Clinicopathological Spectrum of Hodgkin's and Non-Hodgkin's Lymphoma: A Tertiary Care Cancer Hospital Study in Pakistan

Abstract

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.

Clinicopathological Spectrum of B-Cell Non-Hodgkin Lymphoma in Pakistan Population: A Single-Center Study

“…There were 369 males and 179 females in our study, with a male-to-female ratio of 2.06:1. The male-to-female ratio was reported by Aslam et al [15] in patients with NHL is close to ours: 1.83:1.…”

“…Jayanta et al found that the GIT is the most common extranodal site for NHL involvement, based on a retrospective analysis of pictorial positron emission tomography (PET) scans from different regions [18]. Our study showed similar results to those reported in other studies [13][14][15][16][17].…”

“…Our study had several limitations, including the fact that approximately one-third of our patients in Pakistan presented with stage IV disease, as described by Aslam et al [ 15 ]. This could be due to the low socioeconomic status and lack of awareness among people in the northern and southern areas of Pakistan, including Balochistan.…”

Clinico-hematological profile of chronic lymphoproliferative disorders in patients presenting with lymphocytosis

“…4 In Pakistan, the annual incidence of non-Hodgkins chronic lymphomas is reported to be up to 8.4 per 100,000 and majority are B-cell lymphomas (BCLs). [5][6][7] They manifest clinically with a variety of symptoms depending on their histological subtype, aggressive versus indolent, and the site of involvement, exhibiting significant patient-topatient variation. Patients may present with localised or generalised lymphadenopathy, hepatosplenomegaly, cytopenias or constitutional symptoms.…”