Name

Mixed cellularity classic Hodgkin lymphoma

ICD-O-1 Morphology

9652/3: Hodgkin lymphoma, mixed cellularity, NOS
Effective 1978 - 1991

ICD-O-2 Morphology

9652/3: Hodgkin lymphoma, mixed cellularity, NOS
Effective 1992 - 2000

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 (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.

Grade

Not Applicable

Module Rule

None

Alternate Names

Classical Hodgkin lymphoma, mixed cellularity, NOS
Hodgkin lymphoma, mixed cellularity, NOS
MCCHL
MC-HL

Definition

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.

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.

Definitive Diagnostic Methods

Histologic confirmation
Immunophenotyping

Genetics Data

None

Immunophenotyping

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

Treatments

Chemotherapy
Hormone therapy
Radiation therapy

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 (U.S. only)

C81.2 Mixed cellularity classical Hodgkin lymphoma (effective October 01, 2015)

Signs and Symptoms

Drenching night sweats
Fever (for no known reason)
Pain in the chest, abdomen, or bones (for no known reason)
Painless swelling in the lymph nodes
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

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

Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Hodgkin lymphomas
Pages: 440

International Classification of Diseases for Oncology, Third Edition, First Revision. Geneva: World Health Organization, 2013.
Section: ICD-O-3.1 (2011) Morphological Codes
Pages: http://codes.iarc.fr/codegroup/2

National Cancer Institute
Section: General Information About Adult Hodgkin Lymphoma (HL)
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-hodgkin-treatment-pdq
Glossary