Background Morphological diagnosis of non-Hodgkin lymphoma (NHL) is usually based on lymph node biopsy. Bone marrow biopsy (BMB) is important for staging, and morphology alone can be challenging for subtyping. Immunohistochemistry (IHC) allows a more precise diagnosis and characterization of NHL using monoclonal antibodies. However, there is a need for a minimal panel that can provide maximum information at an affordable cost. Methods All newly diagnosed cases of B-cell NHL with bone marrow infiltration between 2017 and 2019 were included. BMB was the primary procedure for diagnosing B-cell NHL. Subtyping of lymphomas was performed by immunophenotyping using a panel of monoclonal antibodies on IHC. The primary diagnostic panel of antibodies for B-cell NHL included CD19, CD20, CD79, CD5, CD23, CD10, Kappa, and Lambda. The extended panel of antibodies for further subtyping included CD30, CD45, CD56, Cyclin D1, BCL2, and BCL6. Results All cases of B-cell NHL were classified into the chronic lymphocytic leukemia (CLL) and non-CLL groups based on morphology and primary IHC panel. In the CLL group, the most significant findings were CD5 expression, CD23 expression, dim CD79 expression, and weak surface immunoglobulin (Ig) positivity. In the non-CLL group, they were CD5 expression, positive or negative CD23 expression, strong CD79 expression, and strong surface Ig expression. An extended panel was used for further subtyping of non-CLL cases, which comprised CD10, Cyclin D1, BCL2, and BCL6. Conclusion We propose a two-tier approach for immunophenotypic analysis of newly diagnosed B-cell NHL cases with a minimum primary panel including CD5, CD23, CD79, Kappa, and Lambda for differentiation into CLL/non-CLL group and Kappa and Lambda for clonality assessment. An extended panel may be used wherever required for further subtyping of non-CLL.
The diagnosis of lymphoproliferative disorder of orbit is quite challenging as both Pseudolymphomas and Non‑Hodgkin’s lymphomas can occur in orbit. Primary orbital lymphoma is a rare entity comprising of 1-2% of Non‑Hodgkin’s lymphoma, majority of them are B‑cell type. It is a slow growing tumor. It presents in the age group of 50–70 years, with a slight female preponderance. Proptosis is the most common presentation. We, herein, report a case of 48 years old male presenting with right non-axial proptosis, watering of eye, blurring of vision and redness for the last 9 months. After thorough clinical and radiological evaluation, a biopsy was taken for histopathological examination. A primary diagnosis of Lymphoproliferative Disorder was made. Following this, a panel of immunohistochemical markers was applied and a final diagnosis of Non-Hodgkin Lymphoma, B-cell type was given.
Background: Congenital nasolacrimal duct obstruction is inflammation of lacrimal sac due to nasolacrimal duct obstruction in children. Congenital nasolacrimal duct obstruction is a common disorder in infants, with up to 20% of all newborns suffering from epiphora during the first year of life. The purpose of this study is examining the various risk factors in patients of congenital nasolacrimal duct obstruction. Method: In this study, 121 patients were examined in L.N. Medical College and J.K Hospital, Kolar Road, Bhopal between June to July to August 2015.A clinical examination was being conducted in the children below age of 3 years after the history taking started by torch light examination, slit lamp examination, and the regurgitation test was being done. All the other conditions which presented like complaints of congenital Dacryocystitis like-Opthalmia Neonatorum, Congenital Glaucoma, allergic conjunctivitis, trauma to eye were being ruled out. Mothers of the children were asked to fill the Questionnaire about risk factor of Congenital nasolacrimal duct obstruction. The awareness about the disease in the mothers via the above questionnaire whether the mothers were familiar with the disease or not was asked. Results: 121 patients were seen over the period under review out of which 60% were males. Most common age at the presentation was between 0 to 2 months. 2 significant risk factors were observed, Prematurity and Poor hygienic status in this study. Conclusion: Current study done to find association of various risk factors. A further study is needed in this field to find any other risk factors responsible for the high incidence of congenital Dacryocystitis and all the mothers need to be educated regarding these risk factors, and awareness should be created in the mothers.
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