ICD-10: C83.83

ICD-10 code C83.83 refers to "Other non-follicular lymphoma, intra-abdominal 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 lymphoma that does not arise from follicle center (germinal center) B-cells, which are typically involved in follicular lymphoma. Instead, these lymphomas can originate from various types of lymphoid tissue, including T-cells and other B-cell lineages. The designation "other" indicates that the lymphoma does not fit into the more commonly recognized subtypes, such as diffuse large B-cell lymphoma or peripheral T-cell lymphoma.

Intra-abdominal Lymph Nodes

The term "intra-abdominal lymph nodes" refers to lymph nodes located within the abdominal cavity. These nodes play a crucial role in the immune response and can be sites for lymphoma involvement. When lymphoma affects these nodes, it may lead to various symptoms, including abdominal pain, swelling, or discomfort, and can be associated with systemic symptoms such as fever, night sweats, and weight loss.

Clinical Features

Symptoms

Patients with C83.83 may present with:
- Abdominal pain or discomfort
- Swelling or a palpable mass in the abdomen
- Systemic symptoms like fever, night sweats, and unexplained weight loss
- Lymphadenopathy in other regions, depending on the extent of the disease

Diagnosis

Diagnosis typically involves:
- Imaging studies (CT scans, MRI) to identify enlarged lymph nodes
- Biopsy of affected lymph nodes to confirm the histological type of lymphoma
- Flow cytometry and immunohistochemistry to characterize the lymphoma subtype and guide treatment decisions

Treatment

Treatment options for non-follicular lymphoma affecting intra-abdominal lymph nodes 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 therapies: Depending on the specific characteristics of the lymphoma, targeted agents may be employed.
- Stem cell transplant: In certain cases, particularly for aggressive forms of lymphoma or relapsed disease.

Prognosis

The prognosis for patients with C83.83 varies widely based on several factors, including the specific subtype of non-follicular lymphoma, the stage at diagnosis, the patient's overall health, and response to treatment. Generally, non-Hodgkin lymphomas can be aggressive, but many patients respond well to treatment, leading to remission.

Conclusion

ICD-10 code C83.83 captures a specific category of non-follicular lymphoma affecting intra-abdominal lymph nodes, highlighting the importance of accurate diagnosis and tailored treatment strategies. Understanding the clinical features, diagnostic approaches, and treatment options is essential for healthcare providers managing patients with this condition. As research continues, advancements in targeted therapies and personalized medicine may further improve outcomes for individuals diagnosed with this type of lymphoma.

The ICD-10 code C83.83 refers to "Other non-follicular lymphoma, intra-abdominal lymph nodes." This classification encompasses a variety of lymphomas that do not fall under the follicular category and specifically involve lymph nodes located in the abdominal region. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for accurate diagnosis and management.

Clinical Presentation

Overview of Non-Follicular Lymphoma

Non-follicular lymphomas are a diverse group of hematological malignancies that arise from lymphoid tissue. They can manifest in various forms, including diffuse large B-cell lymphoma, mantle cell lymphoma, and others. The intra-abdominal involvement indicates that the lymph nodes affected are located within the abdominal cavity, which can significantly influence the clinical presentation.

Signs and Symptoms

Patients with C83.83 may present with a range of symptoms, which can vary based on the extent of the disease and the specific lymphatic structures involved. Common signs and symptoms include:

• Abdominal Pain: Patients often report discomfort or pain in the abdominal area, which may be due to lymphadenopathy or organ involvement.
• Swelling or Masses: Palpable abdominal masses may be detected during physical examination, often indicating enlarged lymph nodes.
• Weight Loss: Unintentional weight loss is a frequent symptom, often associated with malignancies.
• Fever and Night Sweats: Systemic symptoms such as fever, chills, and night sweats may occur, reflecting the body's response to the malignancy.
• Fatigue: Generalized fatigue and weakness are common, stemming from the disease process and potential anemia.
• Nausea and Vomiting: These symptoms may arise if the lymphoma affects the gastrointestinal tract or causes obstruction.

Patient Characteristics

Certain demographic and clinical characteristics may be associated with patients diagnosed with C83.83:

• Age: Non-follicular lymphomas can occur at any age, but they are more commonly diagnosed in adults, particularly those over 60 years old.
• Gender: Some studies suggest a male predominance in certain types of non-follicular lymphomas, although this can vary by subtype.
• Comorbidities: Patients may have underlying health conditions, such as autoimmune diseases or previous infections, which can influence lymphoma development.
• Immunocompromised Status: Individuals with weakened immune systems, such as those with HIV/AIDS or those undergoing immunosuppressive therapy, may be at higher risk for developing lymphomas.

Conclusion

The clinical presentation of C83.83, or other non-follicular lymphoma involving intra-abdominal lymph nodes, is characterized by a combination of localized abdominal symptoms and systemic manifestations. Recognizing these signs and symptoms is essential for timely diagnosis and treatment. Given the complexity of lymphomas, a multidisciplinary approach involving oncologists, radiologists, and pathologists is often necessary to ensure accurate diagnosis and effective management of the disease.

ICD-10 code C83.83 refers specifically to "Other non-follicular lymphoma, intra-abdominal 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 cells. Below are alternative names and related terms associated with this specific code:

Alternative Names

1. Non-follicular lymphoma: This term broadly describes lymphomas that do not arise from follicular B-cells, which includes a variety of subtypes.
2. Diffuse large B-cell lymphoma (DLBCL): While not synonymous, DLBCL is a common type of non-follicular lymphoma that may be included under this code if it presents in intra-abdominal lymph nodes.
3. Mantle cell lymphoma: Another subtype of non-follicular lymphoma that can affect intra-abdominal lymph nodes.
4. Peripheral T-cell lymphoma: This term refers to a group of aggressive lymphomas that can also be classified under non-follicular lymphomas.

Related Terms

1. Lymphadenopathy: This term describes the enlargement of lymph nodes, which can occur in various types of lymphoma, including C83.83.
2. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas.
3. Non-Hodgkin lymphoma (NHL): A broader category that includes all types of lymphomas except Hodgkin lymphoma, encompassing C83.83.
4. Intra-abdominal lymph nodes: This term specifies the location of the lymph nodes affected by the lymphoma, which is crucial for diagnosis and treatment.

Clinical Context

Understanding these alternative names and related terms is essential for healthcare professionals involved in the diagnosis, treatment, and coding of lymphomas. Accurate coding is vital for proper billing and insurance purposes, as well as for clinical research and epidemiological studies.

In summary, ICD-10 code C83.83 is associated with various alternative names and related terms that reflect the complexity and diversity of non-follicular lymphomas, particularly those affecting intra-abdominal lymph nodes. This knowledge aids in better communication among healthcare providers and enhances the accuracy of medical records.

The diagnosis of non-follicular lymphoma, specifically under the ICD-10 code C83.83, which refers to "Other non-follicular lymphoma, intra-abdominal lymph nodes," involves several criteria and considerations. Here’s a detailed overview of the diagnostic process and criteria used for this specific lymphoma type.

Understanding Non-Follicular Lymphoma

Non-follicular lymphomas are a category of lymphomas that do not arise from follicle center (germinal center) B-cells. This group includes various subtypes, such as diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma, among others. The classification is crucial for determining the appropriate treatment and prognosis.

Diagnostic Criteria

1. Clinical Evaluation

• Symptoms: Patients may present with symptoms such as unexplained weight loss, fever, night sweats, and lymphadenopathy. Abdominal symptoms may also arise due to the involvement of intra-abdominal lymph nodes.
• Physical Examination: A thorough physical examination is essential to identify lymphadenopathy, hepatosplenomegaly, or other signs of systemic illness.

2. Imaging Studies

• CT or MRI Scans: Imaging studies are critical for visualizing lymph node enlargement and assessing the extent of disease. Intra-abdominal lymph nodes can be evaluated through abdominal CT scans, which may reveal enlarged lymph nodes indicative of lymphoma.
• PET Scans: Positron emission tomography (PET) scans can help assess metabolic activity in lymph nodes and differentiate between benign and malignant processes.

3. Laboratory Tests

• Blood Tests: Complete blood counts (CBC) and metabolic panels can provide supportive information, such as anemia or elevated lactate dehydrogenase (LDH) levels, which may indicate lymphoma.
• Bone Marrow Biopsy: In cases where there is suspicion of bone marrow involvement, a biopsy may be performed to assess for lymphoma cells.

4. Histopathological Examination

• Biopsy: A definitive diagnosis of non-follicular lymphoma requires a tissue biopsy from an affected lymph node or other involved tissue. This can be done through excisional biopsy, core needle biopsy, or fine-needle aspiration.
• Immunophenotyping: The biopsy sample is analyzed using immunohistochemistry to identify specific markers that characterize the lymphoma subtype. This is crucial for distinguishing between different types of non-follicular lymphomas.

5. Molecular and Genetic Testing

• Cytogenetic Analysis: Certain genetic abnormalities can be associated with specific types of non-follicular lymphoma. Testing for these abnormalities can aid in diagnosis and prognosis.
• Next-Generation Sequencing (NGS): This advanced technique may be used to identify mutations and help classify the lymphoma more precisely.

Conclusion

The diagnosis of non-follicular lymphoma, particularly for the ICD-10 code C83.83, involves a comprehensive approach that includes clinical evaluation, imaging studies, laboratory tests, histopathological examination, and molecular testing. Each of these components plays a vital role in confirming the diagnosis and guiding treatment decisions. Accurate diagnosis is essential for effective management and improving patient outcomes in lymphoma cases.

When addressing the standard treatment approaches for ICD-10 code C83.83, which refers to "Other non-follicular lymphoma, intra-abdominal lymph nodes," it is essential to understand the nature of non-follicular lymphomas and the specific treatment modalities available. Non-follicular lymphomas encompass a variety of lymphoproliferative disorders that do not fall under the follicular lymphoma category, and they can present in various anatomical locations, including intra-abdominal lymph nodes.

Overview of Non-Follicular Lymphoma

Non-follicular lymphomas are a subset of non-Hodgkin lymphomas (NHL) characterized by their aggressive behavior and varied histological subtypes. The treatment approach often depends on the specific subtype, stage of the disease, and the patient's overall health. Common subtypes include diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, and others.

Standard Treatment Approaches

1. Chemotherapy

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

• CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is frequently used for aggressive lymphomas like DLBCL.
• R-CHOP: The addition of Rituximab (a monoclonal antibody targeting CD20) to the CHOP regimen has significantly improved outcomes for patients with B-cell lymphomas, including those with non-follicular types[1].

2. Targeted Therapy

Targeted therapies have emerged as effective options for certain subtypes of non-follicular lymphoma:

• Ibrutinib: This Bruton's tyrosine kinase inhibitor is particularly effective in treating mantle cell lymphoma and other B-cell malignancies. It is often used in relapsed or refractory cases[2].
• Rituximab: As mentioned, Rituximab is used in combination with chemotherapy but can also be used as a standalone treatment in certain cases, especially in patients who are not candidates for intensive chemotherapy[3].

3. Radiation Therapy

Radiation therapy may be employed in specific scenarios, particularly for localized disease or as a palliative measure to relieve symptoms. It can be used in conjunction with chemotherapy or as a standalone treatment for localized lymphomas[4].

4. Stem Cell Transplantation

For patients with aggressive non-follicular lymphomas who achieve remission after initial treatment, autologous stem cell transplantation may be considered. This approach is typically reserved for younger patients or those with high-risk features[5].

5. Clinical Trials

Participation in clinical trials can provide access to novel therapies and treatment regimens that are not yet widely available. Patients are encouraged to discuss this option with their healthcare providers, especially if standard treatments have been ineffective[6].

Conclusion

The treatment of non-follicular lymphoma, particularly when involving intra-abdominal lymph nodes, is multifaceted and tailored to the individual patient based on the lymphoma subtype, stage, and overall health. Chemotherapy, targeted therapies, radiation, and stem cell transplantation are all integral components of the treatment landscape. Ongoing research and clinical trials continue to evolve the management strategies for these complex malignancies, offering hope for improved outcomes in affected patients. For personalized treatment plans, consultation with a hematologist or oncologist specializing in lymphomas is essential.

References

1. Billing and Coding: Intensity Modulated Radiation Therapy.
2. Subject: Ibrutinib (Imbruvica®) - Medical Coverage Guideline.
3. Rituxan Hycela® (rituximab and hyaluronidase human).
4. CMS Manual System.
5. HCT for Non-Hodgkin Lymphoma.
6. Medical Drug Clinical Criteria.