ADULT NON-HODGKIN LYMPHOMA

ALTERNATE NAMES

Cancer - Non-Hodgkin's Lymphoma; Diffuse Large B-Cell Lymphoma; DLBCL; Histiocytic Lymphoma; Lymphoma - Non-Hodgkin's; Lymphoblastic Lymphoma; Lymphocytic Lymphoma

DESCRIPTION

Adult Non-Hodgkin Lymphoma (NHL) is a type of cancer that starts in the lymphatic system, which in turn allows spread to other organs and tissues in the body. Adult NHL is categorized into three grades:

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  Low grade or indolent, which are slow growing lymphomas;

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  Intermediate grade or aggressive and faster growing lymphomas; and

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  High-grade or highly aggressive and very fast growing lymphomas.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM CODING

Diagnostic testing:Diagnostic testing for adult NHL includes:

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  Blood chemistry studies;

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  Computerized tomography (CT) scan;

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  Positron emission tomography (PET) scan;

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  Magnetic resonance imaging (MRI); and

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  Bone marrow aspiration and biopsy.

Physical findings: Adult NHL may cause different signs and symptoms, depending on the location of the tumor. These signs may include:

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  Swollen lymph nodes in the neck, armpit, or groin;

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  Discomfort or feeling of fullness in the abdomen;

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  Fatigue;

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  Shortness of breath; and

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  Unexplained fever, night sweats, or weight loss.

ICD-9: 200.2; 200.5; 200.6; 200.7; 202.0; 202.7; 202.8

ICD-10: C85.90

PROGRESSION

NHL can occur at any age, with the risk of increasing with age. Most people are diagnosed in their 60s. The prognosis for adult NHL is dependent on the type and characteristics of the malignant tumor, the growth and location of the tumor, and the spread (metastasis) at the time of diagnosis.

TREATMENT

Adult NHL is mainly treated with chemotherapy, with radiation therapy, or antibody or biological therapy added depending on response to treatment.

Suggested MER for Evaluation:

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  Clinical history and examination that describes diagnostic features of the impairment;

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  Imaging tests;

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  Biopsy reports;

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  Pathology reports;

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  Surgical procedures;

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  Pertinent treatment records; and

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  Up-to-date progress notes.

DETERMINATION

LISTING

REMARKS

Meets

13.05 A

Listing level aggressive adult NHL requires that the cancer be recurrent after initial anti-neoplastic treatment. Listing level indolent adult NHL requires initiation of more than one antineoplastic treatment regimen within a consecutive 12-month period.

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