ICD-10: C82

Follicular lymphoma, classified under ICD-10 code C82, is a type of non-Hodgkin lymphoma that primarily affects the lymphatic system. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for diagnosis and management. Below is a detailed overview of these aspects.

Clinical Presentation

Overview of Follicular Lymphoma

Follicular lymphoma is characterized by the proliferation of B-lymphocytes in the lymph nodes and other lymphatic tissues. It is typically indolent, meaning it progresses slowly, but it can transform into a more aggressive form over time. The disease is most commonly diagnosed in adults, particularly those over the age of 60, and has a slight predominance in females[12][14].

Signs and Symptoms

The clinical presentation of follicular lymphoma can vary significantly among patients, but common signs and symptoms include:

• Lymphadenopathy: The most common initial finding is painless swelling of lymph nodes, often in the neck, armpits, or groin. Patients may notice enlarged lymph nodes during routine examinations or self-examinations[12][14].

• B Symptoms: Some patients may experience systemic symptoms known as "B symptoms," which include:

• Fever: Unexplained fevers that may be intermittent.
• Night Sweats: Profuse sweating during the night that can soak through clothing and bedding.

• Weight Loss: Unintentional weight loss of more than 10% of body weight over six months[12][14].

• Fatigue: Many patients report a general sense of fatigue or weakness, which can be debilitating and affect daily activities[12][14].

• Abdominal Symptoms: In cases where the lymphoma involves the spleen or abdominal lymph nodes, patients may experience abdominal pain, fullness, or discomfort due to organ enlargement[12][14].

• Skin Manifestations: Rarely, follicular lymphoma can present with skin lesions, which may appear as nodules or plaques[12][14].

Patient Characteristics

Demographics

• Age: Follicular lymphoma is most commonly diagnosed in older adults, particularly those aged 60 and above. The median age at diagnosis is around 60 years[12][14].
• Gender: There is a slight female predominance, with women being more frequently diagnosed than men[12][14].

Risk Factors

Several factors may increase the risk of developing follicular lymphoma, including:
- Family History: A family history of lymphoma or other hematologic malignancies can increase risk.
- Immune System Disorders: Conditions that compromise the immune system, such as HIV/AIDS or autoimmune diseases, may predispose individuals to lymphoma[12][14].
- Environmental Exposures: Certain environmental factors, including exposure to pesticides and chemicals, have been suggested as potential risk factors, although evidence is not definitive[12][14].

Comorbidities

Patients with follicular lymphoma may have other health conditions that can complicate treatment and management. Common comorbidities include cardiovascular diseases, diabetes, and other malignancies, which can influence treatment decisions and overall prognosis[12][14].

Conclusion

Follicular lymphoma, represented by ICD-10 code C82, presents with a range of clinical features, primarily painless lymphadenopathy and systemic symptoms. Understanding the signs, symptoms, and patient demographics is essential for timely diagnosis and effective management. Given its indolent nature, many patients may live for years with the disease, but regular monitoring and appropriate treatment are crucial to managing symptoms and preventing transformation to a more aggressive form of lymphoma. For patients experiencing any of the symptoms mentioned, it is important to seek medical evaluation for proper diagnosis and management.

Follicular lymphoma, classified under ICD-10 code C82, is a type of non-Hodgkin lymphoma that originates in the lymphatic system. It is characterized by the proliferation of follicle center (germinal center) B-cells. Understanding the alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some of the key alternative names and related terms associated with follicular lymphoma.

Alternative Names for Follicular Lymphoma

1. Follicular Lymphoma, Grade 1: This refers to the less aggressive form of follicular lymphoma, which typically has a better prognosis and slower progression[2].

2. Follicular Lymphoma, Grade 2: This variant indicates a more aggressive form of the disease, with a higher proliferation index compared to grade 1[2][3].

3. Follicular Lymphoma, Grade 3: This is the most aggressive form of follicular lymphoma, often treated similarly to diffuse large B-cell lymphoma[2].

4. Nodal Follicular Lymphoma: This term emphasizes the lymph node involvement, which is common in follicular lymphoma[3].

5. Non-Hodgkin Follicular Lymphoma: This term is used to specify that follicular lymphoma is a subtype of non-Hodgkin lymphoma, distinguishing it from Hodgkin lymphoma[3].

Related Terms

1. B-cell Lymphoma: Follicular lymphoma is classified as a B-cell lymphoma, as it arises from B-lymphocytes, a type of white blood cell[2].

2. Lymphoproliferative Disorder: This broader term encompasses conditions like follicular lymphoma, where there is an abnormal proliferation of lymphocytes[3].

3. Chronic Lymphocytic Leukemia (CLL): While distinct, CLL can sometimes be confused with follicular lymphoma due to overlapping features in lymphocyte proliferation[3].

4. Lymphoma: A general term for cancers that originate in the lymphatic system, which includes both Hodgkin and non-Hodgkin lymphomas, including follicular lymphoma[3].

5. Stage I, II, III, IV Follicular Lymphoma: These terms refer to the stages of the disease, indicating the extent of spread within the body, which is crucial for treatment planning[2].

Conclusion

Understanding the alternative names and related terms for ICD-10 code C82: Follicular lymphoma is essential for accurate diagnosis, treatment planning, and communication among healthcare professionals. This knowledge aids in the classification of the disease and helps in distinguishing it from other lymphoproliferative disorders. For further information or specific inquiries regarding treatment options or prognosis, consulting with a healthcare provider specializing in hematology or oncology is recommended.

Follicular lymphoma, classified under ICD-10 code C82, is a type of non-Hodgkin lymphoma characterized by the proliferation of follicle center (germinal center) B-cells. It is typically indolent, meaning it progresses slowly, but it can transform into a more aggressive form. The treatment approaches for follicular lymphoma vary based on several factors, including the stage of the disease, the patient's overall health, and specific characteristics of the lymphoma itself.

Standard Treatment Approaches

1. Watchful Waiting (Active Surveillance)

For patients with asymptomatic early-stage follicular lymphoma, especially those with low tumor burden, a strategy of watchful waiting may be employed. This approach involves regular monitoring without immediate treatment, as many patients may not require intervention for years. This is particularly common in older patients or those with other significant health issues[1].

2. Chemotherapy

Chemotherapy remains a cornerstone of treatment for symptomatic or advanced follicular lymphoma. Common regimens include:

• CHOP: Cyclophosphamide, doxorubicin, vincristine, and prednisone.
• R-CHOP: This is the CHOP regimen combined with rituximab, a monoclonal antibody that targets CD20 on B-cells. R-CHOP is often the standard first-line treatment for advanced-stage follicular lymphoma[2].

3. Immunotherapy

Rituximab is a key component in the treatment of follicular lymphoma. It can be used alone or in combination with chemotherapy. In cases of relapsed or refractory disease, rituximab can be administered as a single agent or combined with other agents like lenalidomide (Revlimid) to enhance efficacy[3].

4. Targeted Therapy

Recent advancements have introduced targeted therapies that focus on specific pathways involved in the growth of lymphoma cells. Examples include:

• B-cell receptor inhibitors: Such as ibrutinib and acalabrutinib, which target the Bruton’s tyrosine kinase (BTK) pathway.
• PI3K inhibitors: Such as idelalisib, which target the phosphoinositide 3-kinase pathway, are also used in certain cases, particularly for relapsed disease[4].

5. Radiation Therapy

Radiation therapy may be utilized in localized cases, particularly for patients with limited-stage disease or for palliative care to relieve symptoms caused by lymphadenopathy. It is often used in conjunction with other treatments[5].

6. Stem Cell Transplantation

For patients with relapsed or refractory follicular lymphoma, high-dose chemotherapy followed by autologous stem cell transplantation may be considered. This approach is typically reserved for younger patients or those with more aggressive disease features[6].

7. Clinical Trials

Participation in clinical trials is encouraged for patients with follicular lymphoma, as these studies may provide access to novel therapies and treatment strategies that are not yet widely available. Trials often explore new combinations of existing therapies or entirely new agents[7].

Conclusion

The treatment of follicular lymphoma (ICD-10 code C82) is multifaceted and tailored to the individual patient. While watchful waiting may be appropriate for some, others may require a combination of chemotherapy, immunotherapy, targeted therapies, or radiation. As research continues to evolve, new treatment modalities and combinations are being explored, offering hope for improved outcomes in patients with this type of lymphoma. For those considering treatment options, consulting with a healthcare provider specializing in hematology or oncology is essential to determine the most appropriate course of action based on the latest evidence and individual circumstances.

Follicular lymphoma, classified under ICD-10 code C82, is a type of non-Hodgkin lymphoma (NHL) that originates from B-lymphocytes, specifically in the follicle or germinal center of lymph nodes. This lymphoma is characterized by its indolent (slow-growing) nature, although it can transform into a more aggressive form over time. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Follicular Lymphoma

Definition and Classification

Follicular lymphoma is a malignancy of the lymphatic system, primarily affecting the lymph nodes. It is classified as a low-grade lymphoma, which means it typically grows slowly and may not require immediate treatment upon diagnosis. The ICD-10 code C82 encompasses various subtypes of follicular lymphoma, including:

• C82.0: Follicular lymphoma, grade 1
• C82.1: Follicular lymphoma, grade 2
• C82.2: Follicular lymphoma, grade 3
• C82.9: Follicular lymphoma, unspecified[2][10].

Epidemiology

Follicular lymphoma is one of the most common types of non-Hodgkin lymphoma, accounting for approximately 20% of all NHL cases. It predominantly affects adults, with a higher incidence in individuals aged 60 and older. The condition is slightly more common in women than in men[3][4].

Symptoms

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

• Painless lymphadenopathy: Swelling of lymph nodes, often in the neck, armpits, or groin.
• B symptoms: These may include fever, night sweats, and unexplained weight loss.
• Fatigue: Generalized tiredness and lack of energy.
• Abdominal discomfort: If lymph nodes in the abdomen are affected, patients may experience pain or fullness[5][6].

Diagnosis

Diagnosis of follicular lymphoma typically involves:

• Physical examination: Assessment of swollen lymph nodes.
• Imaging studies: CT scans or PET scans to evaluate the extent of the disease.
• Biopsy: A definitive diagnosis is made through a biopsy of the affected lymph node, which is then examined histologically to identify the characteristic follicular pattern of the lymphoma cells.
• Immunophenotyping: This laboratory test helps determine the specific type of lymphoma by analyzing the proteins expressed on the surface of the cancer cells[6][7].

Treatment

Treatment options for follicular lymphoma depend on the stage of the disease and the patient's overall health. Common approaches include:

• Watchful waiting: In cases where the lymphoma is asymptomatic and slow-growing, doctors may recommend monitoring the patient without immediate treatment.
• Chemotherapy: Often used for more advanced stages or symptomatic cases, chemotherapy regimens may include agents such as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP).
• Immunotherapy: Monoclonal antibodies like rituximab are frequently used in combination with chemotherapy to target CD20-positive B-cells.
• Radiation therapy: This may be employed for localized disease or to alleviate symptoms from enlarged lymph nodes[8][9].

Prognosis

The prognosis for patients with follicular lymphoma varies widely based on several factors, including the grade of the lymphoma, the patient's age, and overall health. Generally, follicular lymphoma has a favorable prognosis, with many patients living for years with the disease, especially when managed appropriately. However, it is important to note that follicular lymphoma can transform into a more aggressive form, which may complicate treatment and affect outcomes[4][5].

Conclusion

Follicular lymphoma, represented by ICD-10 code C82, is a prevalent form of non-Hodgkin lymphoma characterized by its slow growth and potential for transformation. Understanding its clinical features, diagnostic methods, and treatment options is crucial for effective management and improving patient outcomes. Regular follow-up and monitoring are essential for managing this condition, given its indolent nature and the possibility of progression.