A Retrospective Study of the Clinico-pathological Profile of Primary Extra Nodal Lymphomas in a Tertiary Care Hospital
DOI:
https://doi.org/10.15379/2408-9877.2019.06.01.01Keywords:
Lymphoma, Extranodal lymphoma, Non Hodgkin lymphoma, Lymphoproliferative disorders, Diffuse large B cell.Abstract
Introduction: Primary extranodal lymphomas (pENL) are a group of lymphomas arising from tissues other than lymph nodes and are a highly heterogenous group of lymphoproliferative disorders. The incidence of pENL is increasing and is probably due to improved diagnostics. This study was undertaken to ascertain the clinical and pathological characteristics of extranodal non-Hodgkin lymphoma from a tertiary care hospital.
Materials and Methods: This was a retrospective study of histologically proven Non Hodgkin lymphoma patients, conducted during the period January 2015 to December 2017 in the Department of Medical Oncology, Omega Hospitals, Hyderabad, India. Detailed clinical history, laboratory reports, imaging and histopathological reports were obtained from the medical records. All cases were classified based on morphologic and immunophenotypic criteria according to World Health Organization 2008 classification.
Results: Primary extranodal non Hodgkin lymphoma constituted 32.2% (38/118) of all Non Hodgkin lymphomas. The mean age of presentation was 47.2 years. Majority (68.4%) had Stage I & II disease. The most common site of extranodal lymphoma was the Gastro intestinal tract (36.8%) followed by Head and neck region (26.3%). The most common histopathological type was Diffuse large B-cell lymphoma (DLBCL) (47.4%).
Conclusion: The study showed that the primary extra nodal Non hodgkin lymphomas constituted almost 1/3rd of all NHLs & is comparable to data from other parts of India. Hence NHL must be strongly suspected in patients with extranodal disease and an appropriate pathological and immunophenotypic evidence will clinch the diagnosis.
References
E vans LS, Hancock BW. Non-Hodgkin lymphoma. Lancet 2003; 362: 139-46. https://doi.org/10.1016/S0140-6736(03)13868-8
Zucca E, Roggero E, Bertoni F, Cavalli F. Primary extranodalnon Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol 1997; 8: 727-37. https://doi.org/10.1023/A:1008282818705
Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the committee on Hodgkin's disease staging classification. Cancer Res 1971; 31: 1860?1.
Zucca E, Roggero E, Bertoni F, Conconi A, Cavalli F. Primary extranodal non-Hodgkin's lymphomas. Part 2: Head and neck, central nervous system and other less common sites. Ann Oncol 1999; 10: 1023-33. https://doi.org/10.1023/A:1008313229892
Krol AD, le Cessie S, Snijder S, Kluin-Nelemans JC, Kluin PM, Noordijk EM. Primary extranodal non-Hodgkin's lymphoma (NHL): The impact of alternative definitions tested in the Comprehensive Cancer Centre West population-based NHL registry. Ann Oncol 2003; 14: 131-9. https://doi.org/10.1093/annonc/mdg004
Cavalli F, Stein H, Zucca E. Extranodal Lymphomas: Pathology and Management London. Informa: Healthcare; 2008.
Fujita A, Tomita N, Fujita H, Motohashi K, Hyo R, Yamazaki E, et al. Features of primary extranodal lymphoma in Kanagawa, a human T-cell leukemia virus type 1 nonendemic area in Japan. Med Oncol 2009; 26: 49-54. https://doi.org/10.1007/s12032-008-9080-0
Yoon SO, Suh C, Lee DH, Chi HS, Park CJ, Jang SS, et al. Distribution of lymphoid neoplasms in the Republic of Korea: Analysis of 5318 cases according to the World Health Organization classification. Am J Hematol 2010; 85: 760-4. https://doi.org/10.1002/ajh.21824
Sukpanichnant S. Analysis of 1983 cases of malignant lymphoma in Thailand according to the World Health Organization classification. Hum Pathol 2004; 35: 224-30. https://doi.org/10.1016/j.humpath.2003.10.007
Aoki R, Karube K, Sugita Y, Nomura Y, Shimizu K, Kimura Y, et al. Distribution of malignant lymphoma in Japan: Analysis of 2260 cases, 2001-2006. PatholInt 2008; 58: 174-82. https://doi.org/10.1111/j.1440-1827.2007.02207.x
Gross SA, Zhu X, Bao L, Ryder J, Le A, Chen Y, et al. A prospective study of 728 cases of non-Hodgkin lymphoma from a single laboratory in Shanghai, China. Int J Hematol 2008; 88: 165-73. https://doi.org/10.1007/s12185-008-0132-1
Padhi S, Paul TR, Challa S, Prayaga AK, Rajappa S, Raghunadharao D, et al. Primary extra nodal non Hodgkin lymphoma: A 5 year retrospective analysis. Asian Pac J Cancer Prev 2012; 13: 4889?95. https://doi.org/10.7314/APJCP.2012.13.10.4889
Biagi JJ, Seymour JF. Insights into the molecular pathogenesis of follicular lymphoma arising from analysis of geographic variation. Blood 2002; 99: 4265-75. https://doi.org/10.1182/blood.V99.12.4265
Kim JM, Ko YH, Lee SS, Huh J, Kang TS, Kim CW, etal. WHO classification of malignant lymphomas in Korea: Report of the third nationwide study. Korean J Pathol 2011; 45: 254-60. https://doi.org/10.4132/KoreanJPathol.2011.45.3.254
Arora N, Manipadam MT, Pulimood A, Ramakrishna BS, Chacko A, Kurian SS, et al. Gastrointestinal lymphomas: Pattern of distribution and histological subtypes: 10 years experience in a tertiary centre in South India. Indian J Pathol Microbiol 2011; 54: 712-9.
Yang QP, Zhang WY, Yu JB, Zhao S, Xu H, Wang WY, et al. Subtype distribution of lymphomas in Southwest China: Analysis of 6,382 cases using WHO classification in a single institution. Diagn Pathol 2011; 6: 77. https://doi.org/10.1186/1746-1596-6-77
Chen WL, Tsai WC, Chao TY, Sheu LF, Chou JM, Kao WY, et al. The clinicopathological analysis of 303 cases with malignant lymphoma classified according to the World Health Organization classification system in a single institute of Taiwan. Ann Hematol 2010; 89: 553-62. https://doi.org/10.1007/s00277-009-0870-z
Singh D, Kumar L, Goyal H, Raina V, Bijlani L, Wadhwa J, etal. Primary extranodal non-Hodgkin's lymphoma in Northern India. Proc Am SocClinOncol 2003; 22: 2457.
Lal A, Bhurgri Y, Vaziri I, Rizvi NB, Sadaf A, Sartajuddin S,
et al. Extranodal non?Hodgkin's lymphomas – A retros-
pective review of clinico?pathologic features and outcomes in comparison with nodal non?Hodgkin's lymphomas. Asian Pac J Cancer Prev 2008; 9: 453?8.
Nagi AH, Al Minawy L, Naseem N, Henna SN, Naveed IA. A study of the morphological patterns of extranodal non?Hodgkin lymphoma in Pakistani and Saudi populations. Biomedica 2010; 26: 118?23.
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