SEER is an authoritative source of information on cancer incidence and survival in the United States. SEER currently collects and publishes cancer incidence and survival data from population-based cancer registries covering approximately 28 percent of the U.S. population.
Code grade specified by pathologist. If no grade specified, code 9
Hodgkin lymphoma, NOS
Malignant lymphoma, Hodgkin
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.
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
Reed-Sternberg cells with clonal Ig gene rearrangements