Immunohistochemical Profile and Distribution of Non-Hodgkin and Hodgkin Lymphoma - An Experience in a Medical College Hospital in Tamil Nadu

Abstract

Context: The subtype distribution of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) shows distinct pattern across geographic regions. This study analyzes the subtype distribution of lymphomas based on the WHO 2017 Classification using immunohistochemistry (IHC) and also investigates the IHC profile of various lymphomas. Subjects and Methods: Fifty consecutive cases of lymphoma diagnosed in the department of pathology in a medical college hospital were included in the study. The cases were subcategorized using panels of IHC based on the light microscopic findings. Results: The ratio of NHL to HL was 4.5:1. B-NHL formed 78.5% (n = 32), while T-cell NHL formed 21.5% (n = 9). Among the B-NHL cases, small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) (34.4%) was the most common, followed by diffuse large B-cell lymphoma, NOS (DLBCL NOS) (31.2%), follicular lymphoma (FL) (25%), and then by Burkitt's lymphoma (BL) constituting 9.4%. Peripheral T-cell lymphoma, NOS (PTCL NOS) (14.1%) (n = 6) was the most common T-cell NHL, followed by angioimmunoblastic T-cell lymphoma (4.8%), and then by lymphoblastic lymphoma (T-LL) (2.4%). Among Hodgkin lymphomas, mixed cellularity (MC) accounted for 55.6% (n = 5), lymphocyte depleted type (LD) being 22.2%, while nodular lymphocyte predominant and lymphocyte rich type each constituted 11.1%. Conclusion: SLL/CLL was the most common lymphoma reported in the study followed by DLBCL which is different from the other Indian studies where DLBCL was most common. CD5 expression was noted in 21% of FLs. PTCL-NOS constituted the most common T-cell lymphoma and MC, the most frequent subtype of classical HL. Further replication studies including larger sample size will be needed to understand the difference in subtype distribution in our population.

Keywords

CD5 - Hodgkin lymphoma - immunohistochemistry - Lennert's lymphoma - non-Hodgkin lymphoma - small lymphocytic lymphoma

Publikationsverlauf

Eingereicht: 06. März 2020

Angenommen: 22. Mai 2020

Artikel online veröffentlicht:
17. Mai 2021

• References

• 1 Nair R, Arora N, Mallath MK. Epidemiology of non-Hodgkin's lymphoma in India. Oncology 2016; 91 Suppl 1: 18-25
• 2 Boffetta P. Epidemiology of adult non-Hodgkin lymphoma. Ann Oncol 2011; 22: 27-31
• 3 Yeole BB. Trends in the incidence of non-Hodgkin's lymphoma in India. Asian Pac J Cancer Prev 2008; 9: 433-6
• 4 Parkin D M, Bray F, Ferlay J. Global cancer statistics. Cancer J Clin 2005; 55: 74-108
• 5 Morton LM. Dissecting lymphoma incidence to inform epidemiologic and clinical research. Leuk Lymphoma 2013; 54: 1575-6
• 6 Chan JK. The new World Health Organization classification of lymphomas: The past, the present and the future. Hematol Oncol 2001; 19: 129-50
• 7 Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pilleri SA, Stein H. et al. editors World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissue. Lyon: IARC Press; 2008
• 8 Mondal SK, Mandal PK, Samanta TK, Chakaborty S, Roy SD, Roy S. Malignant lymphoma in Eastern India: A retrospective analysis of 455 cases according to World Health Organization classification. Indian J Med Paediatr Oncol 2013; 34: 242-6
• 9 Arora N, Manipadam MT, Nair S. Frequency and distribution of lymphoma types in a tertiary care hospital in South India: Analysis of 5115 cases using the World Health Organization 2008 classification and comparison with world literature. Leuk Lymphoma 2013; 54: 1004-11
• 10 Sandhu DS, Sharma A, Kumar L. Non-Hodgkin's lymphoma in Northern India: An analysis of clinical features of 241 cases. Indian J Med Paediatr Oncol 2018; 39: 42-5
• 11 Devi AA, Sharma TD, Singh YI, Sonia H. Clinicopathological profile of patients with non-hodgkin's lymphoma at a regional cancer center in Northeast India. J Sci Soc 2017; 44: 140-4
• 12 Sharma M, Mannan R, Madhukar M, Navani S, Manjari M, Bhasin TS. et al. Immunohistochemical (IHC) analysis of non-Hodgkin's Lymphoma (NHL) spectrum according to WHO/REAL classification: A single centre experience from Punjab, India. J Clin Diagn Res 2014; 8: 46-9
• 13 Naresh KN, Srinivas V, Soman CS. Distribution of various subtypes of nonHodgkin's lymphoma in India: A study of 2773 lymphomas using R.E.A.L. And WHO classifications. Ann Oncol 2000; 11: 637
• 14 Chakrabarti S, Sarkar S, Goswami BK, Mondal S, Roy A, Das S. Hodgkin's and Non-Hodgkin's lymphomas in an Indian rural medical institution: Comparative clinicopathologic analysis. Asian Pac J Cancer Prev 2010; 11: 1605-8
• 15 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 neoplasms. Asian Pac J Cancer Prev 2008; 9: 229-32
• 16 Prakash G, Sharma A, Raina V, Kumar L, Sharma MC, Mohanti BK. et al. B cell non-Hodgkin's lymphoma: Experience from a tertiary care cancer center. Ann Hematol 2012; 91: 160311
• 17 Prevodnik VK, Lavrenčak J, Horvat M, Novakovič BJ. The predictive significance of CD20 expression in B-cell lymphomas. Diagn Pathol 2011; 6: 33
• 18 Gragera MR, Allemani C, Tereanu C, De Angelis R, Capocaccia R, Maynadie M. et al. HAEMACARE Working Group (2011) Survival of European patients diagnosed with lymphoid neoplasms in 2000-2002: Results of the HAEMACARE project. Haematologica 2011; 96: 720-8
• 19 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: 103-8
• 20 Kalyan K, Basu D, Soundararaghavan J. Immunohistochemical typing of non-Hodgkin's lymphoma-comparing working formulation and WHO classification. Indian J Pathol Microbiol 2006; 49: 203-7
• 21 Babu SM, Garg S, Kanakasetty GB, Kuntegowdanahalli LC, Dasappa L, Rao SA. Diffuse large B-cell lymphoma: A retrospective study from a regional care center in South India. Indian J Cancer 2018; 55: 66-9
• 22 Dwivedi A, Mehta A, Solanki P. Evaluation of immunohistochemical subtypes in diffuse large B-cell lymphoma and its impact on survival. Indian J Pathol Microbiol 2015; 58: 453-8
• 23 Dong HY, Gorczyca W, Liu Z, Tsang P, Wu CD, Cohen P. et al. B-cell lymphomas with coexpression of CD5 and CD10. Am J Clin Pathol 2003; 119: 218-30
• 24 Rao IS. Role of immunohistochemistry in lymphoma. Indian J Med Paediatr Oncol 2010; 31: 145-7
• 25 Higgins RA, Blankenship JE, Kinney MC. Application of immunohistochemistry in the diagnosis of non-Hodgkin and Hodgkin lymphoma. Arch Pathol Lab Med 2008; 132: 441-61
• 26 Janbabai G, Kayedimajd S, Alian S, Naghshvar F, Rashidi M, Farazmandfar T. Bilateral breast swelling in a 23-year-old woman with Burkitt lymphoma. J Res Med Sci 2012; 17: 1188-91
• 27 Lakshmanan A, Sikri D, Patil S, Kurian A, Annapurneswari S, Nair S. Frequency, distribution, and immunomorphologic characteristics of peripheral T-cell lymphoma, not otherwise specified in a tertiary care center in Southern India. Indian J Pathol Microbiol 2018; 61: 204-8
• 28 Nair RA, Vasudevan JA, Jacob PM, Sukumaran R. Profiling of peripheral T-cell lymphomas in Kerala, South India: A 5-year study. Indian J Pathol Microbiol 2017; 60: 206-8
• 29 Bidyut Krishna Goswami BK, Sarkar S, Chakrabarti S, Mondal S, Roy A, Deb AR. Clinico-pathologic profile of Hodgkin's lymphoma in a rural medical college. Indian J. Hematol. Blood Transfus 2008; 24: 166-9
• 30 Patkar N, Mehta J, Kulkarni B, Pande R, Advani S, Borges A. Immunoprofile of Hodgkin's lymphoma in India. Indian J Cancer 2008; 45: 59-63