Introduction. Iron deficiency affects approximately 30% of the world population and is frequently encountered in hypothyroid patients. Early recognition and prompt treatment of iron deficiency in hypothyroid patients lead to a favorable outcome. The aim of this study is to prove the usefulness of reticulocyte hemoglobin equivalent (Ret-He) as a reliable and effective tool in diagnosis of iron deficiency in hypothyroid patients. Materials and Methods. 154 patients with hypothyroidism were included in the study. They were divided into 4 groups. Group 1 included 66 hypothyroid patients without iron deficiency. They were taken as controls. Group 2 included 66 hypothyroid patients with iron deficiency anemia (IDA). Group 3 included 12 hypothyroid patients with iron deficiency but without anemia (ID). Group 4 included 10 hypothyroid patients which had concomitant iron deficiency with anemia of chronic disorder (ACDC). Ret-He was measured by analyzing blood samples on System XN 350. Thyroid profile, serum ferritin, and biochemical data were measured by an automated analyzer. Statistical analysis was performed by using SPSS 23. Results. Ret-He was significantly lower with ( p < 0.001 ) in group 2 (hypothyroid patients with IDA), group 3 (hypothyroid patients with ID), and in group 4 (hypothyroid patients with ACDC) as compared to controls in group 1 (hypothyroid patients without iron deficiency). After ROC analysis area under the curve (AUC) of Ret-He for hypothyroid patients with IDA was 0.96 at cutoff 28.5 pg with sensitivity of 93% and specificity of 90%. AUC of Ret-He in the hypothyroid group with ACDC was 0.99 at cutoff 30.8 pg with sensitivity of 90% and specificity of 90%. AUC of Ret-He in hypothyroid patients with ID was 0.97 at cutoff 31.7 pg with sensitivity of 91% and specificity of 70%. Conclusion. Ret-He is a reliable, rapid, and cost-effective tool for diagnosing iron deficiency in hypothyroid patients.

Objective Diffuse Large B Cell Lymphoma (DLBCL) is the most common type of Non-Hodgkin Lymphoma (NHL). The aim of this study was to assess the clinico pathological characteristics of DLBCL specifically, among the affected individuals residing in Northern areas of Pakistan who had not been previously included in major lymphoma studies due to their remote location. Results Mean age of the patients was 49.7 years. Male: female ratio was 1.5:1. Primary site was lymph node in 99 (71.74%) patients, out of which, 36 (26.09%) patients had B symptoms and 19 (13.77%) patients had stage IV disease. 39 (28.26%) patients had primary extra nodal involvement, 4 (2.90%) patients had B symptoms and 3 (2.17%) had stage IV disease. Extra nodal sites involved in primary extra nodal DLBCL were gastrointestinal tract (GIT) 19 (48.72%), tonsils 6 (15.38%), spine 4 (10.26%), soft tissue swelling 3 (7.69%), parotid gland 2 (5.13%), thyroid 2 (5.13%) central nervous system (CNS) 1 (2.56), breast 1 (2.56%) and bone marrow 1 (2.56%). Our study revealed increased percentage of patients with nodal DLBCL in stage IV and with B symptoms. Few patients with primary extra nodal DLBCL had B symptoms and stage IV disease at presentation. GIT was the most common site of involvement in primary extra nodal DLBCL.

IntroductionLymphomas are a heterogeneous group of disorders that arise primarily from lymphoid tissue and are categorized based on histological features and immunophenotypes. The distribution and frequency of different types of lymphoma vary in different parts of the world. This study aimed to document the frequency and clinicopathological characteristics of various types of lymphoma in our population to understand the ever-increasing burden of disease and formulate the optimal management and prevention plans. Materials and methodsThis study was conducted at Nuclear Medicine, Oncology and Radiotherapy Institute (NORI) from August 2015 to March 2022. A total of 300 cases of lymphoma that were diagnosed and treated at NORI were included in the study. We measured the frequency of different lymphomas and patient age, sex, and stage IV presentation at the time of diagnosis. IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp.) was used to analyze the data. ResultsThree hundred patients with lymphoma were included in the study. There were more non-Hodgkin's lymphoma (NHL) cases (n=224; 74.6%) than Hodgkin's lymphoma (HL) cases (n=76; 25.3%). T-cell NHL was seen in 11 cases (4.8%), while B-cell NHL was found in 214 cases (95%). Diffuse large B-cell lymphoma was the predominant type (n=156; 69.3%). Among T-cell lymphomas, anaplastic T-cell lymphoma was the most common subtype (n=6; 2.6%) followed by angioimmunoblastic T-cell lymphoma (n=2; 0.8%) and T-cell lymphoblastic lymphoma (n=1; 0.4%). For classical HL, mixed cellularity was the predominant type (n=38; 50%) followed by nodular sclerosis (n=31; 40.8%), lymphocyte depleted (n=5; 6.6%), and lymphocyte rich (n=2; 2.6%). Stage IV was present in 21 HL cases (27.6%), and stage IV was seen in 67 NHL cases (29.7%) at the time of diagnosis. Most HL and NHL patients were male. Most HL cases presented in the younger age group (aged 15 to 35 years), while the largest group of NHL patients were aged 56 to 75 years. ConclusionOur population has a broad spectrum of lymphoma and its subtypes. NHL is more common than HL, and the frequency of B-cell NHL is higher than that of T-cell NHL. Approximately one-third of the patients presented in stage IV at the time of diagnosis. An awareness of clinicopathological characteristics of lymphoma in our setup would aid in diagnosis, formulating standard management plans, and prevention strategies for optimal patient outcomes.

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