Classical Hodgkin lymphoma
Help me code for diagnosis year :
Lymphoproliferative disorder defined histologically by characteristic Reed-Sternberg cells, characterized by paucity of malignant cells surrounded by abundant "bystander" cells.
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 disease.
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 disease (Stage IV).
Radiation and chemotherapy have made CHL curable in more than 85% of cases.
Per WHO, Hodgkin lymphomas are primarily B-cell lymphomas. If the medical record states B-cell, code 6. Since there are Hodgkin lymphomas that are not B-cell, the default grade is 9 (unknown) when the documentation does not specifically state B-cell.
For more information on this neoplasm, see the NCI website: http://www.cancer.gov/types/lymphoma/hp/adult-hodgkin-treatment-pdq or http://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq