Mixed cellularity classical Hodgkin lymphoma

Name
Mixed cellularity classical Hodgkin lymphoma
ICD-O-1 Morphology
9652/3
Effective 1978 - 1991
ICD-O-2 Morphology
9652/3
Effective 1992 - 2000
ICD-O-3 Morphology
9652/3
Effective 2001 and later
Reportable
for cases diagnosed 1978 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, then code to that primary site. See Module 7.

Help me code for diagnosis year :

Grade
Code grade specified by pathologist. If no grade specified, code 9
Module Rule
None
Alternate Names
Classical Hodgkin lymphoma, mixed cellularity, NOS
Hodgkin lymphoma, mixed cellularity, NOS
MCCHL
MC-HL
Definition
Subtype of classic Hodgkin's lymphoma (HL), classic Reed-Sternberg (RS) cells with prominent inclusion-like nucleoli, lacunar cells inconspicuous, nodular fibrosing sclerosis absent. Usually associated with diffuse architectural effacement. Rich inflammatory background with numerous eosinophils, plasma cells, histiocytes.
Abstractor Notes
Mixed cellularity classical Hodgkin lymphoma (MCCHL) frequently involves peripheral lymph nodes. Mediastinal involvement is uncommon. The spleen is involved in 30%, bone marrow in 10%, liver in 3%, and other organs in 1-3%. MCCHL is more frequent in patients with HIV infection and in developing countries.

With current regimens, MCCHL has approximately the same prognosis as nodular sclerosis and a better prognosis than lymphocyte-depleted CHL.

Per WHO, Hodgkin lymphomas are primarily B-cell lymphomas. If the medical record states B-cell, code 6. Since there are Hodgkin lymphomas that are not B-cell, the default grade is 9 (unknown) where the documentation does not specifically state B-cell.
Definitive Diagnostic Methods
Histologic confirmation
Immunophenotyping
Genetics Data
None
Immunophenotyping
CD15+
CD30+
CD45-
EBER+
EBV-encoded LMP1
Treatments
Chemotherapy
Hormone
Radiation
Transformations to
None
Corresponding ICD-9 Codes
201.6 Hodgkin's disease, mixed cellularity
Corresponding ICD-10 Codes
C81.2 Hodgkin's disease, mixed cellularity
Corresponding ICD-10-CM Codes (effective October 1, 2015 U.S. only)
C81.2 Mixed cellularity classical Hodgkin lymphoma
Signs and Symptoms
Drenching night sweats
Fatigue
Fever (for no known reason)
Pain in the chest, abdomen, or bones (for no known reason)
Painless swelling in the lymph nodes
Peripheral lymphadenopathy
Skin rash or itchy skin
Weight loss (for no known reason)
Diagnostic Exams
CT (CAT) scan
Complete blood count (CBC)
MRI (magnetic resonance image)
PET (positron emission tomography) scan
Recurrence and Metastases
None
Epidemiology and Mortality
Age: 38 years median age
Incidence: 20-25% of classical Hodgkin lymphomas
Sex: male predominance
Survival: good prognosis with changes in therapy