Histomorphological and Immunohistochemical Study of Extra Nodal Lymphoma

  • B R Vani Department of Pathology, ESICMC & PGIMSR, Bangalore
  • Sandhyalakshmi B N Department of Pathology, ESICMC & PGIMSR, Bangalore
  • Netra M Sajjan Department of Pathology, ESICMC & PGIMSR, Bangalore
  • Panduranga C Department of Pathology, ESICMC & PGIMSR, Bangalore
  • Deepak Kumar B Department of Pathology, ESICMC & PGIMSR, Bangalore
  • Srinivasamurthy V Department of Pathology, ESICMC & PGIMSR, Bangalore
DOI: https://doi.org/10.21276/apalm.2919
Keywords: Extra nodal lymphoma, Non-Hodgkin’s lymphoma, IHC, Histopathology

Abstract

Background: NHL are heterogeneous group of hematolymphoid malignancy occurring in nodal and extra nodal sites. Extra nodal lymphoma (ENL) is distinct from nodal lymphomas due to varied anatomical location, morphological diversity. Methods: A retrospective observational study was conducted in the department of pathology from January 2011 till December 2019. Clinical details and other investigations were recorded. Gross morphological features were noted. Slides are reviewed microscopically and blocks were subjected to IHC for further typing cases were selected as per Dawson et al criteria. Result: During study period, ENL constituted 25 cases (29.4%) of the 85 cases of all NHL. Age range is 05 to 63 years with a mean age of 42.5 years. Male to female ratio is 2.2 :1.Head and neck is the most common site of ENHL constituting 19 cases(76%), next commonest location is in the GIT with 3 cases (12%). We had one each case of ENHL in testis, breast and spine (4% each). On IHC, 92% cases (23 cases) exhibited   B cell phenotype and the remaining 08 % (02 cases) were of T cell phenotype. Conclusion: Lymphomas in the extra nodal sites are rare but has the propensity to occur in any anatomic site. Hence a differential of lymphoma to be considered in extra nodal site. Histology with IHC enables to differentiate from poorly differentiated carcinoma as the treatment modalities and prognosis varies.

References

Padhi S, Paul TR, Challa S, Prayaga AK, Rajappa S, Raghunadharao D, Sarangi R. Primary extra nodal non hodgkin lymphoma: a 5 year retrospective analysis. Asian pacific J cancer prev 2012; 13(10): 4889-4895.

Mishra P, Das S, Kar R, Jacob Se, Basu D. Primary extranodal non-Hodgkin lymphoma: a 3-year record-baseddescriptive study from a tertiary care center in southern India. Indian jpatholmicrobiol2015;58:296-300.

CortiM ,Villafane M, Bistmans A, Narbaitz M, Gilard L. Primary extranodal non-hodgkin lymphoma of the head and neck in patients with acquired immunodeficiency syndrome: a clinicopathologic study of 24 patients in a single hospital of infectious diseases in Argentina. Int. Arch Otorhinolaryngol 2014 ;18:3.

Guruwale S,Gore CR,Karia KM,Paranjape SP,Bardapurkar PR,Kumar H,Buch AC.Extranodal NON hodgkins lymphoma: A rare case series.Clin Cancer Investig J 2018;7:137-142.

VannataB, ZuccaE. Primary extranodalB-cell lymphoma: current concepts and treatment strategies. Chin clin oncol 2015:4(1):01-17.

Pai A, Kannan T, Balambika RG,Vasini V.A study of clinical profile of primary extranodal lymphomas in a teritiary care institute in south india. Indian J Med Paediatr Oncol 2017;38:251-255.

SimhaNV,Nitha, Sreenivas N. Primary Extranodal Non Hodgkins lymphoma of Left Tonsil: A case report. Journal of Evidence based medicine and Healthcare 2014; 1(12):1484-1488.

Payandeh M, Sadeghi M, Sadeghi E,Aeinfar M.The survival of extra nodal non-Hodgkin’s lymphoma patients in the west of Iran.American journal of cancer prevention2015;3:96-99.

Goldlum J R, Lamps L W, McKenney JK, Myers JL.Rosai and Ackermans Surgical pathology.11th ed.Philadelphia:Elsevier;2018.

Mertsoylu H, Muallaoglu S, Besen A, Erdogdu S,SezerA, Sedef AM et al.Primary extranodal non-hodgkin’s lymphoma: clinicopathological features, survival and treatment outcome in two cancer centers of southern turkey. Asian pac j cancer prev 2014; 15 (17):7207-7211.

Salplahta D, Comanescu M V,Anghelina F, Ioniţa E, Mogoanta C A, Anghelina L. Non-Hodgkin lymphomas of Waldeyer’s ring. Rom j morpholembryol 2012, 53(4):1057–1060.

VasilakakiT, MyoteriD, TsavariA, SkafidaE, ArkoumaniE, KouliaK et al. Localised extranodal non-hodgkin’s lymphoma of the tonsil: report of a rare case. OA case reports 2013;2(11):1-2.

Harry L Ioachim, L Jeffery Medeiros. Iocham’s Lymph node pathology. 4th edition. Philadelphia: Wolter Kluwer; 2009.391-400.

Aparna C, Renuka IV, RajaniM,Sailabala G, Annapurna P. Primary extranodal lymphomas-spectrum of distribution and morphology with immunophenotyping-Spectrum of distribution and morphology with immunophenotyping 3 year institutional study. Med J DY Univ2015;8:138-43.

Mohan H. Textbook of pathology. 6th ed. New Delhi: Jaypee brothers; 2010.

Published
2021-02-28
Issue
Vol 8 No 2 (2021)
Section
Original Article

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).