Name
Lymphoplasmacytic lymphoma
Reportable
for cases diagnosed
1978 and later
Primary Site(s)
See Module 6
Most common sites of involvement: lymph nodes, bone marrow and other organs
Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
LPL is an NOS which has two variants. All three diseases are diagnosed by an increased number of immunoglobulins. WM is caused by increased lymphocytes which causes an increase in IgM. Gamma heavy chain disease is caused by increased plasma cells which results in an increase of IgG. LPL has mixed abnormalities, both the lymphocytes and plasma cells are increased which results in an abnormally high IgM AND IgG.
1. Waldenstrom Macroglobulinemia (WM) (9761/3) is a subset of LPL. WM is caused by increased lymphocytes which causes an increase in IgM. See the abstractor notes for WM for more information.
2. Gamma heavy chain disease (9762/3) is a variant of LPL. Gamma heavy chain disease is caused by increased plasma cells which results in an increase of IgG. See the abstractor notes for Gamma heavy chain disease for more information.
All three diseases are diagnosed by an increased number of immunoglobulins.
1. Waldenstrom Macroglobulinemia (WM) (9761/3) is a subset of LPL. WM is caused by increased lymphocytes which causes an increase in IgM. See the abstractor notes for WM for more information.
2. Gamma heavy chain disease (9762/3) is a variant of LPL. Gamma heavy chain disease is caused by increased plasma cells which results in an increase of IgG. See the abstractor notes for Gamma heavy chain disease for more information.
All three diseases are diagnosed by an increased number of immunoglobulins.
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.
Grade
Not Applicable
Module Rule
Module 6: PH17
Alternate Names
Definition
Lymphoplasmacytic lymphoma (LPL) is a neoplasm of small B lymphocytes, plasmacytoid lymphocytes, and plasma cells, usually involving bone marrow and sometimes lymph nodes and spleen, which does not fulfill the criteria for any of the other small B-cell lymphoid neoplasms that can also have plasmacytic differentiation.
Definitive Diagnostic Methods
Bone marrow biopsy
Genetic testing
Histologic confirmation
Immunophenotyping
Peripheral blood smear
Genetics Data
Immunophenotyping
CD5- (no expression/negative)
CD10- (no expression/negative)
CD19+ (expression/positive)
CD20+ (expression/positive)
CD22+ (expression/positive)
CD23- (no expression/negative)
CD25+ (expression/positive)
CD38+ (expression/positive)
CD45+ (expression/positive)
CD79a+ (expression/positive)
CD103- (no expression/negative)
CD138+ (expression/positive)
IgA + (expression/positive) (rare)
IgD- (no expression/negative)
IgG+ (expression/positive)
IgM monclonal gammopathy+ (expression/positive)
Treatments
Chemotherapy
Hormone therapy
Transformations to
Transformations from
None
Same Primaries
Corresponding ICD-9 Codes
273.3 Macroglobulinemia
Corresponding ICD-10 Codes
C88.0 Waldenstrom macroglobulinemia
Corresponding ICD-10-CM Codes (U.S. only)
C88.0 Waldenstrom macroglobulinemia (effective October 01, 2015)
Signs and Symptoms
Adenopathy
Anemia
Drenching night sweats
Fatigue
Fever (for no known reason)
Hepatomegaly
Pain in the chest, abdomen, or bones (for no known reason)
Painless swelling in the lymph nodes
Skin rash or itchy skin
Splenomegaly
Weakness
Weight loss (for no known reason)
Diagnostic Exams
Blood chemistry studies
Bone marrow aspiration and biopsy
CT (CAT) scan
Cytogenetic analysis
Flow cytometry
Immunohistochemistry
Immunophenotyping
Laparoscopy (rarely performed)
Laparotomy (rarely performed)
Lymph node biopsy
Peripheral blood smear
PET (positron emission tomography) scan
Progression and Transformation
Transformation to DLBCL occurs in a small proportion and indicates poor survival
Epidemiology and Mortality
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: Mature B-cell neoplasms
Pages: 232-235
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 232-235
International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 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
National Cancer Institute
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)
Pages: https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq