Icd 10 code for large b cell lymphoma

Created Feb 2012
Reviewed Dec 2019

Question

What ICD-10-AM diagnosis code should be assigned for ‘grey (gray) zone lymphoma’?
Grey zone lymphoma has features of Hodgkin lymphoma as well as diffuse B-cell.

Response

Advice was sought from the New Zealand Cancer Registry (NZCR).

In the World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th Edition 2008 manual, Grey Zone Lymphoma is referenced as ‘B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma.’

Definition is:

‘A B lineage lymphoma that demonstrates overlapping clinical, morphological and/or immunophenotypic features, between classical Hodgkin lymphoma (CHL) and diffuse large B-cell lymphoma (DLBCL), especially primary mediastinal large B-cell lymphoma (PMBL).’

Synonyms include ‘Grey zone lymphoma, large B-cell lymphoma with Hodgkin features, and Hodgkin-like anaplastic large cell lymphoma.’

NZCR ICD-O code is M9596/3 Composite Hodgkin and non-Hodgkin lymphoma.

Therefore following the ICD-10-AM Alphabetic Index the most appropriate diagnosis code to assign is C85.7 Other specified types of non-Hodgkin lymphoma.

Chapter 2 - Neoplasms (C00-D49) » Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96) » Diffuse large B-cell lymphoma (C83.3)

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The immune cells are part of the blood cells and are formed in the bone marrow. Some of the immune cells are in the blood, some are in different organs. There are many immune cells in the spleen, the lymph nodes and in the skin.

With a lymphoma, certain lymph nodes divide uncontrollably. As a result, there are a great many immune cells in your body. But these immune cells are not working properly. The diseased immune cells often accumulate in the lymph nodes or in the spleen. This results in the lymph nodes or the spleen being too big. Sometimes the diseased immune cells also accumulate in the bone marrow. If there are a great many diseased immune cells in the bone marrow, then other blood cells there can no longer be produced properly. You may then feel ill much more often and more seriously.

There are various kinds of immune cells. Different types of lymphoma can develop depending on which immune cells are changed. These different types of lymphoma cause different symptoms. There are types of lymphoma that cause serious symptoms in a short time. You may then have fever or lose a lot of weight without wanting to. But there are also types of lymphoma that are discovered accidentally and only cause a few symptoms at the beginning.

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