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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
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 (CHL), NOS 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)
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 neoplasms 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
9651-Lymphocyte-rich classical Hodgkin lymphoma
9652-Mixed cellularity classical Hodgkin lymphoma
9653-Lymphocyte-rich depleted classical Hodgkin lymphoma
9655-Hodgkin lymphoma, lymphocyte depletion, reticular
9659-Nodular lymphocyte predominant Hodgkin lymphoma
Classical Hodgkin lymphoma (CHL)
1. Cervical region lymph nodes involved (75%) followed by mediastinal, axillary, and paraaortic regions.
2. Non-axial lymph node groups such as mesenteric or epitrochlear LN are rarely involved.
3. Primary extranodal involvement is rare.
4. More than 60% have localized involvement.
5.Splenic involvement is not uncommon (20%) and is associated with an increased risk of extranodal dissemination.
6. Bone marrow involvement is less common (5%). BM infiltration indicates disseminated involvement (Stage IV).
Radiation and chemotherapy have made CHL curable in more than 85% of cases.
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 neoplasms 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
9651-Lymphocyte-rich classical Hodgkin lymphoma
9652-Mixed cellularity classical Hodgkin lymphoma
9653-Lymphocyte-rich depleted classical Hodgkin lymphoma
9655-Hodgkin lymphoma, lymphocyte depletion, reticular
9659-Nodular lymphocyte predominant Hodgkin lymphoma
Classical Hodgkin lymphoma (CHL)
1. Cervical region lymph nodes involved (75%) followed by mediastinal, axillary, and paraaortic regions.
2. Non-axial lymph node groups such as mesenteric or epitrochlear LN are rarely involved.
3. Primary extranodal involvement is rare.
4. More than 60% have localized involvement.
5.Splenic involvement is not uncommon (20%) and is associated with an increased risk of extranodal dissemination.
6. Bone marrow involvement is less common (5%). BM infiltration indicates disseminated involvement (Stage IV).
Radiation and chemotherapy have made CHL curable in more than 85% of cases.
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
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)
Definitive Diagnostic Methods
Cytogenetics
Genetic testing
Histologic confirmation
Immunohistochemistry
Immunophenotyping
Immunophenotyping
BOBI- (decreased expression)
CD15+ (expression/positive)
CD20- (no expression/weak)
CD30+ (expression/positive)
CD45- (no expression/negative)
CD75- (no expression/negative)
OCT2- (decreased expression)
PAX5+ (expression/positive)
Treatments
Chemotherapy
Hormone therapy
Radiation therapy
Transformations to
None
Transformations from
Same Primaries
Corresponding ICD-10 Codes (Cause of Death codes only)
C81.9 Hodgkin disease, unspecified
Corresponding ICD-10-CM Codes (U.S. only)
C81.9_ Hodgkin lymphoma, unspecified (effective October 01, 2015)
C81.9A Hodgkin lymphoma, unspecified, 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
PET (positron emission tomography) scan
Progression and Transformation
None
Epidemiology and Mortality
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 lymphoma
Pages: Part B: 580-590
Section: Hodgkin lymphoma
Pages: Part B: 580-590
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
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
Section: Hodgkin Lymphoma Treatment (PDQ®)–Health Professional Version
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-hodgkin-treatment-pdq
