Clinicopathological Features of Extranodal Lymphomas: Kuwait Experience

Abstract

A total of 935 patients with extranodal non-Hodgkin lymphoma (NHL) diagnosed in the period between January 1985 and December 2000 in Kuwait Cancer Center, serving the whole population of Kuwait, were used to describe the clinicopathological and epidemiological features of extranodal lymphomas in Kuwait. Extranodal lymphomas accounted for 45% of all NHL observed during this time. All NHL cases from Kuwait Cancer registry were analyzed and pathologically reclassified using the latest WHO (2000) classification. The most common lymphoma observed was diffuse large B-cell lymphoma (58.60%) followed by Burkitt´s lymphoma (BL) (3.80%). In the pediatric group, BL comprises more than two thirds of all patients (77.20%). The most common extranodal sites were stomach (19.70%) and skin (17.80%) in the adult group, large intestine (29.80%) and small intestine (19.30%) in the pediatric age group. The majority (73.40%) of adult extranodal lymphomas was in stage IE–IIE and had a very good prognosis. On the contrary, the majority of pediatric extranodal lymphomas were found to be in stage III and IV. Variations in treatment policies (single agent or combined chemotherapy, radiotherapy, combined modality treatment) adopted and changed during the time period of 16 years of this retrospective study were documented.

Primary Extra Nodal Non Hodgkin Lymphoma: A 5 Year Retrospective Analysis

“…Ten percent of gastric MALT lymphomas had history of H. pylori gastritis demonstrated by routine Giemsa staining. Studies from Middle East countries like Iraq (Yaqo et al, 2011) and Kuwait (Temmim et al, 2004) have reported higher incidence of intestinal localization of lymphomas, as these studies have reported more number of Burkitt lymphomas among pediatric patients which tend to occur more at these sites. Immunoproliferative small intestinal disease (IPSID), more commonly reported from the Middle East countries was observed in two young males (26 years, 34 years) with history of loose motion, and malabsorption.…”

“…Worse therapeutic outcome was seen for patients with lymphoma involving rare sites (Yun et al, 2010), those with T-cell phenotype (Ko et al, 2009), and among pediatric age group (Temmim et al, 2004). In another study, age, performance status, stage of disease, and serum LDH level were independent prognostic variables, whereas nodal or extra nodal site did not have any prognostic significance (Lal et al, 2008).…”

“…A previous pioneer study from North India has shown the incidence to be 44% (106 of 241 cases of NHLs over a 3 year period) (Singh et al, 2003). However, the incidence of pENL has been shown to be very high in neighbouring Pakistan and Saudi Arabia (up to 50%) (Nagi et al, 2011), Kuwait (45%) (Temmim et al, 2004), Northern Iraq (48.3%) (Yaqo et al, 2011), Taiwan (47.2%) (Chen et al, 2010), Japan (46.6%) (Fujita et al, 2009), Korea (55%) (Yoon et al, 2010), Thailand (58.7%), and China (44.9%-61.4%) (Yang et al, 2011).…”

“…), skin, central nervous system (CNS), bone, testis, thyroid, breast, orbit, and rarely adrenal, pancreas, and the genitourinary tract (Singh et al, 2003;Temmim et al, 2004;Al Shemmari et al, 2008;Aoki et al, 2008;Gross et al, 2008;Lal et al, 2008;Fujita et al, 2009;Chen et al, 2010;Yoon et al, 2010;Yun et al, 2010;Arora et al, 2011;Nagi et al, 2011;Yaqo et al, 2011;Yang et al, 2011).…”

Disease patterns of pediatric non-Hodgkin lymphoma: A study from a developing area in Egypt

“…BL was the most common NHL subtype (69%) in our series. Furthermore, BL accounted for 78.2, 77.2, 68, 48.2, 42.2 and 39% of the cases in studies conducted in Brazil, Kuwait, Saudi Arabia, Germany, UK and Egypt, respectively (16,(21)(22)(23)(24)(25). By contrast, BL was encountered at a surprisingly low frequency (9-12%) in India, Pakistan and Shanghai (21,26).…”