ICD-10: C83.87

When addressing the standard treatment approaches for ICD-10 code C83.87, which refers to "Other non-follicular lymphoma, spleen," 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 follow the follicular pattern typical of follicular lymphoma. This category includes various subtypes, such as diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma, among others.

Overview of Non-Follicular Lymphoma

Non-follicular lymphomas are characterized by their aggressive behavior and can arise in various anatomical locations, including the spleen. The spleen plays a crucial role in the immune system, and lymphomas affecting this organ can lead to significant clinical manifestations, including splenomegaly, cytopenias, and systemic symptoms.

Standard Treatment Approaches

1. Chemotherapy

Chemotherapy remains a cornerstone of treatment for non-follicular lymphomas. The specific regimen may vary based on the subtype of lymphoma, the stage of the disease, and the patient's overall health. Commonly used chemotherapy regimens include:

• R-CHOP: This regimen combines Rituximab (a monoclonal antibody) with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is particularly effective for DLBCL and is often the first-line treatment for aggressive non-follicular lymphomas[1].
• Hyper-CVAD: This regimen is used for certain aggressive lymphomas, including mantle cell lymphoma, and involves alternating cycles of chemotherapy[2].

2. Targeted Therapy

Targeted therapies have emerged as significant options for treating specific subtypes of non-follicular lymphoma. For instance:

• Bruton’s Tyrosine Kinase Inhibitors (BTK inhibitors): Such as Ibrutinib, are used for mantle cell lymphoma and have shown efficacy in patients with relapsed or refractory disease[3].
• BCL-2 Inhibitors: Venetoclax is another targeted therapy that has been effective in certain non-follicular lymphomas, particularly those with specific genetic mutations[4].

3. Immunotherapy

Immunotherapy has gained traction in the treatment of lymphomas, including:

• CAR T-cell Therapy: This innovative approach involves modifying a patient’s T-cells to better recognize and attack lymphoma cells. It has shown promise in treating relapsed or refractory non-follicular lymphomas, particularly DLBCL[5].
• Monoclonal Antibodies: Besides Rituximab, other monoclonal antibodies targeting specific antigens on lymphoma cells are being explored in clinical trials[6].

4. Radiation Therapy

Radiation therapy may be utilized in specific scenarios, particularly for localized disease or as a palliative measure to relieve symptoms associated with splenic involvement. It is often used in conjunction with chemotherapy for localized lymphomas[7].

5. Stem Cell Transplantation

For eligible patients, especially those with aggressive forms of non-follicular lymphoma, autologous stem cell transplantation may be considered after achieving remission with chemotherapy. This approach can provide a chance for long-term remission and is typically reserved for younger patients or those with good performance status[8].

Conclusion

The treatment of non-follicular lymphoma, particularly when involving the spleen, is multifaceted and tailored to the individual patient based on the specific subtype, disease stage, and overall health. A combination of chemotherapy, targeted therapies, immunotherapy, and possibly radiation or stem cell transplantation forms the backbone of management strategies. Ongoing research and clinical trials continue to refine these approaches, aiming to improve outcomes for patients with this complex group of malignancies. For the most effective treatment plan, consultation with a hematologist or oncologist specializing in lymphomas is essential.

References

1. Article - Billing and Coding: Radiation Therapies (A59350)
2. HCT for Non-Hodgkin Lymphoma
3. Breyanzi® (lisocabtagene maraleucel)
4. Kymriah® (tisagenlecleucel) - Gateway
5. Medical Drug Clinical Criteria
6. Aliqopa® (copanlisib)
7. Medical Necessity Tool for Flow Cytometry
8. Medical Drug Clinical Criteria

The ICD-10 code C83.87 refers to "Other non-follicular lymphoma, spleen," which encompasses a variety of lymphomas that do not fall under the more common follicular lymphoma category. Diagnosing this condition involves a combination of clinical evaluation, imaging studies, and histopathological examination. Below are the key criteria and steps typically used in the diagnosis of non-follicular lymphoma affecting the spleen.

Clinical Evaluation

Symptoms

Patients may present with a range of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, which may be localized or generalized.
- Splenomegaly: Enlargement of the spleen, often detected during a physical examination.
- B Symptoms: These include fever, night sweats, and unexplained weight loss, which are indicative of lymphoma.

Medical History

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

Imaging Studies

Ultrasound and CT Scans

Imaging techniques are crucial for assessing the spleen and surrounding lymphatic structures:
- Ultrasound: Can help visualize splenomegaly and any masses within the spleen.
- CT Scan: Provides detailed images of the spleen and lymph nodes, helping to identify the extent of disease and any associated lymphadenopathy.

Histopathological Examination

Biopsy

A definitive diagnosis of non-follicular lymphoma typically requires a biopsy:
- Fine Needle Aspiration (FNA): May be used for initial sampling of lymph nodes or splenic masses.
- Core Needle Biopsy or Excisional Biopsy: Provides a larger tissue sample for more comprehensive analysis.

Immunophenotyping

Once a biopsy is obtained, immunophenotyping is performed to classify the lymphoma:
- Flow Cytometry: Analyzes the surface markers on the cells to determine the specific type of lymphoma.
- Immunohistochemistry: Stains are used to identify specific proteins that characterize different lymphoma subtypes.

Molecular Studies

In some cases, molecular genetic studies may be conducted to identify specific genetic abnormalities associated with certain types of non-follicular lymphoma, which can aid in diagnosis and treatment planning.

Conclusion

The diagnosis of non-follicular lymphoma of the spleen (ICD-10 code C83.87) is a multifaceted process that involves clinical assessment, imaging studies, and histopathological evaluation. Accurate diagnosis is crucial for determining the appropriate treatment strategy and improving patient outcomes. If you have further questions or need more specific information, feel free to ask!

ICD-10 code C83.87 refers to "Other non-follicular lymphoma, spleen." 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 originate from different types of lymphoid tissue. 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.

Spleen Involvement

When the lymphoma specifically affects the spleen, it can lead to splenomegaly (enlargement of the spleen), which may cause symptoms such as abdominal pain, a feeling of fullness, or discomfort. The spleen plays a crucial role in filtering blood and supporting the immune system, so its involvement can significantly impact a patient's overall health.

Symptoms

Patients with C83.87 may present with a variety of symptoms, including:
- Fatigue: General tiredness and lack of energy.
- Weight Loss: Unintentional weight loss can occur due to the body's increased metabolic demands or loss of appetite.
- Night Sweats: Excessive sweating during the night, often soaking sleepwear or bedding.
- Fever: Low-grade fevers may be present, indicating an underlying infection or malignancy.
- Abdominal Discomfort: Due to splenomegaly or other lymphatic involvement.

Diagnosis

Diagnosis typically involves a combination of:
- Imaging Studies: CT scans or MRIs to assess the size and extent of lymphatic involvement, particularly in the spleen.
- Biopsy: A definitive diagnosis is often made through a biopsy of the affected lymphoid tissue, which can be analyzed histologically to determine the specific type of lymphoma.
- Blood Tests: Complete blood counts and other laboratory tests may help assess the overall health and function of the immune system.

Treatment

Treatment options for non-follicular lymphoma, including those affecting the spleen, may include:
- Chemotherapy: Systemic treatment to target and kill cancer cells.
- Radiation Therapy: Localized treatment to shrink tumors or manage symptoms.
- Immunotherapy: Treatments that harness the body's immune system to fight cancer, such as monoclonal antibodies.
- Stem Cell Transplant: In some cases, hematopoietic cell transplantation may be considered, especially for aggressive forms of lymphoma.

Conclusion

ICD-10 code C83.87 captures a specific category of non-follicular lymphoma affecting the spleen, highlighting the complexity and variability of non-Hodgkin lymphomas. Understanding the clinical presentation, diagnostic methods, and treatment options is essential for effective management of this condition. As with all cancers, early detection and tailored treatment strategies are crucial for improving patient outcomes.

ICD-10 code C83.87 refers to "Other non-follicular lymphoma, spleen," which encompasses a variety of lymphoproliferative disorders 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 arise from lymphoid tissue. They can manifest in various forms, including diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, and others. The spleen is a common site for these lymphomas, and involvement can lead to significant clinical symptoms.

Signs and Symptoms

Patients with C83.87 may present with a range of symptoms, which can vary based on the specific type of lymphoma and the extent of disease. Common signs and symptoms include:

• Splenomegaly: Enlargement of the spleen is a hallmark sign, often leading to abdominal discomfort or pain. Patients may report a feeling of fullness or pressure in the abdomen due to the enlarged spleen.
• Lymphadenopathy: Swelling of lymph nodes, particularly in the neck, armpits, or groin, may be observed. This can be associated with systemic symptoms.
• B Symptoms: These include fever, night sweats, and unexplained weight loss. The presence of B symptoms often indicates a more aggressive disease and can influence treatment decisions.
• Fatigue: Patients frequently report significant fatigue, which can be debilitating and affect daily activities.
• Anemia: Due to bone marrow involvement or splenic sequestration, patients may develop anemia, leading to pallor and weakness.
• Infections: Increased susceptibility to infections may occur due to compromised immune function, particularly if the lymphoma affects the bone marrow.

Patient Characteristics

Demographics

• Age: Non-follicular lymphomas, including those classified under C83.87, are more commonly diagnosed in adults, particularly those over the age of 60. However, they can occur in younger individuals as well.
• Gender: There is a slight male predominance in many types of non-follicular lymphoma, although this can vary by specific subtype.

Risk Factors

Several risk factors may contribute to the development of non-follicular lymphomas, including:
- Immunosuppression: Patients with compromised immune systems, such as those with HIV/AIDS or those undergoing immunosuppressive therapy, are at increased risk.
- Autoimmune Diseases: Conditions like rheumatoid arthritis or Sjögren's syndrome have been associated with a higher incidence of lymphoma.
- Environmental Exposures: Certain chemical exposures, such as pesticides or solvents, may increase risk.

Comorbidities

Patients with non-follicular lymphoma may have other health conditions that can complicate treatment, such as cardiovascular disease, diabetes, or other malignancies. These comorbidities must be considered when planning treatment strategies.

Conclusion

The clinical presentation of ICD-10 code C83.87, or other non-follicular lymphoma of the spleen, is characterized by a range of symptoms including splenomegaly, lymphadenopathy, and systemic B symptoms. Patient demographics typically show a higher prevalence in older adults and a slight male predominance. Understanding these characteristics is essential for healthcare providers to facilitate timely diagnosis and appropriate management of this complex group of lymphoproliferative disorders. Early recognition and intervention can significantly impact patient outcomes and quality of life.

ICD-10 code C83.87 refers to "Other non-follicular lymphoma, spleen." This classification falls under the broader category of non-Hodgkin lymphoma (NHL), which encompasses various types of lymphomas that do not originate from follicle center cells. Below are alternative names and related terms associated with this specific ICD-10 code.

Alternative Names for C83.87

1. Non-Follicular Lymphoma: This term broadly describes lymphomas that do not arise from follicular cells, which are part of the lymphatic system.
2. Spleen Lymphoma: This term emphasizes the involvement of the spleen in the lymphoma process.
3. Diffuse Large B-Cell Lymphoma (DLBCL): While not exclusively synonymous, DLBCL is a common type of non-follicular lymphoma that may be included under this code if it affects the spleen.
4. Mantle Cell Lymphoma: Another subtype of non-follicular lymphoma that can be associated with this code, particularly if it presents in the spleen.
5. Burkitt Lymphoma: Although primarily classified separately, Burkitt lymphoma can sometimes be categorized under non-follicular lymphomas depending on the clinical context.

Related Terms

1. Lymphoproliferative Disorders: This term encompasses a range of conditions, including various types of lymphomas and leukemias, that involve the proliferation of lymphocytes.
2. Hematologic Malignancies: A broader category that includes all cancers of the blood, including lymphomas and leukemias.
3. Spleen Involvement in Lymphoma: This phrase is often used in clinical settings to describe cases where lymphoma has specifically affected the spleen.
4. Stage IV Lymphoma: If the lymphoma has spread to the spleen, it may be classified as stage IV, indicating advanced disease.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C83.87 is crucial for accurate diagnosis, treatment planning, and coding in medical records. These terms help healthcare professionals communicate effectively about the condition and ensure appropriate management strategies are employed. If you need further details on specific types of non-follicular lymphoma or their treatment options, feel free to ask!