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SOP Bulletin 237

ICD Coding

ICD-10-AM Code: C81

Brief description

Hodgkin Lymphoma is a malignant neoplasm of the lymph nodes and of lymphoid tissue.  This condition is characterised by the presence of specific cells called Reed-Sternberg cells, which arise from B lymphocytes (a type of white blood cell).  This neoplasm principally causes a space occupying lesion (mass) effect. 

Confirming the diagnosis

The diagnosis is confirmed based on histopathology from a biopsy of an involved lymph node or a mediastinal mass, or less commonly by biopsy of an involved organ.

The relevant medical specialist is a haematologist or oncologist.

Additional diagnoses covered by SOP

• Hodgkin’s disease
• Hodgkin's lymphoma
  • classic type
    • Nodular sclerosis cHL
    • Mixed cellularity cHL
    • Lymphocyte rich cHL
    • Lymphocyte depleted cHL
  • Nodular lymphocyte predominant type

Conditions excluded from SOP

• Burkitt’s lymphoma^#
• Chronic lymphoid leukaemia* - mature B-cell lymphoid luekaemia/small lymphocytic lymphoma SOP
• Hairy cell leukaemia* - mature B-cell lymphoid leukaemia/small lymphocytic lymphoma SOP
• Non-Hodgkin Lymphoma*
• Plasma call malignancy* - myeloma SOP

* another SOP applies

^# non-SOP condition

Clinical onset

Most patients present with asymptomatic enlarged lymph nodes (particularly in the neck or groin), unexplained fever, fatigue, night sweats, itching, or unintentional weight loss.  This condition is also sometimes detected after the discovery of a mediastinal mass on chest X-ray after a patient initially presents for review of persistent coughing, shortness of breath, or retrosternal chest pain.

There are two peak ages for this condition- first in late adolescence/young adulthood and then a second peak in older adults.

Clinical worsening

The only SOP worsening factor involves the inability to obtain appropriate clinical management.  Advances in treatment (with chemotherapy and radiotherapy) have seen the condition go from a uniformly fatal disease to one that is now curable in about 75% of cases.  Treatment can be associated with serious complications.  The choice of treatment is tailored for the individual patient and involves balancing treatment effectiveness and complication risk.