B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma

Name
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma
ICD-O-3 Morphology
9596/3
Effective 2001 and later
Reportable
for cases diagnosed 2001 and later
Primary Site(s)
C770-C779
Lymph nodes (C770-C779) are the usual primary sites; however, involvement in other sites is possible. If you have confirmation that the only involved site is something other than the lymph nodes, than code to that primary site. See Module 7.

Help me code for diagnosis year :

Grade
6 - B-cell
Module Rule
M5 Module 6: PH 14
Alternate Names
Compositive Hodgkin and non-Hodgkin lymphoma
Composite lymphoma
Gray zone lymphoma
Grey zone lymphoma
Hodgkin-like anaplastic large cell lymphoma
Large B-cell lymphoma with Hodgkin features
Definition
Synchronous OR metachronous occurrence of HL with NHL. Possible explanations:
1) Both arise coincidentally from unrelated lymphoid elements
2) HL progresses from previous NHL
3) Both derive from common precursor cell
Abstractor Notes
Previously, the term for this code was composite Hodgkin and non-Hodgkin lymphoma. In the 2008 WHO, the term used to describe this same disease is B-cell lymphoma, unclassifiable, with features indeterminate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma. The change in terminology reflects current clinical knowledge that the non-Hodgkin portion of this lymphoma has proven to be a B-cell immunophenotype.

The most common presentation is a large anterior mediastinal mass with or without involvement of supraclavicular lymph nodes. Other peripheral lymph node groups are less commonly involved.

There may be direct extension to the lung, spread to liver, spleen, or bone marrow. Non-lymphoid organs are rarely involved. The combination of classical Hodgkin lymphoma and mediastinal large B-cell lymphoma may occur as a composite lymphoma or the patient may present with CHL and relapse/recur as large B-cell lymphoma.
Definitive Diagnostic Methods
Histologic confirmation
Immunophenotyping
Genetics Data
None
Immunophenotyping
ALK-
BOB 1+
CD10-
CD15+
CD20+
CD30+
CD45+
CD79a+
OCT-2+
PAX5+
Treatments
Chemotherapy
Hormone
Stem cell transplant
Transformations to
There are no known transformations
Transformations from
There are no known transformations
Corresponding ICD-9 Codes
202.8 Other lymphoma
Corresponding ICD-10 Codes
C85.9 Non-Hodgkin's lymphoma, unspecified type
Corresponding ICD-10-CM Codes (effective October 1, 2015 U.S. only)
C85.9 Non-Hodgkin's lymphoma, unspecified
Signs and Symptoms
Drenching night sweats
Fatigue
Fever (for no known reason)
Large mediastinal mass
Pain in the chest, abdomen, or bones (for no known reason)
Painless swelling in the lymph nodes
Respiratory distress
Skin rash or itchy skin
Superior vena cava syndrome
Weight loss (for no known reason)
Diagnostic Exams
Bone marrow aspiration and biopsy
Complete blood count (CBC)
CT (CAT) scan
Laparoscopy (rarely performed)
Laparotomy (rarely performed)
MRI (magnetic resonance imaging)
PET (positron emission tomography) scan
Progression and Transformation
None
Epidemiology and Mortality
Age: 20-40 years most common (13-70 years range)
Sex: male predominance