C84.61
Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck
Clinical Classification Guidelines
Medical Intelligence & Overview
Anaplastic Large Cell Lymphoma, ALK-positive (ICD-10 Code C84.61), is a type of non-Hodgkin lymphoma that primarily affects the lymph nodes in the head, face, and neck. This condition involves the abnormal growth of lymphocytes—a kind of white blood cell essential for the immune system. The term "ALK-positive" indicates the presence of a specific genetic change involving the anaplastic lymphoma kinase (ALK) gene, which influences the behavior of the lymphoma cells. While rare, this lymphoma typically shows aggressive growth but can respond well to targeted treatments when diagnosed early.
Causes & Symptoms
Clinical Causes: Chromosomal translocations involving the ALK gene, particularly t(2;5)(p23;q35), which fuse the ALK gene with other genes, leading to abnormal cell growth. Genetic mutations that activate the ALK pathway, promoting uncontrolled proliferation of lymphoma cells. Environmental factors have not been definitively linked to this lymphoma, suggesting that genetic factors play a more significant role. Family history or genetic predisposition appears to be uncommon but may be associated in rare cases.
Key Symptoms: Swelling or painless lumps in the lymph nodes of the head, face, or neck. Persistent sore throat or cough. Difficulty swallowing or a feeling of fullness in the neck. Fever that persists without a clear infection. Night sweats and unexplained weight loss. Fatigue and general malaise. Skin rashes or nodules if the disease spreads beyond lymph nodes. Recurrent infections due to immune system impairment caused by lymphoma.
Diagnostic & Treatment
Diagnosis Path: Medical history review and physical examination focusing on swollen lymph nodes. Imaging tests such as CT scans, PET scans, or MRI to identify the extent and sites of involvement. Lymph node biopsy—removing tissue for microscopic examination to identify characteristic lymphoma cells. Immunohistochemistry tests to detect specific markers associated with ALK-positive lymphoma. Genetic testing, including fluorescence in situ hybridization (FISH) or PCR, to identify ALK gene translocations. Blood tests to assess overall health and organ function.
Treatment Protocols: Chemotherapy regimens, often with combination therapies tailored to lymphoma subtypes. Targeted therapy using ALK inhibitors, such as crizotinib, which specifically blocks the abnormal ALK protein activity. Radiation therapy for localized disease or symptomatic lymph nodes. Stem cell transplantation may be considered in certain cases, especially if initial treatments are not effective. Supportive care to manage side effects from treatments and improve quality of life.
Clinical Advice & FAQs
Billing Guidance
Is C84.61 a billable ICD-10 code?
Yes, C84.61 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report C84.61?
Clinical documentation must specify the nature of Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck and any associated comorbidities for accurate reporting.
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