The Nodal Non-Hodgkin’s Lymphoma: Histomorphological Study with Special Emphasis on Immunomarker Profile of Nodal NHL
Keywords:
Hodgkin disease, Non-Hodgkin Lymphoma, immunohistochemistry
Abstract
Background: Lymphoid malignancies (LM) are a heterogeneous group of disorders that are broadly divided into Hodgkin disease (HD) and Non-Hodgkin Lymphoma (NHL). Diagnosing lymphoid malignancies based on morphology in conjunction with immunohistochemistry (IHC) forms the basis of WHO classification and this has prognostic implications. The distribution of the major subtypes of non-Hodgkin’s lymphoma (NHL) differs across geographic regions. Material & Method: Over all 147 cases of NHL over a period of 16 months (between March 2014 and June 2015) were diagnosed in the Department of Histopathology, Santokba Durlabhji Memorial Hospital cum Medical Research Institute, Jaipur. Of the total of cases of lympho-proliferative disorders, the diagnosis of NHL was done by light microscopy alone and was classified according to International Working Formulation initially. All the cases diagnosed provisionally as NHL were taken up for immunophenotyping with Immunohistochemical (IHC) studies. The individual NHL cases were classified according to the WHO/REAL classification according to the positive or relevant negative immonophenotypic expression and tabulated to ascertain the morphological spectrum of NHL in this part of the country. Out of 147 cases of provisionally diagnosed NHL, 144 cases confirmed as NHL by IHC study. Overall concordance between light microscopy and IHC was 97.96%. Results: B-cell lymphomas formed 88.89%, T-cell lymphomas formed 8.33% and unclassified NHL formed 2.78% of nodal NHLs. Diffuse Large B-Cell Lymphoma (DLBCL) was the most common subtype (61.11% of all NHLs). B-cell small lymphocytic lymphoma, Follicular lymphomas, Mantle-Cell Lymphoma (MCL), marginal zone B-cell lymphomas, Burkitt’s lymphoma and B cell lymphoblastic lymphoma amounted to 11.11%, 5.56%, 4.16%, 2.78%, 1.39% and 1.39% respectively. Among the T-cell lymphomas, T-cell lymphoblastic lymphoma, anaplastic large-cell lymphomas of T/null-cell type, and Angioimmunoblastic T-cell lymphoma (AITL) accounted for 4.16%, 2.78%, and 1.39% of all NHL cases, respectively.References
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3. Gurney KA, Cartwright RA. Increasing incidence and descriptive epidemiology of extranodal non-Hodgkin lymphoma in part of England and Wales. Hematol J, 2002; 3: 95-104.
4. Hicks EB, Rappaport H, Winter WJ. Follicular lymphoma: a re-evaluation of its position in the scheme of malignant lymphoma, based on a survey of 253 cases. Cancer 1956; 9(4):792–821.
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19. Manisha Sharma, Rahul Mannan, Mohit Madhukar, Sanjay Navani, Mridu Manjari, Tejinder Singh Bhasin et al. Immunohistochemical analysis of Non hodgkin’s lymphoma spectrum according to WHO/REAL classification: Single centre experience from Punjab, India. Journal of Clinical and Diagnostic Research. 2014 Jan, Vol-8(1): 46-49. (55)
20. Roy A, Kar R, Basu D, Badhe BA. Spectrum of histopathologic diagnosis of lymph node biopsies: A descriptive study from a tertiary care center in South India over 5½ years. Indian J Pathol Microbiol. 2013; 56: 103-108. (54)
21. Qun-Pei Yang, Wen-Yan Zhang, Jian-Bo Yu, Sha Zhao, Huan Xu, Wei-Ya Wang, et al. Subtype distribution of lymphomas in Southwest China: Analysis of 6,382 cases using WHO classification in a single institution. Diagnostic Pathology 2011, 6:77 (60)
22. Vallabhajosyula S, Baijal G, Vadhiraja B M, Fernandes DJ, Vidyasagar M S. Non- Hodgkin’s lymphoma: Is India ready to incorporate recent advances in day to day practice?. J Can Res Ther. 2010; 6: 36-40. (61)
23. R.N Waduge, N.V.I. Ratnatunga, S. Ramadasa. Unusual histological features of Non-Hodgkin’s lymphoma: a clinicopathological and immunohistochemical study. Journal of diagnostic pathology. 2002-2003; 1: 17-21. (73)
24. Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS. Lymphoma incidence patterns by WHO subtype in the United States, 1992- 2001. Blood. 2006 Jan 1; 107(1):265-276. (48)
2. Seow A, Lee J, Sng I, Fong CM, Lee HP. Non-Hodgkin’s lymphoma in an Asian population: 1968–1992 time trends and ethnic differences in Singapore. Cancer, 1996 May; 77(9): 1899-1904.
3. Gurney KA, Cartwright RA. Increasing incidence and descriptive epidemiology of extranodal non-Hodgkin lymphoma in part of England and Wales. Hematol J, 2002; 3: 95-104.
4. Hicks EB, Rappaport H, Winter WJ. Follicular lymphoma: a re-evaluation of its position in the scheme of malignant lymphoma, based on a survey of 253 cases. Cancer 1956; 9(4):792–821.
5. Lennert K, Stein H, Kaiserling E. Cytological and functional criteria for the classification of malignant lymphomata. Br J Cancer 1975; 31(S2):29–43.
6. Lukes RJ, Collins RD. Immunologic characterization of human malignant lymphomas. Cancer 1974; 34(S8):1488–1503.
7. Garvin AJ, Simon R, Young RC, DeVita VT, Berard CW. The Rappaport Classification of Non Hodgkin’s Lymphoma: a closer look using other proposed classifications. Semin Oncol. 1980 Sep; 7(3):234-243.
8. Rosenberg S, Berard C, Brown Jr. B, Burke J, Dorfman R, Glatstein E, et al. National Cancer Institute sponsored study of classifications of non-Hodgkin’s lymphomas: summary and description of a working formulation for clinical usage. The Non Hodgkin’s Lymphoma Pathologic Classification Project. Cancer 1982; 49(10):2112-2135.
9. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. The Non-Hodgkin’s Lymphoma Classification Project. Blood 1997; 89(11):3909–3918.
10. John P. Greer, Michael E. Williams. Non-Hodgkin Lymphoma in Adults. In: John P. Greer, John Foerster, George M. Rodgers, Frixos Paraskevas, Bertil Glader, Daniel A. Arber, Robert T. Means Jr. (eds.) Wintrobe’s clinical Hematology. 12th edition. Philadelphia, Lippincott Williams & Wilkins; 2009. 2145-2194. (11)
11. H Hjalgrim, M Frisch, K Begtrupand, M Melbye. Recent increase in the incidence of non-Hodgkin's lymphoma among young men and women in Denmark. British Journal of Cancer 1996; 73: 951-954.(42)
12. Anjali S. kulkarni, Anjali P. Ingle, Pragati P. Phulgirkar, Manjusha S. Dhawale, Neela R. Kumbhakarna, Rajan S. Bindu. Morphological Typing of Nodal and Extra-Nodal Non-Hodgkin’s Lymphoma. Indian Medical Gazette.2011:438-441. (53)
13. Aggarwal D, Gupta R, Singh S, Kudesia M. Comparision of working formulation and REAL classification of non-Hodgkin’s lymphoma: an analysis of 52 cases. Hematology, 2011 Jul; 16(4): 195-199 (64)
14. Sudipta Chakrabarti, Supriya Sarkar, Bidyut Krishna Goswami, Srikrishna Mondal, Amitabha Roy, Shikha Das. Hodgkin’s and Non-Hodgkin’s Lymphomas in an Indian Rural Medical Institution: Comparative Clinicopathologic Analysis. Asian Pacific Journal of Cancer Prevention, Vol 11, 2010; 1605-1608. (65)
15. Elizabeth A Holly and Paige M Bracci. Population-based Study of Non-Hodgkin Lymphoma, Histology, and Medical History among Human Immunodeficiency Virus-negative Participants in San Francisco. American Journal of Epidemiology 2003; 158: 316- 327. (66)
16. Naresh KN, Srinivas V, Soman CS. Distribution of various subtypes of non- Hodgkin’s lymphoma in India: a study of 2773 lymphomas using R.E.A.L. and WHO Classifications. Ann Oncol. 2000; 11 Suppl 1:63-67. (45)
17. Kalyan K, Basu D, Soundararaghavan J. Immunohistochemical typing of non- Hodgkin’s lymphoma-comparing working formulation and WHO classification. Indian J Pathol Microbiol. 2006 Apr;49(2):203-207. (49)
18. Mushtaq S, Akhtar N, Jamal S, Mamoon N, Khadim T, Sarfaraz T et al., Malignant lymphomas in Pakistan according to the WHO classification of lymphoid neoplasm. Asian Pac J Cancer Prev. 2008 Apr-Jun; 9 (2):229-232. (50)
19. Manisha Sharma, Rahul Mannan, Mohit Madhukar, Sanjay Navani, Mridu Manjari, Tejinder Singh Bhasin et al. Immunohistochemical analysis of Non hodgkin’s lymphoma spectrum according to WHO/REAL classification: Single centre experience from Punjab, India. Journal of Clinical and Diagnostic Research. 2014 Jan, Vol-8(1): 46-49. (55)
20. Roy A, Kar R, Basu D, Badhe BA. Spectrum of histopathologic diagnosis of lymph node biopsies: A descriptive study from a tertiary care center in South India over 5½ years. Indian J Pathol Microbiol. 2013; 56: 103-108. (54)
21. Qun-Pei Yang, Wen-Yan Zhang, Jian-Bo Yu, Sha Zhao, Huan Xu, Wei-Ya Wang, et al. Subtype distribution of lymphomas in Southwest China: Analysis of 6,382 cases using WHO classification in a single institution. Diagnostic Pathology 2011, 6:77 (60)
22. Vallabhajosyula S, Baijal G, Vadhiraja B M, Fernandes DJ, Vidyasagar M S. Non- Hodgkin’s lymphoma: Is India ready to incorporate recent advances in day to day practice?. J Can Res Ther. 2010; 6: 36-40. (61)
23. R.N Waduge, N.V.I. Ratnatunga, S. Ramadasa. Unusual histological features of Non-Hodgkin’s lymphoma: a clinicopathological and immunohistochemical study. Journal of diagnostic pathology. 2002-2003; 1: 17-21. (73)
24. Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS. Lymphoma incidence patterns by WHO subtype in the United States, 1992- 2001. Blood. 2006 Jan 1; 107(1):265-276. (48)
Published
2019-04-30
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