• Pleural Effusion: Accumulation of fluid in the pleural space may occur, leading to further respiratory distress.
• Superior Vena Cava Syndrome: In cases where lymph nodes compress the superior vena cava, patients may present with facial swelling, distended neck veins, and upper extremity edema.

Patient Characteristics

Demographics

• Age: Non-follicular lymphomas, including those classified under C83.82, can occur in adults of various ages, but they are more commonly diagnosed in middle-aged and older adults.
• Gender: There may be a slight male predominance in certain types of non-follicular lymphomas.

Risk Factors

• Immunosuppression: Patients with compromised immune systems, such as those with HIV/AIDS or those on immunosuppressive therapy, are at increased risk for developing lymphomas.
• Environmental Exposures: Certain environmental factors, including exposure to pesticides or chemicals, may contribute to the risk of developing lymphomas.
• Family History: A family history of lymphoproliferative disorders may increase the likelihood of developing non-follicular lymphoma.

Conclusion

The clinical presentation of C83.82: Other non-follicular lymphoma, intrathoracic lymph nodes, is characterized by a combination of local and systemic symptoms, with lymphadenopathy and respiratory issues being prominent. Understanding these signs and patient characteristics is essential for timely diagnosis and management. Clinicians should remain vigilant for these symptoms, especially in at-risk populations, to facilitate early intervention and improve patient outcomes.

ICD-10 code C83.82 refers specifically to "Other non-follicular lymphoma, intrathoracic lymph nodes." This classification falls under the broader category of non-Hodgkin lymphoma (NHL), which encompasses various types of lymphomas that do not originate from follicular (B-cell) lymphoid tissue. Below are alternative names and related terms associated with this specific code:

Alternative Names

1. Non-follicular Non-Hodgkin Lymphoma: This term emphasizes that the lymphoma is not of the follicular type, which is a common subtype of NHL.
2. Intrathoracic Lymphoma: This name highlights the location of the lymphoma, indicating that it is situated within the thoracic cavity, which includes the chest area.
3. Other Types of Non-Hodgkin Lymphoma: This phrase can be used to describe various non-follicular lymphomas that do not fit into more specific categories.

Related Terms

1. Lymphadenopathy: This term refers to the enlargement of lymph nodes, which can occur in various types of lymphoma, including non-follicular types.
2. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas.
3. Stage IV Lymphoma: If the lymphoma has spread to the intrathoracic lymph nodes, it may be classified as stage IV, indicating advanced disease.
4. B-cell Lymphoma: Many non-follicular lymphomas are of B-cell origin, which is a type of white blood cell involved in the immune response.
5. Peripheral T-cell Lymphoma: This is another category of non-Hodgkin lymphoma that may be related, particularly if the lymphoma is of T-cell origin rather than B-cell.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals involved in the diagnosis, treatment, and coding of lymphomas. Accurate coding is essential for proper billing and insurance purposes, as well as for tracking epidemiological data related to cancer types and their treatment outcomes.

In summary, ICD-10 code C83.82 encompasses a specific type of lymphoma that is not follicular and is located in the intrathoracic lymph nodes, with various alternative names and related terms that help clarify its classification and clinical implications.

The diagnosis of ICD-10 code C83.82, which refers to "Other non-follicular lymphoma, intrathoracic lymph nodes," involves a comprehensive evaluation based on clinical, radiological, and histopathological criteria. Below is a detailed overview of the criteria typically used for diagnosing this specific type of lymphoma.

Clinical Evaluation

Symptoms

Patients may present with a variety of symptoms that can suggest the presence of lymphoma, including:
- Lymphadenopathy: Swelling of lymph nodes, particularly in the thoracic region.
- Respiratory Symptoms: Cough, shortness of breath, or chest pain due to lymph node enlargement affecting the lungs or mediastinum.
- Systemic Symptoms: Fever, night sweats, and unexplained weight loss, which are often referred to as "B symptoms."

Medical History

A thorough medical history is essential, including:
- Previous history of lymphoproliferative disorders.
- Family history of lymphoma or other malignancies.
- Exposure to risk factors such as certain infections (e.g., Epstein-Barr virus) or environmental toxins.

Radiological Assessment

Imaging Studies

Imaging techniques play a crucial role in identifying and characterizing lymphomas:
- Chest X-ray: Initial imaging to detect enlarged lymph nodes or masses in the thoracic cavity.
- CT Scan: A more detailed assessment to evaluate the size, location, and extent of lymphadenopathy, particularly in the mediastinum and hilum of the lungs.
- PET Scan: Positron emission tomography can help assess metabolic activity of the lymph nodes, distinguishing between benign and malignant processes.

Histopathological Examination

Biopsy

A definitive diagnosis of non-follicular lymphoma requires histological confirmation through:
- Excisional Biopsy: Removal of an entire lymph node for examination.
- Core Needle Biopsy: Less invasive option that can provide sufficient tissue for diagnosis.
- Fine Needle Aspiration (FNA): May be used for cytological evaluation, but is less definitive than excisional or core biopsies.

Immunophenotyping

Histopathological analysis includes:
- Immunohistochemistry: Identifying specific markers on the lymphoma cells to differentiate between various types of non-Hodgkin lymphoma (NHL). For instance, markers such as CD20, CD5, and others can help classify the lymphoma subtype.
- Molecular Studies: Genetic testing may be performed to identify specific chromosomal abnormalities associated with certain types of lymphoma.

Differential Diagnosis

Exclusion of Other Conditions

It is essential to rule out other conditions that may mimic lymphoma, such as:
- Infectious Processes: Tuberculosis, sarcoidosis, or other granulomatous diseases.
- Other Malignancies: Metastatic disease from other primary cancers.
- Benign Lymphadenopathy: Reactive lymphadenopathy due to infections or autoimmune diseases.

Conclusion

The diagnosis of ICD-10 code C83.82 involves a multifaceted approach that includes clinical evaluation, imaging studies, and histopathological examination. Accurate diagnosis is critical for determining the appropriate treatment plan and prognosis for patients with non-follicular lymphoma affecting intrathoracic lymph nodes. If you have further questions or need more specific information, feel free to ask!