B-cell non-Hodgkin lymphomas in Uganda: an immunohistochemical appraisal on tissue microarray

Tumwine, Lynnette K; Campidelli, Cristina; Righi, Simona; Neda, Sophia; Wilson, Brian C.; Pileri, Stefano

doi:10.1016/j.humpath.2007.10.025

Cited by 20 publications

(22 citation statements)

References 27 publications

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“…[1][2][3][4] eBL is almost invariably associated with Epstein-Barr virus (EBV) infection, although local environmental toxics (ie, Euphorbia tirucalli) and coinfection with arbovirus or, specially, malaria also appear to be important for its pathogenesis. [5][6][7] sBL is the most commonly recorded form in the United States and Europe.…”

Section: Introductionmentioning

confidence: 99%

Gene expression analysis uncovers similarity and differences among Burkitt lymphoma subtypes

Piccaluga

Falco

Kustagi

et al. 2011

Blood

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Section: Introductionmentioning

confidence: 99%

Gene expression analysis uncovers similarity and differences among Burkitt lymphoma subtypes

Piccaluga

Falco

Kustagi

et al. 2011

Blood

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124

125

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“…In this calculation we assumed that the prevalence of B cell non Hodgkin's lymphoma in the total population of non-Hodgkin lymphoma was 92.1% according to a Ugandan study[2] with a precision of 5% and 95% confidence interval.…”

Section: Methodsmentioning

confidence: 99%

“…In developing countries, clinically aggressive subtypes such as Burkitt and diffuse large B cell lymphoma predominate and, unfortunately, result in poor outcome[2]. Factors that influence survival in non Hodgkin lymphomas in resource poor settings include socio economic status, stage of disease at presentation and getting a full course of treatment.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical and other prognostic factors in B cell non Hodgkin lymphoma patients, Kampala, Uganda

et al. 2009

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BackgroundNon Hodgkin lymphomas are the most common lymphomas in Uganda. Recent studies from developed countries have shown differences in survival for the different immunophenotypes. Such studies are lacking in Africa where diagnosis is largely dependent on morphology alone. We report immunohistochemical and other prognostic factors in B cell non Hodgkin lymphoma patients in Kampala, Uganda.MethodsNon Hodgkin lymphoma tissue blocks from the archives of the Department of Pathology, Makerere University College of Health Sciences, Kampala, Uganda, from 1991-2000, were sub typed using haematoxylin and eosin, Giemsa as well as immunohistochemistry. Using tissue micro array, 119 biopsies were subjected to: CD3, CD5, CD10, CD20, CD23, CD30, CD38, CD79a, CD138, Bcl-6, Bcl-2, IRTA-1, MUM1/IRF4, Bcl-1/cyclin D1, TdT, ALKc, and Ki-67/Mib1. Case notes were retrieved for: disease stage, chemotherapy courses received and retrospective follow up was done for survival.ResultsNon Hodgkin B cell lymphomas comprised of Burkitt lymphoma [BL] (95/119) diffuse large B cell lymphoma (19/119), mantle cell lymphoma (4/119) and precursor B lymphoblastic lymphoma (1/119).For Burkitt lymphoma, good prognosis was associated with receiving chemotherapy, female gender and CD30 positivity. Only receiving chemotherapy remained significant after Cox regression analysis. Diffuse large B cell lymphomas with activated germinal centre B cell (GCB) pattern (CD10+/-, BCL-6+/-, MUM+/-, CD138+/-) had better survival (98.4 months; 95% CI 89.5 -107.3) than the others (57.3 months; 95% CI 35.5 - 79.0) p = 0.027 (log rank test).ConclusionsActivated GCB diffuse large B cell lymphoma had a better prognosis than the others. For Burkitt lymphoma, not receiving chemotherapy carried a poor prognosis. Availability of chemotherapy in this resource limited setting is critical for survival of lymphoma patients.

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“…[1] The diagnosis of lymphoma in developed countries is currently based on morphology, the patient’s clinical data, immmunophenotype and molecular studies.…”

Section: Introductionmentioning

confidence: 99%

EBV-Positive Grey Zone Lymphoma in an HIV Infected Man from Kampala, Uganda: Case Report

Tumwine

Orem

Ayers³

2015

IJMPCR

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Aim We describe the clinical, histopathological and immunophenotypic characteristics of an HIV-infected adult man on antiretroviral therapy who presented with an EBV-positive grey zone lymphoma. Case presentation A 56-year-old HIV infected man from Uganda presented with a four month history of progressive abdominal swelling and B-symptoms. He was on highly active antiretroviral therapy (HAART) and cotrimoxazole. He was afebrile (36.9°C), severely wasted (BMI 14.8), and mildly anaemic. On physical examination, he had a 15 by 8 cm mass in the hypogastrium and umbilical region. The total white cell count was 8.3×103/μL; neutrophils, 5.72×103/μL; haemoglobin 11.1g/dL, platelets 528×103/μL, LDH 197 IU/L and CD4 367/μL. Abdominal ultrasound and CT scan showed a tumour involving the mesentery, jejunum and mid ileum. At laparotomy, a biopsy was taken, fixed, processed and stained with Haematoxylin & Eosin (H & E). Histopathology demonstrated large pleomorphic cells admixed with inflammatory smaller cells, Reed-Sternberg-like cell variants and frequent abnormal mitoses. Biomarkers CD20, PAX5, CD30 were positive but ALK negative (immunohistochemistry and strong EBER positivity in situ hybridization. The patient improved on modified CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy. Discussion The tumour had features intermediate between mediastinal large B cell lymphoma and classical Hodgkin lymphoma. Conclusion We present a case of EBV-positive grey zone lymphoma in an HIV-infected man on HAART therapy diagnosed and treated in a resource constrained medical setting. The histological features are unusual and represent a low incidence lymphoma that is recognized by mixed features reminiscent of Hodgkin’s lymphoma and mediastinal large B-cell lymphoma.

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B-cell non-Hodgkin lymphomas in Uganda: an immunohistochemical appraisal on tissue microarray

Cited by 20 publications

References 27 publications

Gene expression analysis uncovers similarity and differences among Burkitt lymphoma subtypes

Gene expression analysis uncovers similarity and differences among Burkitt lymphoma subtypes

Immunohistochemical and other prognostic factors in B cell non Hodgkin lymphoma patients, Kampala, Uganda

EBV-Positive Grey Zone Lymphoma in an HIV Infected Man from Kampala, Uganda: Case Report

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