CHILD LYMPHOMA
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ALTERNATE NAMES
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Childhood Non-Hodgkin Lymphoma; Pediatric Non-Hodgkin Lymphoma; Diffuse Large B-cell
Lymphoma; B-cell Lymphoma; T-cell Lymphoma; Peripheral T-cell Lymphoma; Follicular
Lymphoma; Burkitt Lymphoma; Anaplastic Large Cell Lymphoma; Hodgkin Lymphoma; Hodgkin
Disease; Pediatric Hodgkin Lymphoma; Classical Hodgkin Lymphoma; Nodular Lyphocyte-Predominant
Hodgkin Lymphoma
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DESCRIPTION
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Cancer cells that start in the lymphatic systems are called lymphomas. When cancer
cells get into the lymphatic system, the cancerous cells can also spread to other
organs and tissues in the body. Child Lymphoma is the third most common cancer in
children. Most childhood lymphomas can be classified as one of the following four
types:
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Burkitt lymphoma (BL), or small noncleaved cell lymphoma (SNCCL);
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Lymphoblastic lymphoma (LL) - adjudicators are reminded that lymphoblastic lymphoma
is a type of lymphoma that is similar to acute leukemia and needs to be evaluated
under listing 13.06;
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Diffuse large B-cell lymphoma (DLBCL); and
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Anaplastic large cell lymphoma (ALDL).
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing:
Diagnostic testing for child lymphoma includes:
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Bone marrow aspirate and biopsy;
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Removal of fluid from chest or abdomen for testing;
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Radionuclide bone scan; and
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Physical findings: Signs of childhood lymphoma may include:
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Swelling of the head, neck, upper body or arms;
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Experience difficulties swallowing;
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Painless swelling of the lymph nodes in the neck, underarm, stomach or groin;
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Childhood lymphoma may cause many different signs and symptoms, depending on the location
of the tumors.
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Lymphoma that grows close to the surface of the body (sides of the neck, underarm
area above the collarbone or in the groin area) may have enlarged nodes that are seen
or felt as in lumps under the skin.
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Lymphoma that is in the abdomen area will cause it to become swollen and tender.
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Lymphoma that starts in the thymus gland or lymph nodes of the chest or near the windpipe
(trachea) may cause swelling and a bluish-red skin color.
ICD-9: 200.2; 200.5; 200.6; 200.7; 202.0; 202.7; 202.8
ICD-10:
C85.90
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PROGRESSION
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Lymphoma is usually a disease of rapid onset and progression. Although the prognosis
greatly depends on histology, extent of the disease, presence or absence of metastasis;
the child’s age; and response to therapy, the majority of children with newly diagnosed
child lymphoma are considered to have an excellent prognosis. Children with recurrent
lymphoma have a less favorable prognosis and require longer treatment. Children with
lymphoma that involves the brain, spinal cord, bone marrow, liver or lung are also
associated with a less favorable prognosis. If the child does not respond to chemotherapy
drugs, the disease can cause rapid death.
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TREATMENT
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By the time that a child is diagnosed with recurrent lymphoma, the lymphoma has spread
to other parts of the body. Most children with recurrent lymphoma are treated with
chemotherapy. Chemotherapy is the most important treatment for children with lymphoma
because chemotherapy can reach all parts of the body and kill lymphoma cells wherever
they may be. It is common to use a combination of drugs and treatment, including intrathecal
therapy (injection of chemotherapy into the spinal fluid), that may last a number
of months or years.
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SUGGESTED PROGRAMMATIC ASSESSMENT*
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Suggested MER for Evaluation:
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Clinical history and examination that describes the diagnostic features of the impairment;
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Pathology/biopsy report of the cancer; and
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CT scan, MRI scan, or ultrasound reports.
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Suggested Listings for Evaluation:
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DETERMINATION
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LISTING
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REMARKS
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Meets
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113.05 A 1
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Primary lymphoma (excluding lymphoblastic) which involves brain, spinal cord, bone
marrow, liver, or lung meets the criteria in listing 113.05 A 1 for non-Hodgkin lymphoma
and Hodgkin lymphoma.
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113.05 A 2
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Recurrent or persistent lymphoma regardless of location, following initial treatment
meets the criteria in listing113.05 A 2, for non-Hodgkin lymphoma and Hodgkin lymphoma.
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113.05 B 1
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Primary lymphoma (excluding lymphoblastic) which involves brain, spinal cord, bone
marrow, liver, or lung meets the criteria in listing and 113.05 B 1 for non-Hodgkin
lymphoma and Hodgkin lymphoma.
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113.05 B 2 |
Recurrent or persistent lymphoma regardless of location, following initial treatment
meets the criteria in listing 113.05 B 2, for non-Hodgkin lymphoma and Hodgkin lymphoma.
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Equals
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* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
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