ICD-10: C83.97

ICD-10 code C83.97 refers to Non-follicular (diffuse) lymphoma, unspecified, 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 diagnosis.

Clinical Description

Definition

Non-follicular lymphoma is characterized by the proliferation of malignant lymphocytes that do not form follicular structures, which are typically seen in follicular lymphomas. The term "diffuse" indicates that the lymphoma cells are spread throughout the lymphatic tissue rather than being localized in discrete nodules. The unspecified designation suggests that the specific subtype of non-follicular lymphoma has not been determined.

Types of Non-follicular Lymphoma

Non-follicular lymphomas include various subtypes, such as:
- Diffuse Large B-cell Lymphoma (DLBCL): The most common subtype of non-Hodgkin lymphoma, known for its aggressive nature.
- Mantle Cell Lymphoma: A less common but aggressive form that often presents with advanced disease.
- Burkitt Lymphoma: A highly aggressive lymphoma that can occur in children and adults.

Symptoms

Patients with non-follicular lymphoma may present with a range of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, which may be painless.
- Splenomegaly: Enlargement of the spleen, which is particularly relevant for C83.97, as the spleen is directly involved.
- Fever, Night Sweats, and Weight Loss: These systemic symptoms, often referred to as "B symptoms," can indicate more advanced disease.
- Fatigue and Weakness: Common due to the body's response to cancer and potential anemia.

Diagnosis

Diagnosis typically involves:
- Imaging Studies: CT scans or PET scans to assess the extent of the disease and involvement of the spleen and other organs.
- Biopsy: A definitive diagnosis is made through a biopsy of the affected lymph node or spleen tissue, which is then examined histologically.
- Immunophenotyping: This process helps to identify the specific type of lymphoma based on the surface markers of the cancer cells.

Treatment

Treatment options for non-follicular lymphoma may include:
- Chemotherapy: Often the first line of treatment, especially for aggressive forms like DLBCL.
- Radiation Therapy: May be used in localized cases or as part of a combined modality approach.
- Targeted Therapy: Newer treatments that target specific pathways involved in the growth of lymphoma cells, such as monoclonal antibodies.
- Stem Cell Transplant: In certain cases, particularly for relapsed or refractory disease, a stem cell transplant may be considered.

Conclusion

ICD-10 code C83.97 captures a critical aspect of non-Hodgkin lymphoma, specifically focusing on the diffuse, non-follicular type affecting the spleen. Understanding the clinical characteristics, diagnostic methods, and treatment options is essential for healthcare providers managing patients with this condition. As research continues to evolve, treatment protocols may adapt, emphasizing the importance of personalized medicine in oncology.

Non-follicular (diffuse) lymphoma, unspecified, particularly when affecting the spleen, is classified under ICD-10 code C83.97. This type of lymphoma is a form of non-Hodgkin lymphoma (NHL) characterized by the diffuse infiltration of malignant lymphoid cells, which can lead to various clinical presentations and symptoms. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with this condition.

Clinical Presentation

General Overview

Non-follicular lymphoma encompasses a range of aggressive lymphomas that do not exhibit the follicular pattern typical of some other lymphomas. The unspecified designation indicates that the specific subtype of diffuse lymphoma has not been determined. When the spleen is involved, it can lead to splenomegaly and other systemic symptoms.

Signs and Symptoms

1. Splenomegaly:
   - One of the hallmark signs of splenic involvement is splenomegaly, which is the enlargement of the spleen. This can be detected through physical examination or imaging studies such as ultrasound or CT scans[1].

2. Lymphadenopathy:
   - Patients may present with swollen lymph nodes, particularly in the cervical, axillary, or inguinal regions. This is due to the proliferation of malignant lymphoid cells in lymphatic tissues[2].

3. B Symptoms:
   - Many patients experience "B symptoms," which include:

   • Fever: Unexplained fevers that may be intermittent.
   • Night Sweats: Profuse sweating during the night, often soaking bedclothes.
   • Weight Loss: Significant and unintentional weight loss over a short period[3].

4. Abdominal Symptoms:
   - Patients may report abdominal discomfort or pain due to splenomegaly or lymphadenopathy affecting abdominal organs. This can also lead to early satiety or a feeling of fullness[4].

5. Fatigue:
   - A common symptom in lymphoma patients, fatigue can be profound and debilitating, often related to the disease process and anemia[5].

6. Cytopenias:
   - Laboratory findings may reveal cytopenias (low blood cell counts), including anemia, leukopenia, or thrombocytopenia, which can result from bone marrow infiltration by lymphoma cells[6].

Patient Characteristics

1. Demographics:
   - Non-follicular lymphomas can occur in adults of any age, but they are more commonly diagnosed in older adults, typically over the age of 60. The incidence may vary by sex, with some studies indicating a higher prevalence in males[7].

2. Risk Factors:
   - Certain risk factors may predispose individuals to develop non-follicular lymphoma, including:

   • Immunosuppression: Conditions such as HIV/AIDS or organ transplantation can increase the risk.
   • Autoimmune Diseases: Patients with autoimmune disorders may have a higher incidence of lymphomas.
   • Family History: A family history of lymphoma or other hematologic malignancies can also be a contributing factor[8].

3. Comorbidities:
   - Patients may present with other health issues, such as diabetes, hypertension, or cardiovascular diseases, which can complicate the clinical picture and management of lymphoma[9].

Conclusion

Non-follicular (diffuse) lymphoma, unspecified, particularly when involving the spleen, presents with a range of clinical signs and symptoms, including splenomegaly, lymphadenopathy, and systemic "B symptoms." Understanding the patient characteristics, including demographics and risk factors, is crucial for early diagnosis and effective management. If you suspect lymphoma based on these clinical features, further diagnostic evaluation, including imaging and biopsy, is essential for confirmation and treatment planning.

ICD-10 code C83.97 refers specifically to "Non-follicular (diffuse) lymphoma, unspecified, 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 code:

Alternative Names

1. Diffuse Large B-Cell Lymphoma (DLBCL): This is one of the most common types of non-follicular lymphoma and is characterized by the rapid growth of large B-cells.
2. Aggressive Non-Hodgkin Lymphoma: This term is often used to describe lymphomas that grow quickly, including many forms of diffuse lymphomas.
3. B-Cell Lymphoma: A broader term that includes various types of lymphomas originating from B-cells, including diffuse types.

Related Terms

1. Non-Hodgkin Lymphoma (NHL): A general term for all lymphomas except Hodgkin lymphoma, which includes both follicular and non-follicular types.
2. Lymphoproliferative Disorders: A category that includes conditions where lymphocytes are produced in excessive quantities, which encompasses various types of lymphomas.
3. Spleen Involvement: This term indicates that the lymphoma has affected the spleen, which is significant for staging and treatment considerations.
4. Stage IV Lymphoma: If the lymphoma has spread to the spleen, it may be classified as stage IV, indicating advanced disease.

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 treatment outcomes.

In summary, ICD-10 code C83.97 is associated with various terms that reflect the nature and classification of non-follicular lymphomas, particularly those affecting the spleen. Recognizing these terms can aid in better communication among healthcare providers and improve patient care strategies.

The diagnosis of Non-follicular (diffuse) lymphoma, unspecified, spleen, classified under ICD-10 code C83.97, involves a comprehensive evaluation that includes clinical, laboratory, and imaging assessments. Below are the key criteria and steps typically used in the diagnostic process:

Clinical Evaluation

Patient History

• Symptoms: Patients often present with symptoms such as unexplained weight loss, fever, night sweats, and fatigue. Lymphadenopathy (swollen lymph nodes) and splenomegaly (enlarged spleen) are also common findings.
• Medical History: A thorough medical history is taken to identify any previous cancers, autoimmune diseases, or family history of lymphoproliferative disorders.

Physical Examination

• Lymph Node Assessment: A physical examination focuses on palpating lymph nodes in various regions (cervical, axillary, inguinal) to check for enlargement.
• Spleen Examination: The spleen is assessed for enlargement, which may indicate involvement by lymphoma.

Laboratory Tests

Blood Tests

• Complete Blood Count (CBC): This test helps identify anemia, thrombocytopenia, or leukopenia, which can be associated with lymphomas.
• Lactate Dehydrogenase (LDH): Elevated LDH levels can indicate tumor burden and are often associated with aggressive lymphomas.

Bone Marrow Biopsy

• A bone marrow biopsy may be performed to assess for the presence of lymphoma cells in the bone marrow, which can help confirm the diagnosis and determine the extent of disease involvement.

Imaging Studies

Ultrasound and CT Scans

• Ultrasound: An abdominal ultrasound can help visualize splenomegaly and assess the spleen's structure.
• CT Scan: A computed tomography (CT) scan of the chest, abdomen, and pelvis is crucial for evaluating lymph node involvement and the extent of disease, including any splenic lesions.

Histopathological Examination

Biopsy

• Tissue Biopsy: A definitive diagnosis of diffuse lymphoma typically requires a biopsy of the affected lymph node or spleen. The biopsy sample is examined histologically to identify the type of lymphoma.
• Immunohistochemistry: This technique is used to characterize the lymphoma further, distinguishing between different subtypes of non-Hodgkin lymphoma (NHL) and confirming the diagnosis of diffuse large B-cell lymphoma (DLBCL) or other non-follicular types.

Molecular and Genetic Testing

• Cytogenetic Analysis: Testing for specific chromosomal abnormalities can provide additional information about the lymphoma's prognosis and guide treatment decisions.
• Molecular Markers: Assessing for markers such as CD20, CD10, and BCL2 can help classify the lymphoma subtype and inform treatment strategies.

Conclusion

The diagnosis of Non-follicular (diffuse) lymphoma, unspecified, spleen (ICD-10 code C83.97) is a multifaceted process that requires careful clinical assessment, laboratory testing, imaging studies, and histopathological evaluation. Each of these components plays a critical role in confirming the diagnosis and determining the appropriate treatment plan for the patient. If you have further questions or need more specific information, feel free to ask!

Non-follicular (diffuse) lymphoma, classified under ICD-10 code C83.97, refers to a type of non-Hodgkin lymphoma (NHL) that is characterized by the diffuse infiltration of malignant lymphocytes in the spleen and potentially other lymphoid tissues. The treatment approaches for this condition can vary based on several factors, including the specific subtype of lymphoma, the stage of the disease, the patient's overall health, and their preferences. Below is a detailed overview of standard treatment approaches for this type of lymphoma.

Standard Treatment Approaches

1. Chemotherapy

Chemotherapy is often the first-line treatment for diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-follicular lymphoma. The standard regimen typically includes:

• R-CHOP: This combination therapy includes Rituximab (R), Cyclophosphamide (C), Doxorubicin (H), Vincristine (O), and Prednisone (P). R-CHOP is administered in cycles, usually every 21 days, and is effective in inducing remission in many patients[1].

2. Targeted Therapy

Rituximab, a monoclonal antibody targeting CD20, is a cornerstone of treatment for B-cell lymphomas, including diffuse lymphomas. It can be used in combination with chemotherapy or as a standalone treatment in certain cases, particularly for patients who may not tolerate intensive chemotherapy[2].

3. Radiation Therapy

Radiation therapy may be utilized in specific scenarios, such as:

• Localized Disease: If the lymphoma is localized to the spleen or nearby lymph nodes, radiation may be used to target these areas directly.
• Palliative Care: In cases where the disease is advanced and symptomatic, radiation can help alleviate symptoms by reducing tumor burden[3].

4. Stem Cell Transplantation

For patients with relapsed or refractory diffuse lymphoma, high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) may be considered. This approach allows for the administration of higher doses of chemotherapy than would be tolerated otherwise, with the goal of achieving a durable remission[4].

5. Clinical Trials

Participation in clinical trials may be an option for patients, especially those with relapsed or refractory disease. These trials may offer access to novel therapies or combinations that are not yet widely available[5].

6. Supportive Care

Supportive care is crucial throughout the treatment process. This includes managing side effects of chemotherapy, providing nutritional support, and addressing psychosocial needs. Patients may also require prophylactic treatments to prevent infections, particularly during periods of immunosuppression[6].

Conclusion

The treatment of non-follicular (diffuse) lymphoma, particularly as classified under ICD-10 code C83.97, involves a multifaceted approach that includes chemotherapy, targeted therapies, radiation, and potentially stem cell transplantation. The choice of treatment is highly individualized, taking into account the specific characteristics of the lymphoma, the patient's health status, and their treatment goals. Ongoing research and clinical trials continue to evolve the landscape of treatment options, offering hope for improved outcomes in patients with this challenging diagnosis.

For patients and caregivers, it is essential to engage in thorough discussions with healthcare providers to understand the best treatment options available and to consider participation in clinical trials when appropriate.