Search Database ICD-O-3 Code Lists

Name

Classic Hodgkin lymphoma, mixed cellularity (MC-cHL)

ICD-O-3 Morphology

9652/3: Hodgkin lymphoma, mixed cellularity, 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, mixed cellularity (MC-cHL) 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)

Mixed cellularity classical Hodgkin lymphoma (MC-cHL) 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.

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, mixed cellularity, NOS
Hodgkin lymphoma, mixed cellularity, 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).

Mixed cellularity classic Hodgkin lymphoma (MCCHL) is a subtype of classic Hodgkin lymphoma (CHL) characterized by classic Hodgkin/Reed-Sternberg (HRS) cells in a diffuse mixed inflammatory background. Fine interstitial fibrosis may be present, but fibrous brands are absent, and capsular fibrosis is usually absent.

Definitive Diagnostic Methods

Cytogenetics
Genetic testing
Histologic confirmation
Immunohistochemistry
Immunophenotyping

Genetics Data

Reed-Sternberg cells with clonal Ig gene rearrangements

Immunophenotyping

EBV-encoded small RNA (EBER)
EBV-encoded LMP1

Treatments

Chemotherapy
Hormone therapy
Radiation therapy

Transformations to

None

Transformations from

Same Primaries

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

C81.2 Hodgkin mixed cellularity

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

C81.2_ Mixed cellularity Hodgkin lymphoma (effective October 01, 2015)
C81.2A Mixed cellularity 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
Peripheral 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
MRI (magnetic resonance image)
PET (positron emission tomography) scan

Progression and Transformation

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

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