Search Database ICD-O-3 Code Lists

Name

Classic Hodgkin lymphoma, lymphocyte depleted, NOS (LDCHL)

ICD-O-3 Morphology

9653/3: Hodgkin lymphoma, lymphocytic depletion, NOS
Effective 2001 and later

Reportable

for cases diagnosed 1978 and later

Primary Site(s)

C770-C779
Lymph nodes are the most common primary sites.
Common metastatic sites include the bone, CNS, liver, lung, and bone marrow.
Spleen involvement is common due to dissemination of disease

Assign C779 if specific primary site cannot be determined.

See abstractor notes

Coding Manual: Hematopoietic Coding Manual (PDF)

Abstractor Notes

Classic Hodgkin lymphoma, lymphocyte depleted, NOS (LDCHL) is part of the Hodgkin lymphoma neoplasms lineage table in the WHO 5th edition of Hematolymphoid Tumors. (See Appendix B in the Hematopoietic Manual, Table B16)

Lymphocyte-depleted classical Hodgkin lymphoma (LDCHL) has a predilection for retroperitoneal lymph nodes, abdominal organs, and bone marrow. Compared to other subtypes of CHL, LDCHL presents at a more advanced stage (III-IV) and with B symptoms.

Diagnostic Confirmation

This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.

Module Rule

None

Alternate Names

Classical Hodgkin lymphoma, lymphocyte-depletion, diffuse fibrosis [OBS] (see 9654/3 prior to 2010)
Classical Hodgkin lymphoma, lymphocyte depletion, NOS
Hodgkin lymphoma, lymphocyte depletion, diffuse fibrosis [OBS] (see 9654/3 prior to 2010)
Hodgkin lymphoma, lymphocyte depletion, NOS

Definition

Classic Hodgkin lymphoma (CHL) is a neoplasm derived from germinal-centre B cells, characterized by a low fraction of tumour cells embedded in a reactive microenvironment rich in immune cells. The large neoplastic Hodgkin and Reed–Sternberg cells show a defective B-cell expression programme. (WHO 5th edition).

Lymphocyte-depleted classic Hodgkin lymphoma (LDCHL) is a diffuse form of classic Hodgkin lymphoma (CHL) rich in Hodgkin/Reed-Sternberg (HRS) cells and/or depleted of non-neoplastic lymphocytes. Histiocytes are usually abundant. Frequent association with EBV.

Definitive Diagnostic Methods

Cytogenetics
Genetic testing
Histologic confirmation
Immunohistochemistry
Immunophenotyping

Genetics Data

None

Immunophenotyping

CD30+ (expression/positive)
CD79a- (no expression/negative)
EBV/LMP1+ (expression/positive)
OCT2+ (expression/positive)
PAX5+ (expression/positive)

Treatments

Chemotherapy
Hormone therapy
Radiation therapy

Transformations to

Transformations from

Same Primaries

Corresponding ICD-10 Codes (Cause of Death codes only)

C81.3 Hodgkin lymphocytic depletion

Corresponding ICD-10-CM Codes (U.S. only)

C81.3_ Lymphocyte depleted Hodgkin lymphoma (effective October 01, 2015)
C81.3A Lymphocyte depleted Hodgkin lymphoma, in remission (effective October 01, 2024)

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
Retroperitoneal lymphadenopathy
Skin rash or itchy skin
Weight loss (for no known reason)

Diagnostic Exams

Blood chemistry studies
Bone marrow aspiration and biopsy
CT (CAT) scan
Erythrocyte sedimentation rate
Immunophenotyping
Lymph node biopsy
PET (positron emission tomography) scan

Progression and Transformation

None

Epidemiology and Mortality

Age: 30-37 years median age
Incidence: <1% of classical Hodgkin lymphomas
Sex: male predominance
Survival: good prognosis

Sources

WHO Classification of Tumours Editorial Board. Haematolymphoid tumours. Lyon (France): International Agency for Research on Cancer; 2024. (WHO classification of tumours series, 5th ed.; vol. 11). https://publications.iarc.who.int/637.
Section: Hodgkin lymphomas
Pages: Part B: 580-588

International Classification of Diseases for Oncology, 3rd edition (including revisions). Geneva: World Health Organization, 2001, 2011, 2020.
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577

PDQ® Adult Treatment Editorial Board. PDQ Hodgkin Lymphoma Treatment. Bethesda, MD: National Cancer Institute. Updated <02/12/2025>. Available at: https://www.cancer.gov/types/lymphoma/hp/adult-hodgkin-treatment-pdq. Accessed <03/30/2025>. [PMID: 26389473]
Section: Hodgkin Lymphoma Treatment (PDQ®)–Health Professional Version
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-hodgkin-treatment-pdq
Glossary