CLINCOPATHOLOGIC STUDY OF LYMPHOMA: a relook

Abstract

Lymphomas are heterogeneous group of malignant lymphoproliferative disorders. Broadly categorized into Non-Hodgkin's lymphoma [NHLs] and Hodgkin's lymphoma [HL]. Decades back one of the challenging topics in morphologic pathology was accurate diagnosis and classification of lymphoma. Studies on lymphoma with clinicopathologic correlation were found to be much significant. STUDY OBJECTIVES: This was a retrospective study aimed to describe lymphomas on histo morphology and thus classify NHLs using working formulation for clinical usage (1982) and HL using Rye (1966) classification respectively. To attempt clinicopathologic correlation. METHODS: The study was done in the department of pathology, Mahadevappa Rampure Medical College, Gulbarga during the period 1989-1999. Formalin fixed paraffin wax embedded tissue blocks previously diagnosed as lymphomas in the department were used. Morphologic details by light microscopy on haematoxylin and eosin (H&E) stained sections were noted. Clinical history of each case were analysed from hospital records. Clinical and pathologic correlation was done. Special stains Reticulin (Gomori) and Periodic acid Schiff's stain [PAS] was done in relevant cases. RESULTS: Study of total 102 cases of lymphoma it was observed NHLs formed 70 cases with an incidence of 68.3%. HL accounted for 32 cases with incidence of 37.2%. NHLs commonly presented in fifth decade 24.2%, followed by fourth and sixth decade. Sex distribution showed Male: Female ratio as 2.5:1. Majority of cases presented with cervical and axillary lymphadenopathy at 41% and 20% respectively. The most frequent grade was clinically aggressive intermediate grade NHLs seen in 80% of all cases. 20 cases of NHLs were of extranodal in origin. The most common site was gastrointestinal tract (60%) and head and neck region with (30%). The major histologic type in both nodal and extranodal NHLs was diffuse small cleaved cell type (DSCC). HL showed sex ratio of 1.8:1.The common age group was in third and second decade. Mixed cellularity was most frequent type. No extranodal HL was noted. CONCLUSION: This study confirmed the usefulness of histomorphology in diagnosis of lymphomas and its basis used in the classification systems. Clinicopathologic correlation was significant. The Result was comparable with various author study series. A relook into the still clinical usefulness of the above classification system in this era of immunophenotyping for lymphomas.