ICD-10: C86.31

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare type of non-Hodgkin lymphoma characterized by the infiltration of T-cells into the subcutaneous fat tissue. The ICD-10 code C86.31 specifically refers to SPTCL that is in remission, indicating that the disease has responded to treatment and is no longer active.

Clinical Description of Subcutaneous Panniculitis-like T-cell Lymphoma

Pathophysiology

SPTCL is classified under peripheral T-cell lymphomas and is characterized by the presence of atypical T-cells that infiltrate the subcutaneous fat. This infiltration can lead to the formation of painful nodules or plaques on the skin, primarily affecting the trunk and extremities. The exact etiology of SPTCL remains unclear, but it is believed to be associated with immune dysregulation and may occur in both immunocompetent and immunocompromised individuals[1].

Symptoms

Patients with SPTCL typically present with:
- Subcutaneous nodules or plaques that may be tender or painful.
- Skin lesions that can vary in size and may be erythematous.
- Systemic symptoms such as fever, weight loss, and night sweats may occur but are less common compared to other lymphomas[1][2].

Diagnosis

Diagnosis of SPTCL involves:
- Histopathological Examination: A biopsy of the affected tissue is essential to confirm the presence of atypical T-cells and to rule out other conditions.
- Immunophenotyping: This technique helps in identifying the specific type of T-cells involved, which is crucial for diagnosis.
- Imaging Studies: While not always necessary, imaging may be used to assess the extent of disease involvement[2].

Treatment and Management

The management of SPTCL typically includes:
- Systemic Therapy: Treatment may involve chemotherapy, particularly with agents effective against T-cell lymphomas. In some cases, targeted therapies or immunotherapy may be considered.
- Local Therapy: In cases where lesions are localized, radiation therapy may be utilized.
- Monitoring: Regular follow-up is essential to monitor for disease recurrence or progression, especially in cases classified as in remission[3].

ICD-10 Code C86.31: Subcutaneous Panniculitis-like T-cell Lymphoma, in Remission

The ICD-10 code C86.31 is used to classify cases of SPTCL that are currently in remission. This designation is important for clinical documentation, billing, and coding purposes. It indicates that the patient has undergone treatment and that the disease is not currently active, which can influence management decisions and follow-up care[3][4].

Importance of Remission Status

Documenting the remission status is crucial for:
- Treatment Planning: It helps healthcare providers determine the need for ongoing therapy or surveillance.
- Insurance and Billing: Accurate coding ensures appropriate reimbursement for services rendered and reflects the patient's current health status[4].

Conclusion

Subcutaneous panniculitis-like T-cell lymphoma is a rare but significant condition that requires careful diagnosis and management. The ICD-10 code C86.31 specifically denotes cases that are in remission, highlighting the importance of ongoing monitoring and appropriate treatment strategies. Understanding the clinical features, diagnostic criteria, and management options is essential for healthcare providers involved in the care of patients with this lymphoma type.

References

1. Subcutaneous panniculitis-like T-cell lymphoma - ICD-10 Subcutaneous panniculitis-like T-cell lymphoma - ICD-10.
2. NON-HODGKIN LYMPHOMA Includes Follicular, ...
3. Billing and Coding: Allogeneic Hematopoietic Cell ...
4. 2025 ICD-10-CM Diagnosis Code C86.3.

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare type of cutaneous T-cell lymphoma characterized by specific clinical presentations, signs, symptoms, and patient characteristics. The ICD-10 code C86.31 specifically refers to SPTCL in remission, indicating that the disease has been treated and is currently not active. Below is a detailed overview of the clinical aspects associated with this condition.

Clinical Presentation

Overview of SPTCL

SPTCL primarily affects the subcutaneous tissue and is often associated with a variety of clinical manifestations. It is characterized by the infiltration of atypical T-cells in the subcutaneous fat, leading to distinctive skin lesions. The condition can present in both adults and children, although it is more commonly diagnosed in young adults.

Signs and Symptoms

1. Skin Lesions:
   - The most prominent feature of SPTCL is the presence of subcutaneous nodules or plaques, which may be tender or painful. These lesions can vary in size and may appear as erythematous or violaceous nodules.
   - Lesions are typically located on the trunk and extremities, but they can occur anywhere on the body.

2. Systemic Symptoms:
   - Patients may experience systemic symptoms such as fever, weight loss, and fatigue, particularly in more advanced stages of the disease. However, in the remission phase, these symptoms are usually absent or significantly reduced.

3. Lymphadenopathy:
   - While lymphadenopathy (swelling of lymph nodes) is not a primary feature, it may occur in some cases, especially if the disease has progressed before remission.

4. Histological Findings:
   - Biopsy of the affected tissue typically reveals a dense infiltrate of atypical T-cells in the subcutaneous fat, which is crucial for diagnosis.

Patient Characteristics

Demographics

• Age: SPTCL can occur in individuals of any age but is most frequently diagnosed in young adults, particularly those in their 20s to 40s.
• Gender: There is a slight male predominance in the incidence of SPTCL.

Risk Factors

• Immunosuppression: Patients with compromised immune systems, such as those with HIV/AIDS or those undergoing immunosuppressive therapy, may be at higher risk for developing SPTCL.
• Autoimmune Disorders: There is an association between SPTCL and certain autoimmune conditions, which may predispose individuals to this type of lymphoma.

Clinical Course

• Remission: The term "in remission" indicates that the patient has undergone treatment (which may include chemotherapy, radiation, or other modalities) and is currently free from active disease. During this phase, patients typically show improvement in skin lesions and a resolution of systemic symptoms.

Conclusion

Subcutaneous panniculitis-like T-cell lymphoma, particularly in its remission phase (ICD-10 code C86.31), presents with distinctive skin lesions and may be associated with systemic symptoms in its active form. Understanding the clinical presentation, signs, symptoms, and patient characteristics is essential for accurate diagnosis and management. Regular follow-up and monitoring are crucial to ensure that the disease remains in remission and to address any potential recurrence.

Subcutaneous panniculitis-like T-cell lymphoma (SPL-TCL) is a rare type of lymphoma characterized by the infiltration of T-cells into the subcutaneous fat tissue. The ICD-10 code C86.31 specifically denotes this condition when it is in remission. Understanding alternative names and related terms can be beneficial for healthcare professionals, researchers, and patients alike.

Alternative Names for Subcutaneous Panniculitis-like T-cell Lymphoma

1. Subcutaneous Panniculitis-like T-cell Lymphoma (SPL-TCL): This is the most commonly used name and is often abbreviated as SPL-TCL.
2. Panniculitis-like T-cell Lymphoma: This term emphasizes the similarity of the lymphoma to panniculitis, a condition involving inflammation of the subcutaneous fat.
3. T-cell Lymphoma, Subcutaneous Type: This name highlights the T-cell origin of the lymphoma and its subcutaneous location.

Related Terms

1. Cutaneous T-cell Lymphoma (CTCL): While CTCL refers to a broader category of T-cell lymphomas that primarily affect the skin, SPL-TCL is considered a subtype due to its specific characteristics and presentation.
2. Lymphoproliferative Disorders: This term encompasses a range of conditions, including various types of lymphomas, where there is an abnormal proliferation of lymphocytes.
3. Subcutaneous Lymphoma: This term can be used to describe lymphomas that primarily affect the subcutaneous tissue, although it is less specific than SPL-TCL.
4. T-cell Non-Hodgkin Lymphoma: SPL-TCL falls under the umbrella of non-Hodgkin lymphomas, specifically those derived from T-cells.

Clinical Context

SPL-TCL is often associated with specific clinical features, including the presence of subcutaneous nodules and a tendency to occur in young adults. The diagnosis is typically confirmed through histopathological examination and immunophenotyping. The term "in remission" indicates that the disease is currently not active, which is an important aspect of patient management and prognosis.

Conclusion

Understanding the alternative names and related terms for ICD-10 code C86.31 is crucial for effective communication among healthcare providers and for accurate documentation in medical records. This knowledge aids in the recognition and management of subcutaneous panniculitis-like T-cell lymphoma, particularly in its remission state. If you have further questions or need more specific information, feel free to ask!

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL), classified under ICD-10 code C86.31, is a rare type of non-Hodgkin lymphoma characterized by specific clinical and histopathological features. The diagnosis of SPTCL, particularly in the context of remission, involves a combination of clinical evaluation, imaging studies, and histological examination. Below are the key criteria used for diagnosis:

Clinical Presentation

1. Symptoms: Patients typically present with subcutaneous nodules or plaques, often located on the trunk and extremities. These lesions may be painful or tender and can vary in size.
2. Duration: The lesions usually persist for weeks to months before diagnosis, and the absence of systemic symptoms (such as fever, weight loss, or night sweats) is common in cases of SPTCL.

Histopathological Criteria

1. Biopsy: A skin biopsy is essential for diagnosis. Histological examination typically reveals:
   - Infiltration of atypical lymphocytes: The presence of a dense infiltrate of atypical T-cells in the subcutaneous fat layer.
   - Cytological features: The lymphocytes may exhibit pleomorphism, and there may be a mixture of small and large cells.
   - Necrosis: Areas of necrosis may be present, which can help differentiate SPTCL from other conditions.

2. Immunophenotyping: Flow cytometry or immunohistochemistry is used to characterize the T-cells. The following markers are often assessed:
   - CD4+ T-cells: SPTCL is typically associated with a predominance of CD4+ T-cells.
   - CD8+ T-cells: Some cases may show a CD8+ T-cell predominance.
   - Other markers: The expression of T-cell markers such as CD3, and the absence of B-cell markers (e.g., CD20) are also evaluated.

Imaging Studies

1. Radiological Assessment: Imaging studies, such as ultrasound or MRI, may be performed to assess the extent of the disease and to rule out other conditions. However, imaging is not typically definitive for diagnosis.

Diagnostic Criteria for Remission

1. Clinical Remission: In the context of remission, the absence of clinical symptoms and the resolution of skin lesions are critical indicators.
2. Histological Remission: Follow-up biopsies may be performed to confirm the absence of atypical lymphocytes in the previously affected areas.

Conclusion

The diagnosis of subcutaneous panniculitis-like T-cell lymphoma (ICD-10 code C86.31) relies heavily on clinical presentation, histopathological findings, and immunophenotyping. In cases of remission, both clinical and histological evaluations are essential to confirm the absence of disease activity. Given the complexity of this condition, a multidisciplinary approach involving dermatologists, oncologists, and pathologists is often necessary for accurate diagnosis and management.

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL), classified under ICD-10 code C86.31, is a rare type of non-Hodgkin lymphoma characterized by the infiltration of T-cells in the subcutaneous fat tissue. This condition can present with various symptoms, including subcutaneous nodules, skin lesions, and systemic symptoms like fever and weight loss. When discussing treatment approaches for SPTCL, particularly in cases where the patient is in remission, it is essential to consider both standard and supportive care strategies.

Standard Treatment Approaches

1. Observation and Monitoring

For patients in remission, the primary approach often involves careful observation. Regular follow-up appointments are crucial to monitor for any signs of recurrence. This may include physical examinations, imaging studies, and laboratory tests to assess overall health and detect any potential relapse early.

2. Chemotherapy

In cases where SPTCL is active or if there is a risk of recurrence, chemotherapy may be employed. Common regimens include:
- CHOP Regimen: This includes Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. It is a standard treatment for various types of non-Hodgkin lymphoma and may be effective in SPTCL.
- EPOCH Regimen: This is a more intensive regimen that includes Etoposide, Prednisone, Vincristine, Doxorubicin, and Cyclophosphamide, which may be considered in more aggressive cases.

3. Targeted Therapy

Recent advancements in targeted therapies have shown promise in treating T-cell lymphomas. Agents such as brentuximab vedotin, which targets CD30, may be considered, especially in cases where traditional chemotherapy is not effective or suitable.

4. Radiation Therapy

Radiation therapy can be beneficial for localized disease or for palliative care in symptomatic patients. It may also be used in conjunction with chemotherapy to enhance treatment efficacy.

5. Stem Cell Transplantation

For patients with relapsed or refractory SPTCL, autologous stem cell transplantation may be an option. This approach is typically reserved for younger patients or those with a good performance status, as it can offer a chance for long-term remission.

Supportive Care

In addition to the above treatments, supportive care plays a vital role in managing symptoms and improving the quality of life for patients with SPTCL. This may include:
- Pain Management: Addressing pain through medications or palliative care strategies.
- Nutritional Support: Ensuring adequate nutrition, especially if the patient experiences weight loss or gastrointestinal symptoms.
- Psychosocial Support: Providing counseling and support groups to help patients cope with the emotional aspects of living with lymphoma.

Conclusion

For patients with subcutaneous panniculitis-like T-cell lymphoma in remission, the focus is primarily on monitoring and supportive care, with treatment options available should the disease recur. Regular follow-ups and a multidisciplinary approach involving oncologists, dermatologists, and supportive care teams are essential to ensure optimal management of this rare lymphoma. As research continues, new therapies may emerge, offering hope for improved outcomes in SPTCL patients.