Coding Grey (gray) zone lymphoma
Created Feb 2012
Reviewed Dec 2019
What ICD-10-AM diagnosis code should be assigned for ‘grey (gray) zone lymphoma’?
Grey zone lymphoma has features of Hodgkin lymphoma as well as diffuse B-cell.
Advice was sought from the New Zealand Cancer Registry (NZCR).
In the World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th Edition 2008 manual, Grey Zone Lymphoma is referenced as ‘B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma.’
‘A B lineage lymphoma that demonstrates overlapping clinical, morphological and/or immunophenotypic features, between classical Hodgkin lymphoma (CHL) and diffuse large B-cell lymphoma (DLBCL), especially primary mediastinal large B-cell lymphoma (PMBL).’
Synonyms include ‘Grey zone lymphoma, large B-cell lymphoma with Hodgkin features, and Hodgkin-like anaplastic large cell lymphoma.’
NZCR ICD-O code is M9596/3 Composite Hodgkin and non-Hodgkin lymphoma.
Therefore following the ICD-10-AM Alphabetic Index the most appropriate diagnosis code to assign is C85.7 Other specified types of non-Hodgkin lymphoma.
Lymphoma (malignant) (M9590/3) C85.9
- Hodgkin (M9650/3) C81.9
- - and non-Hodgkin, composite (M9596/3) C85.7
- non-Hodgkin type NEC (M9591/3) C85.9
- - and Hodgkin, composite (M9596/3) C85.7