Nodular Sclerosis Hodgkin Lymphoma, Lymph Nodes of Multiple Sites (C81.18)

Name of the Condition

• Common Name: Nodular Sclerosis Hodgkin Lymphoma
• Medical Terms: Hodgkin's Disease, NSHL

Summary

Nodular sclerosis Hodgkin lymphoma (NSHL) is a type of cancer that originates from white blood cells called lymphocytes. It is characterized by the presence of large, abnormal cells known as Reed-Sternberg cells and typically involves lymph nodes at multiple sites in the body. NSHL is the most common subtype of Hodgkin lymphoma and tends to affect young adults.

Causes

The exact cause of NSHL is not well understood, but it is believed to result from a combination of genetic and environmental factors. Viral infections, such as Epstein-Barr virus (EBV), may play a role in the disease's development.

Risk Factors

• Age: Most commonly diagnosed in young adults between 15 and 35.
• Gender: Slightly more prevalent in males.
• Family History: Having a family member with lymphoma may increase risk.
• History of Epstein-Barr virus (EBV) infection.

Symptoms

• Painless swelling of lymph nodes, often in the neck, armpits, or groin.
• Persistent fatigue.
• Unexplained fever.
• Night sweats.
• Unintended weight loss.
• Itchy skin.

Diagnosis

• Physical examination of swollen lymph nodes.
• Imaging tests such as CT, PET, or MRI scans.
• Lymph node biopsy to identify Reed-Sternberg cells.
• Blood tests to assess general health and organ function.

Treatment Options

• Chemotherapy: Uses drugs to kill cancer cells or stop them from growing.
• Radiation Therapy: Uses high-energy rays to target and destroy cancer cells.
• Targeted Therapy: Drugs that specifically target cancer cell mechanisms.
• Stem Cell Transplant: Replaces diseased bone marrow with healthy stem cells. Each treatment aims to eliminate cancer cells, reduce symptoms, and achieve remission.

Prognosis and Follow-Up

With advances in treatment, the prognosis for NSHL is generally favorable, with many patients achieving long-term remission or cure. Regular follow-up is crucial to monitor for recurrence or treatment side effects.

Complications

• Secondary cancers due to treatment.
• Cardiovascular issues from radiation therapy.
• Fertility problems depending on treatment type.
• Infections due to a weakened immune system.

Lifestyle & Prevention

• While NSHL cannot be fully prevented, reducing exposure to known risk factors, maintaining a healthy lifestyle, and regular medical check-ups could be beneficial.
• Adopting a balanced diet, regular exercise, and avoiding smoking.

When to Seek Professional Help

• Persistent swollen lymph nodes, especially if painless.
• Experience any of the symptoms mentioned without explanation.
• Rapid intervention can aid in effective management.

Additional Resources

• Leukemia & Lymphoma Society: LLS Website
• American Cancer Society: ACS Website
• Lymphoma Research Foundation: LRF Website

Tips for Medical Coders

• Ensure accurate documentation distinguishing between Hodgkin lymphoma subtypes as treatment and prognosis may vary.
• Avoid using unspecified codes; gather detailed clinical information for accurate coding.
• Double-check lymph node involvement details for precise coding decisions.