Search Database ICD-O-3 Code Lists

Name

Classic Hodgkin lymphoma, nodular sclerosis, NOS (NS-cHL)

ICD-O-1 Morphology

9656/3: Hodgkin disease, nodular sclerosis, NOS
Effective 1978 - 1991

ICD-O-2 Morphology

9663/3: Hodgkin lymphoma, nodular sclerosis, NOS
Effective 1992 - 2000

ICD-O-3 Morphology

9663/3: Hodgkin lymphoma, nodular sclerosis, 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.

Coding Manual: Hematopoietic Coding Manual (PDF)

Abstractor Notes

Nodular sclerosis classical Hodgkin lymphoma (NSCHL) occurs in the mediastinum in 90% of the cases, bulky involvement in 54%, splenic and/or lung involvement in 8-10%, bone involvement in 5%, bone marrow involvement in 3%, and liver involvement in 2%.

Most patients present with stage II involvement. B symptoms are encountered in approximately 40% of cases. Massive mediastinal involvement is an adverse prognostic factor.

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 7 for primary site

Alternate Names

Classical Hodgkin lymphoma, nodular sclerosis, cellular phase
Classical Hodgkin lymphoma, nodular sclerosis, grade 1
Classical Hodgkin lymphoma, nodular sclerosis grade 2
Classical Hodgkin lymphoma, nodular sclerosis, NOS
Classical Hodgkin lymphoma, nodular sclerosis, syncytial variant
Hodgkin disease, nodular sclerosis, lymphocyte predominance
Hodgkin disease, nodular sclerosis, lymphocyte depletion
Hodgkin disease, nodular sclerosis, mixed cellularity
Hodgkin disease, nodular sclerosis, NOS
Nodular sclerosis, classic Hodgkin lymphoma (NSCHL)

Definition

Nodular sclerosis classic Hodgkin lymphoma (NSCHL) is a subtype of classic Hodgkin lymphoma (CHL) characterized by collagen bands that surround at least one nodule, and by HRS cells with lacunar-type morphology.

Definitive Diagnostic Methods

Histologic confirmation
Immunophenotyping

Genetics Data

None

Immunophenotyping

CD2+ (expression/positive)
CD4+ (expression/positive)
CD15-(no expression/negative)
CD20+ (expression/positive)
CD30+ (expression/positive)
CD45- (no expression/negative)
CD79a+ (expression/positive)
EBV-encoded small RNA (EBER)

Treatments

Chemotherapy
Hormone therapy
Radiation therapy

Transformations to

None

Transformations from

Same Primaries

Corresponding ICD-9 Codes

201.5 Hodgkin's disease, nodular sclerosis

Corresponding ICD-10 Codes

C81.1 Hodgkin nodular sclerosis

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

C81.1 Nodular sclerosis Hodgkin lymphoma (effective October 01, 2015)

Signs and Symptoms

Drenching night sweats
Fatigue
Fever (for no known reason)
Mediastinal mass (bulky disease)
Pain in the chest, abdomen, bones (for no known reason)
Painless swelling in the lymph nodes
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
Physican exam and history (H&P)

Progression and Transformation

None

Epidemiology and Mortality

Age: peaks at 15-34 years
Incidence: 70% of classical Hodgkin lymphomas, most common subtype of Hodgkin lymphoma in developed countries
Sex: no male or female predominance
Survival: better survival than other types of CHL

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: 435-437

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

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