ICD-10: C83.98

Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites, is classified under ICD-10 code C83.98. This type of lymphoma is a form of non-Hodgkin lymphoma (NHL) characterized by the diffuse infiltration of malignant lymphoid cells in lymph nodes and other tissues. Below is a detailed overview of its clinical presentation, signs, symptoms, and patient characteristics.

Clinical Presentation

Definition and Classification

Non-follicular lymphoma refers to a group of lymphomas that do not exhibit the follicular pattern typically seen in follicular lymphomas. Instead, these lymphomas are characterized by a diffuse pattern of growth, which can involve multiple lymph nodes and extranodal sites. The unspecified designation indicates that the specific subtype of diffuse lymphoma has not been determined.

Common Subtypes

While C83.98 encompasses various subtypes, it is often associated with:
- Diffuse large B-cell lymphoma (DLBCL)
- Burkitt lymphoma
- Other aggressive lymphomas

Signs and Symptoms

General Symptoms

Patients with non-follicular lymphoma may present with a variety of symptoms, which can include:
- Lymphadenopathy: Swelling of lymph nodes, often painless, in multiple regions such as the neck, armpits, or groin.
- B Symptoms: These are systemic symptoms that may indicate more advanced disease and include:
- Fever
- Night sweats
- Unexplained weight loss
- Fatigue: A common complaint among patients, often due to the disease's impact on overall health and energy levels.
- Pruritus: Itching of the skin, which can occur in some patients.

Extranodal Involvement

In cases where the lymphoma has spread beyond the lymph nodes, patients may experience additional symptoms related to affected organs, such as:
- Abdominal pain or swelling: If the spleen or liver is involved.
- Respiratory symptoms: If there is mediastinal involvement, leading to cough or difficulty breathing.

Patient Characteristics

Demographics

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

Risk Factors

Several factors may increase the risk of developing non-follicular lymphoma:
- Immunosuppression: Patients with weakened immune systems, such as those with HIV/AIDS or those undergoing immunosuppressive therapy, are at higher risk.
- Autoimmune diseases: Conditions like rheumatoid arthritis or Sjögren's syndrome may predispose individuals to lymphoma.
- Family history: A family history of lymphoma or other hematological malignancies can increase risk.

Diagnostic Considerations

Diagnosis typically involves:
- Biopsy: A tissue sample from an affected lymph node or extranodal site is essential for histological examination.
- Imaging studies: CT scans or PET scans may be used to assess the extent of disease involvement.
- Laboratory tests: Blood tests may help evaluate overall health and organ function.

Conclusion

Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites (ICD-10 code C83.98) presents with a range of clinical features, including lymphadenopathy, systemic symptoms, and potential extranodal involvement. Understanding the signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and management. Early recognition and appropriate treatment can significantly impact patient outcomes, emphasizing the importance of awareness among healthcare providers.

Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites, classified under ICD-10 code C83.98, is a specific diagnosis within the broader category of non-Hodgkin lymphoma. This condition is characterized by the proliferation of lymphoid tissue that does not exhibit the follicular pattern typical of some other lymphomas. Below are alternative names and related terms associated with this diagnosis.

Alternative Names

1. Diffuse Large B-Cell Lymphoma (DLBCL): While DLBCL is a specific subtype of non-follicular lymphoma, it is often colloquially referred to in discussions about diffuse lymphomas due to its prevalence and aggressive nature.

2. Non-Hodgkin Lymphoma (NHL): This is a broader category that includes various types of lymphomas, including non-follicular types. C83.98 falls under this classification.

3. Aggressive Non-Follicular Lymphoma: This term may be used to describe the aggressive nature of certain non-follicular lymphomas, including those that are diffuse in character.

4. Lymphoma, Diffuse Type: This is a more general term that can refer to any lymphoma that presents in a diffuse pattern, not limited to specific subtypes.

Related Terms

1. Lymphadenopathy: This term refers to the enlargement of lymph nodes, which is a common symptom in patients with non-follicular lymphoma.

2. Lymphoma, Unspecified: This term may be used when the specific type of lymphoma is not determined, which can include cases coded as C83.98.

3. Stage IV Lymphoma: In cases where the lymphoma has spread to multiple lymph nodes, it may be classified as Stage IV, indicating advanced disease.

4. Histological Subtypes: Within the non-follicular category, there are various histological subtypes that may be relevant, such as T-cell lymphomas or other specific non-Hodgkin lymphoma types.

5. ICD-10 Code C83.9: This code refers to non-follicular lymphoma, unspecified, which is a broader category that may encompass C83.98.

Understanding these alternative names and related terms can aid healthcare professionals in accurately diagnosing and coding for non-follicular (diffuse) lymphoma, ensuring appropriate treatment and management strategies are employed.

Non-follicular lymphoma, classified under ICD-10 code C83.98, refers to a group of aggressive lymphomas that do not exhibit the follicular pattern typical of certain types of non-Hodgkin lymphoma (NHL). This category includes diffuse large B-cell lymphoma (DLBCL) and other aggressive lymphomas that can affect multiple lymph nodes and other organs. The treatment approaches for this condition are multifaceted and depend on various factors, including the specific subtype of lymphoma, the stage of the disease, and the patient's overall health.

Standard Treatment Approaches

1. Chemotherapy

Chemotherapy remains the cornerstone of treatment for non-follicular lymphomas. The most commonly used regimen is R-CHOP, which includes:

• Rituximab: A monoclonal antibody targeting CD20 on B-cells.
• Cyclophosphamide: An alkylating agent.
• Doxorubicin (Adriamycin): An anthracycline antibiotic.
• Vincristine (Oncovin): A vinca alkaloid.
• Prednisone: A corticosteroid.

This combination is typically administered in cycles over several months, with the number of cycles depending on the response to treatment and the specific characteristics of the lymphoma[1][2].

2. Radiation Therapy

Radiation therapy may be used in conjunction with chemotherapy, particularly in cases where localized disease is present or to target specific areas of lymph node involvement. It can also be employed as a consolidative treatment after chemotherapy to eliminate residual disease[3].

3. Stem Cell Transplantation

For patients with high-risk or relapsed non-follicular lymphoma, autologous stem cell transplantation may be considered. This involves harvesting the patient's own stem cells, administering high-dose chemotherapy to eradicate the lymphoma, and then reinfusing the stem cells to restore bone marrow function[4].

4. Targeted Therapy

In addition to traditional chemotherapy, targeted therapies are increasingly being integrated into treatment protocols. For instance, Brentuximab vedotin is an antibody-drug conjugate that targets CD30 and may be used in specific subtypes of non-follicular lymphoma. Other investigational agents and combinations are also being studied in clinical trials[5].

5. Immunotherapy

Recent advancements in immunotherapy, including CAR T-cell therapy, have shown promise in treating aggressive lymphomas. This approach involves modifying a patient's T-cells to better recognize and attack lymphoma cells. While still primarily in the research phase for some non-follicular lymphomas, it represents a significant advancement in treatment options[6].

Conclusion

The treatment of non-follicular lymphoma (ICD-10 code C83.98) is complex and requires a tailored approach based on individual patient factors and disease characteristics. Standard treatment typically involves a combination of chemotherapy, radiation therapy, and potentially stem cell transplantation or targeted therapies. Ongoing research continues to explore new treatment modalities, including immunotherapy, which may offer additional options for patients in the future. It is essential for patients to discuss their specific case with a healthcare provider to determine the most appropriate treatment plan.

The diagnosis of Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites, classified under ICD-10 code C83.98, 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 a variety of symptoms, including:
- Lymphadenopathy: Swelling of lymph nodes, which may be painless and can occur in multiple regions.
- B Symptoms: These include fever, night sweats, and unexplained weight loss, which are indicative of systemic involvement.
- Fatigue: Generalized weakness or fatigue is common among patients.

Medical History

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

Diagnostic Tests

Imaging Studies

Imaging plays a crucial role in identifying the extent of lymphadenopathy and potential organ involvement:
- CT Scans: Computed tomography scans of the chest, abdomen, and pelvis are commonly used to assess lymph node enlargement and other abnormalities.
- PET Scans: Positron emission tomography can help evaluate metabolic activity in lymph nodes and detect areas of lymphoma involvement.

Laboratory Tests

• Blood Tests: Complete blood count (CBC) may reveal anemia or thrombocytopenia, which can be associated with lymphoma.
• Lactate Dehydrogenase (LDH): Elevated levels can indicate a higher tumor burden and are often used as a prognostic marker.

Biopsy

A definitive diagnosis of non-follicular lymphoma typically requires a biopsy:
- Excisional Biopsy: Removal of an entire lymph node or a portion of it for histopathological examination is the gold standard.
- Fine Needle Aspiration (FNA): This may be used for initial evaluation, but excisional biopsy is preferred for definitive diagnosis.

Histopathological Examination

The biopsy specimen is examined microscopically to identify:
- Cell Type: Non-follicular lymphomas are characterized by diffuse infiltration of lymphoid tissue by atypical lymphoid cells.
- Immunophenotyping: Flow cytometry or immunohistochemistry is used to determine the specific type of lymphoma based on cell surface markers (e.g., CD20, CD5).

Staging

Once diagnosed, staging is crucial to determine the extent of the disease:
- Ann Arbor Staging System: This system classifies lymphomas based on the number of lymph node regions involved and whether the disease has spread to other organs.

Conclusion

The diagnosis of non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites (ICD-10 code C83.98) is a multifaceted process that requires careful clinical evaluation, imaging studies, laboratory tests, and histopathological confirmation. Each of these components plays a vital role in ensuring an accurate diagnosis and guiding appropriate treatment strategies. If you have further questions or need more specific information, feel free to ask!

ICD-10 code C83.98 refers to Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites. 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, often referred to as diffuse lymphoma, is characterized by the proliferation of malignant lymphocytes that do not form follicular structures. This type of lymphoma can manifest in various forms, including diffuse large B-cell lymphoma (DLBCL) and other aggressive lymphomas. The unspecified designation indicates that the specific subtype of non-follicular lymphoma has not been determined.

Symptoms

Patients with non-follicular lymphoma may present with a range of symptoms, which can include:
- Lymphadenopathy: Swelling of lymph nodes, often in multiple sites, which is a hallmark of lymphoma.
- Fever: Unexplained fevers that may be persistent or intermittent.
- Night Sweats: Excessive sweating during the night, often soaking through clothing.
- Weight Loss: Unintentional weight loss over a short period.
- Fatigue: Persistent tiredness that does not improve with rest.

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 identify specific subtypes of lymphoma.

Treatment

Treatment options for non-follicular lymphoma vary based on the specific subtype, stage of the disease, and patient factors. Common treatment modalities include:
- Chemotherapy: Often the first line of treatment, especially for aggressive forms.
- Radiation Therapy: May be used in localized cases or as a palliative measure.
- Targeted Therapy: Agents such as monoclonal antibodies (e.g., Rituximab) may be employed, particularly in B-cell lymphomas.
- Stem Cell Transplant: Considered for eligible patients with relapsed or refractory disease.

Coding and Classification

The ICD-10-CM code C83.98 is part of the classification for non-Hodgkin lymphoma, specifically under the category of non-follicular lymphomas. The code is used for billing and coding purposes in healthcare settings, ensuring accurate documentation of the patient's diagnosis for treatment and insurance reimbursement.

Related Codes

• C83.90: Non-follicular lymphoma, unspecified, lymph nodes, unspecified.
• C83.91: Non-follicular lymphoma, unspecified, lymph nodes, cervical region.
• C83.92: Non-follicular lymphoma, unspecified, lymph nodes, axillary region.
• C83.93: Non-follicular lymphoma, unspecified, lymph nodes, inguinal region.

Conclusion

ICD-10 code C83.98 captures the complexity of non-follicular lymphoma, unspecified, affecting multiple lymph node sites. Understanding this classification is crucial for healthcare providers in diagnosing, treating, and managing patients with this type of lymphoma. Accurate coding not only facilitates appropriate treatment but also aids in research and epidemiological studies related to lymphoma. For further management, oncologists may consider a multidisciplinary approach, involving hematologists, radiologists, and pathologists, to optimize patient outcomes.