Classical Hodgkin lymphoma

Name
Classical Hodgkin lymphoma
ICD-O-1 Morphology
9650/3
Effective 1978 - 1991
ICD-O-2 Morphology
9650/3
Effective 1992 - 2000
ICD-O-3 Morphology
9650/3
Effective 2001 and later
Reportable
for cases diagnosed 1978 and later
Primary Site(s)
C770-C779

Help me code for diagnosis year :

Grade
Code grade specified by pathologist. If no grade specified, code 9
Module Rule
None
Alternate Names
CHL
HL
Hodgkin lymphoma, NOS
Malignant lymphoma, Hodgkin
Definition
Monoclonal lymphoid neoplasm composed of mononuclear Hodgkin cells and multinucleated Reed-Sternberg cells residing in infiltrate of non-neoplastic small lymphocytes, eosinophils, neutrophils, histiocytes, plasma cells, fibroblasts, collagen fibers.

Lymphoproliferative disorder defined histologically by characteristic Reed-Sternberg cells, characterized by paucity of malignant cells surrounded by abundant "bystander" cells.
Abstractor Notes
9650/3 is used in ICD-O-3 to describe Hodgkin lymphoma, NOS and by WHO to describe classical Hodgkin lymphoma. Both terms are "NOS" or generic disease descriptions. DCO cases or path report only cases stay in this category when no additional information is available. Classical Hodgkin may be a final diagnosis, but Hodgkin lymphoma, NOS more commonly is the provisional diagnosis given at the start of the work-up process; further review of the medical record should be done. Look for additional tests such as immunophenotyping or genetics. When a patient has a history of Hodgkin lymphoma, NOS or classical Hodgkin lymphoma and subsequently a more specific Hodgkin lymphoma is diagnosed, change the histology code to the more specific neoplasm/code. More specific Hodgkin lymphomas include: Hodgkin lymphocyte predominant Hodgkin lymphoma, nodular sclerosis, mixed cellularity classical Hodgkin lymphoma, lymphocyte-rich classical Hodgkin lymphoma, and lymphocyte-depleted classical Hodgkin lymphoma. See the histology tables for more information on NOS and more specific codes.

Classical Hodgkin lymphoma (CHL) most commonly involves lymph nodes of the cervical region (75%) followed by mediastinal, axillary, and paraaortic regions. Non-axial lymph node groups such as mesenteric or epitrochlear LN are rarely involved. Primary extranodal involvement is rare. More than 60% have localized disease. Splenic involvement is not uncommon (20%) and is associated with an increased risk of extranodal dissemination. Bone marrow involvement is less common (5%). BM infiltration indicates disseminated disease (Stage IV). Patients usually present with peripheral lymphadenopathy, localized to 1 or 2 lymph node areas. Radiation and chemotherapy have made CHL curable in more than 85% of cases.

Preferred primary sites are listed for this disease in the primary site field; however, involvement in other sites is possible, but rare. If you have confirmation that the only involved site is something other than the preferred primary listed, then code to that primary site.
Definitive Diagnostic Methods
FISH
Histologic confirmation
Immunophenotyping
Genetics Data
Reed-Sternberg cells with clonal Ig gene rearrangements
Immunophenotyping
CD14+
CD15+
CD30+
CD45-
CD75-
Treatments
Chemotherapy
Hormone
Radiation
Transformations to
No Transformations
Corresponding ICD-9 Codes
201.9 Hodgkin's disease, unspecified
Corresponding ICD-10 Codes
C81.9 Hodgkin's disease, unspecified
C81.7 Other Hodgkin's disease
Corresponding ICD-10-CM Codes (effective October 1, 2015 U.S. only)
C81.9 Hodgkin lymphoma, unspecified
C81.7 Other classical Hodgkin lymphoma
Signs and Symptoms
None
Diagnostic Exams
None
Recurrence and Metastases
None
Epidemiology and Mortality
None