ICD-10: C83.94

Non-follicular (diffuse) lymphoma, classified under ICD-10 code C83.94, refers to a type of non-Hodgkin lymphoma (NHL) that is characterized by the diffuse infiltration of malignant lymphocytes in lymph nodes, particularly affecting the axilla and upper limb. This condition requires a comprehensive treatment approach tailored to the individual patient, considering factors such as the specific subtype of lymphoma, stage of the disease, and overall health of the patient.

Standard Treatment Approaches

1. Chemotherapy

Chemotherapy remains a cornerstone of treatment for diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-follicular lymphoma. The standard regimen often includes:

• R-CHOP: This combination therapy includes Rituximab (a monoclonal antibody), Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. R-CHOP is typically administered in cycles over several months and is effective in inducing remission in many patients[1].

2. Radiation Therapy

Radiation therapy may be utilized in specific scenarios, particularly for localized disease or as a consolidation treatment after chemotherapy. It can help reduce the size of lymph nodes and eliminate residual disease. The decision to use radiation therapy depends on the extent of the disease and the patient's response to chemotherapy[2].

3. Targeted Therapy

Targeted therapies are increasingly being integrated into treatment regimens for non-follicular lymphomas. These therapies focus on specific molecular targets associated with cancer cells. For instance:

• Brentuximab vedotin: This is an antibody-drug conjugate that targets CD30, which may be relevant in certain subtypes of lymphoma.
• PI3K inhibitors: Such as copanlisib (Aliqopa®), which may be used in relapsed or refractory cases[3].

4. Stem Cell Transplantation

For patients with aggressive forms of diffuse lymphoma who do not respond adequately to initial treatments, autologous stem cell transplantation may be considered. This involves harvesting the patient's own stem cells, administering high-dose chemotherapy, and then reinfusing the stem cells to restore bone marrow function[4].

5. Clinical Trials

Participation in clinical trials may be an option for patients, especially those with relapsed or refractory disease. These trials often explore new therapies or combinations of existing treatments that may offer improved outcomes[5].

Supportive Care

In addition to the primary treatment modalities, supportive care is crucial in managing symptoms and side effects associated with lymphoma and its treatment. This may include:

• Antiemetics: To manage nausea and vomiting associated with chemotherapy[6].
• Pain management: Addressing any discomfort or pain related to lymphadenopathy or treatment side effects.
• Psychosocial support: Providing counseling and support groups to help patients cope with the emotional aspects of their diagnosis and treatment.

Conclusion

The treatment of non-follicular lymphoma, particularly in the axilla and upper limb, involves a multidisciplinary approach that includes chemotherapy, radiation therapy, targeted therapies, and potentially stem cell transplantation. Each treatment plan should be individualized based on the patient's specific circumstances, and ongoing research continues to refine these approaches. Patients are encouraged to discuss all available options, including participation in clinical trials, with their healthcare team to determine the best course of action for their condition.

For further information on specific treatment protocols and emerging therapies, consulting with a hematologist or oncologist specializing in lymphomas is recommended.

ICD-10 code C83.94 refers to Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of axilla and upper limb. 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 of Non-follicular Lymphoma

Non-follicular lymphoma is characterized by the proliferation of lymphoid tissue that does not exhibit the follicular architecture typical of follicular lymphoma. This type of lymphoma can manifest in various forms, including diffuse large B-cell lymphoma (DLBCL), which is the most common subtype of non-Hodgkin lymphoma. The term "diffuse" indicates that the cancer cells are spread throughout the lymph nodes rather than being localized in distinct follicles.

Presentation and Symptoms

Patients with non-follicular lymphoma may present with a variety of symptoms, which can include:

• Swollen Lymph Nodes: Enlargement of lymph nodes, particularly in the axillary (armpit) and upper limb regions, is a common initial sign.
• Systemic Symptoms: These may include fever, night sweats, and unexplained weight loss, often referred to as "B symptoms."
• Fatigue: Patients frequently report a general sense of fatigue or malaise.
• Pain or Discomfort: Depending on the extent of lymph node involvement, patients may experience localized pain or discomfort in the affected areas.

Diagnosis

Diagnosis typically involves a combination of clinical evaluation, imaging studies (such as CT scans), and histopathological examination of lymph node biopsies. Immunophenotyping and genetic studies may also be performed to determine the specific subtype of lymphoma and guide treatment decisions.

Treatment Options

The treatment for non-follicular lymphoma varies based on the specific subtype, stage of the disease, and the patient's overall health. Common treatment modalities include:

• Chemotherapy: Often the first line of treatment, particularly for aggressive forms like DLBCL.
• Radiation Therapy: May be used in localized cases or as a palliative measure.
• Targeted Therapy: Newer treatments, such as monoclonal antibodies (e.g., rituximab), may be employed, especially in cases with specific genetic markers.
• Stem Cell Transplant: In certain cases, particularly for relapsed or refractory disease, stem cell transplantation may be considered.

Prognosis

The prognosis for patients with non-follicular lymphoma can vary widely based on several factors, including the specific subtype, stage at diagnosis, and response to treatment. Generally, diffuse large B-cell lymphoma has a variable prognosis, with some patients achieving complete remission while others may experience recurrence.

Conclusion

ICD-10 code C83.94 captures a specific diagnosis of non-follicular lymphoma affecting the lymph nodes of the axilla and upper limb. Understanding the clinical presentation, diagnostic approach, treatment options, and prognosis is crucial for effective management of this condition. As research continues to evolve, new therapies and treatment strategies are being developed, offering hope for improved outcomes for patients diagnosed with this type of lymphoma.

ICD-10 code C83.94 refers to Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of axilla and upper limb. 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. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for diagnosis and management.

Clinical Presentation

Overview of Non-follicular Lymphoma

Non-follicular lymphoma is characterized by the proliferation of malignant lymphocytes that do not form follicular structures. This type of lymphoma can manifest in various forms, with diffuse large B-cell lymphoma (DLBCL) being one of the most common subtypes. The unspecified nature of C83.94 indicates that the specific subtype has not been determined, which can complicate treatment and prognosis.

Common Symptoms

Patients with non-follicular lymphoma may present with a range of symptoms, including:

• Lymphadenopathy: Swelling of lymph nodes, particularly in the axillary (armpit) and upper limb regions, is often the most noticeable sign. Patients may report painless lumps or swelling in these areas.
• B Symptoms: These systemic symptoms include:
• Fever: Unexplained fevers that may be intermittent.
• Night Sweats: Profuse sweating during the night, often soaking bedclothes.
• Weight Loss: Unintentional weight loss of more than 10% of body weight over six months.
• Fatigue: Persistent tiredness that does not improve with rest.
• Pruritus: Itching of the skin, which can occur without a rash.

Additional Signs

• Splenomegaly: Enlargement of the spleen may occur, leading to discomfort or a feeling of fullness.
• Hepatomegaly: Liver enlargement can also be present, although it is less common.
• Cytopenias: Blood tests may reveal low levels of red blood cells, white blood cells, or platelets, indicating bone marrow involvement.

Patient Characteristics

Demographics

• Age: Non-follicular lymphomas can occur at any age but are more prevalent in adults, particularly those over 60 years old.
• Gender: There is a slight male predominance in the incidence of non-Hodgkin lymphoma, including non-follicular types.

Risk Factors

• Immunosuppression: Patients with weakened immune systems, such as those with HIV/AIDS or those on immunosuppressive therapy, are at higher risk.
• Autoimmune Diseases: Conditions like rheumatoid arthritis or Sjögren's syndrome may increase the risk of developing lymphoma.
• Environmental Exposures: Certain chemicals, such as pesticides and solvents, have been linked to an increased risk of lymphoma.

Comorbidities

Patients may present with other health conditions that can complicate the diagnosis and treatment of lymphoma, including cardiovascular diseases, diabetes, or other malignancies.

Conclusion

The clinical presentation of non-follicular lymphoma, particularly in the axillary and upper limb lymph nodes, is characterized by lymphadenopathy, systemic B symptoms, and potential splenomegaly. Understanding the signs, symptoms, and patient characteristics associated with ICD-10 code C83.94 is essential for healthcare providers to facilitate timely diagnosis and appropriate management. Early recognition of these symptoms can lead to better outcomes through prompt treatment interventions.

ICD-10 code C83.94 refers specifically to "Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of axilla and upper limb." 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) structures.

Alternative Names and Related Terms

1. Non-Hodgkin Lymphoma (NHL): This is a general term for a diverse group of blood cancers that includes all types of lymphomas except Hodgkin's lymphoma. Non-follicular lymphomas are a subset of NHL.

2. Diffuse Large B-Cell Lymphoma (DLBCL): While not synonymous with C83.94, DLBCL is a common type of non-follicular lymphoma and is often included in discussions about diffuse lymphomas. It is characterized by large B-cells that proliferate in a diffuse pattern.

3. Lymphoma, Diffuse Type: This term can be used interchangeably with non-follicular lymphoma, emphasizing the diffuse nature of the cancer.

4. Axillary Lymph Node Lymphoma: This term specifies the location of the lymphoma, indicating that it affects the lymph nodes in the axilla (armpit area) and upper limb.

5. Unspecified Non-Follicular Lymphoma: This phrase highlights that the specific subtype of non-follicular lymphoma is not identified, which is the case for C83.94.

6. Lymphoproliferative Disorders: This broader category includes various conditions where lymphocytes (a type of white blood cell) proliferate abnormally, including non-follicular lymphomas.

7. Stage IV Lymphoma: If the lymphoma has spread to lymph nodes in the axilla and upper limb, it may be classified as stage IV, although this is a staging term rather than a direct synonym.

Related ICD Codes

• C83.90: Non-follicular lymphoma, unspecified, lymph nodes of unspecified site.
• C83.91: Non-follicular lymphoma, unspecified, lymph nodes of head, face, and neck.
• C83.92: Non-follicular lymphoma, unspecified, lymph nodes of mediastinum.
• C83.93: Non-follicular lymphoma, unspecified, lymph nodes of abdomen.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C83.94 is crucial for accurate diagnosis, treatment planning, and billing purposes. These terms help healthcare professionals communicate effectively about the condition and ensure that patients receive appropriate care based on the specific type and location of the lymphoma. If you need further details or specific information about treatment options or prognosis, feel free to ask!

The diagnosis of Non-follicular (diffuse) lymphoma, unspecified, specifically coded as ICD-10 C83.94, involves a comprehensive evaluation that includes clinical, laboratory, and imaging assessments. Below is a detailed overview of the criteria typically used for diagnosing this condition.

Clinical Presentation

Symptoms

Patients with non-follicular lymphoma may present with various symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, particularly in the axilla (armpit) and upper limb regions.
- B Symptoms: These include fever, night sweats, and unexplained weight loss, which are indicative of systemic involvement.
- Fatigue: Generalized tiredness that is not relieved by rest.

Physical Examination

A thorough physical examination is crucial. Physicians will assess:
- The size, consistency, and tenderness of lymph nodes.
- The presence of splenomegaly (enlarged spleen) or hepatomegaly (enlarged liver).

Laboratory Tests

Blood Tests

• Complete Blood Count (CBC): To check for anemia, leukopenia, or thrombocytopenia, which may indicate bone marrow involvement.
• Lactate Dehydrogenase (LDH): Elevated levels can suggest aggressive disease and correlate with tumor burden.

Biopsy

• Lymph Node Biopsy: A definitive diagnosis is often made through an excisional or incisional biopsy of the affected lymph node. Histopathological examination is essential to differentiate non-follicular lymphoma from other types of lymphoma and to confirm the diagnosis.

Imaging Studies

Radiological Evaluation

• CT Scan: A computed tomography scan of the chest, abdomen, and pelvis is typically performed to assess the extent of lymphadenopathy and to identify any extranodal involvement.
• PET Scan: Positron emission tomography may be used to evaluate metabolic activity in lymph nodes and to help stage the disease.

Immunophenotyping and Molecular Studies

Flow Cytometry

• This technique is used on biopsy samples to analyze the surface markers of the lymphoma cells, helping to classify the lymphoma subtype.

Genetic Studies

• Cytogenetic Analysis: May be performed to identify specific chromosomal abnormalities associated with certain types of lymphoma.

Staging

The Ann Arbor staging system is commonly used to determine the extent of the disease, which is crucial for treatment planning. Staging considers:
- The number of lymph node regions involved.
- Whether the disease is localized or has spread to extranodal sites.

Conclusion

The diagnosis of non-follicular (diffuse) lymphoma, unspecified (ICD-10 C83.94), requires a multifaceted approach that includes clinical evaluation, laboratory tests, imaging studies, and histopathological confirmation. Each of these components plays a vital role in establishing an accurate diagnosis and guiding appropriate treatment strategies. If you have further questions or need more specific information, feel free to ask!