A comparison of clinical and histopathologic features of childhood malignant lymphoma in Uganda

Abstract

One‐hundred seventy‐two Ugandan children with lymphoma have been studied with a view to determining the value of morphology (histology and cytology) as a means of predicting clinical behavior and response to treatment. In the group where a morphological diagnosis of BL was made (147), duration of symptoms was shorter than in the other groups; 85% of patients had a tumor distribution considered to be typical of BL (jaws, orbits, intra‐abdominal, epidural, meningeal, or cranial nerve tumor). In the HL group (11), no patient had a tumor distribution typical of BL, while in the LL g4roup (14), 8 patients might have been considered to be BL on clinical grounds alone. Response to cyclophosphamide therapy was complete in 92% of the BL group, 27% of the LL group, and none of the HL group. Survival was significantly better in patients with BL (65% long term remission) than in the other groups (median survival 28 weeks). Anti‐VCA titers were invariably raised in the BL group, and sometimes raised in the other groups. We confirm that BL is a separate clinical entity and can in the majority of cases be clearly distinguished from other types of lymphoma on morphological grounds alone. In individual cases where difficulty in making a diagnosis arises, there is no final arbiter. We must await the development of more sophisticated techniques of biochemical, immunologic, and etiologic classification of tumors.

The distribution of non‐burkitt, non‐Hodgkin's lymphomas in Uganda in relation to malarial endemicity

“…Since they show a geographical correlation within Uganda, our tentative conclusion is that BL and other types of NHL may share to a varying degree some common pathogenetic origin (Tables I11 and V). Infections by Epstein-Ban virus (EBV) and human herpes virus type 6 may be of importance (Epstein, 1985;Josephs, 1988); some years ago, high EBV-titres were occasionally detected in the serum of Ugandan children suffering from NBNHL (Magrath et al, 1974). If malaria has an aetiological role in the development of NBNHL, as has been suggested for BL, it would be of interest to know whether these tumours show similar chromosomal translocations to BL or whether they show the 14: 18 translocation that characterizes follicle centre cell lymphomas seen in the West (Nowell et al, 1984).…”

Burkitt's Lymphoma of the Vulva Case Report

“…In our patient the spread from an abdominal primary lesion was probably retrograde via the para-aortic, iliac and inguinal lymph nodes. The clinical and histopathological features of Burkitt's lymphoma have been well documented (Magrath et al, 1974), and in the hands of an experienced pathologist, the diagnosis is fairly easy. However, where tissues are crushed, or biopsies are taken from unusual sites like the vulva or ovary, other round-cell tumours must be considered and excluded.…”