Pattern of bone marrow involvement in non Hodgkin’s lymphoma classified according to WHO classification: Report of a developing country Pakistan

Abstract

BACKGROUND:Limited information is available from developing countries in patients of non-Hodgkin's lymphoma (NHL). Hence, we reviewed the demographical profile along with bone marrow infiltration pattern in patients with NHL presented at Liaquat National Hospital and Medical College.MATERIALS AND METHODS:In this descriptive study, adult patients with NHL were enrolled from January 2011 to December 2015.RESULTS:One hundred and Eighty-four histopathologically confirmed cases of NHL were identified. There were 139 males and 45 females, with a male-to-female ratio of 3:1. The mean age was 48.5 ± 16.0 years with the median age of 50 years. B-symptoms were present in 80.4% of patients. Lymph node enlargement was present in 71.1% of the cases. One hundred and sixty-eight patients had B-cell lymphoma (91.3%) and 16 patients had T-cell lymphoma (8.6%). Overall 158 (85.8%) patients had aggressive lymphoma. The frequency of bone marrow infiltration in our NHL patients was found to be 31.5%. Pattern of infiltrate was diffuse (14.6%) predominantly followed by interstitial (6.5%) and paratrabecular (5.4%) types of infiltration. The least common was nodular infiltrate accounted in 9 (4.8%) patients.CONCLUSIONS:B-cell lymphoma is more frequent than T-cell lymphoma. Younger age, aggressive lymphoma, and predominance of B-symptoms are more frequently seen. Diffuse bone marrow infiltration is more common in our set up probably because of a relatively late presentation in our patients.

Incidence and clinicohematological profile of lymphomas in Southern Punjab Pakistan

“…Possibly shorter life expectancy and relatively younger population in developing countries might be one explanation of this disparity 17 . Moreover, B symptoms were observed among 96% of our patients which was different from study conducted by Sultan et al, where B symptoms were common among 80.4% patients 18 . The difference might be due to the fact that they included only NHLs in their study while we studied both Hodgkin and NHLs.…”

Frequency of Bone Marrow Involvement in Cases of Lymphoma: A Hospital Based Observational Study

“…Kumar S et al [11] in a study on 49 cases of Non Hodgkin lymphoma found that the overall incidence of marrow involvement by Non Hodgkin lymphoma was 55.1%. Sultan S et al [12] found the frequency of bone marrow inltration in Non Hodgkin lymphoma patients to be 31.5% (58/187) . Kittivorapart J et al [13] found the incidence of bone marrow involvement in cases of Non Hodgkin lymphoma to be 23.8% which is on the lower side when compared to our study.…”

“…Maximum number of cases were seen in the age group of 51 to 60 years (mean age 52.1 years and median age 59.5 years). Maximum number of patients (12) with bone marrow involvement also belonged to the age group of 51 to 60 years (median 60 years). Male preponderance was seen and constituted 66.7% cases and females constituted 33.3% with male to female ratio of 2:1.…”

The Role of Texture Analysis and Radiomics in Prediction of Bone Marrow Infiltration in Patients with Lymphoma

“…Another reason is that CT is not effective in diagnosis lymphoma being not reliable in the detection of bone marrow disease, which, if present, by definition indicates stage IV disease 4 . 18 F-FDG PET/CT has an impact on the assessment of both newly diagnosed, prognosed and previously treated patients with lymphoma and also alters the initial clinical staging of this disease 5,6 . Incidence of marrow disease varies with histological subtype of lymphoma.…”

“…Bone marrow biopsy is fundamental in identifying marrow involvement for therapy purpose 7 . Marrow diseases can be diagnosed with 18 F-FDG PET/CT scan and the visual interpretation of marrow FDG uptake throughout whole-body. PET scans can efficiently determine marrow disease status in a high proportion of lymphoma patients.…”