The Pattern of Malignant Lymphoma in Al-Qassim, Saudi Arabia: A Retrospective Study

Abstract

The incidence and clinical characteristics of malignant lymphomas (ML), the most common tumors encountered in the Middle East, vary in different regions. [1][2][3][4][5] This retrospective study analyzed histologically confirmed cases of malignant lymphoma seen in King Fahd Specialist Hospital (KFSH) during an eight-year period (01/01/87 to 31/12/94). The results were compared with data from other regions of the Kingdom and the Middle East. KFSH is a 570-bed regional referral hospital of Al-Qassim region and the majority of malignant disease patients of the region are referred here for further management. Patients and MethodsThe records of 160 consecutive patients of histologically confirmed lymphoma, seen in KFSH between 01/01/87 and 31/12/94, were reviewed. There were 145 Saudis and 15 non-Saudi patients. Twenty-one patients (nine Saudis and 12 non-Saudis) did not have either enough clinical details or pathological material available for inclusion in the study.The patient's age, sex, site of initial presentation and symptoms with duration were all noted. The majority of the patients had undergone a complete staging workup, including hemogram, liver function tests, chest x-ray, abdominal ultrasonography, CT scan of the chest and abdomen, as well as bone marrow examination. Laparotomy was not carried out for staging purposes.Patients were staged according to the Ann Arbor classification. 6 B symptoms were defined as weight loss >10% over six months prior the admission and/or unexplained fever with temperature >38°C and/or night sweats. The histopathology of Hodgkin disease (HD) was classified according to the Rye scheme of classification 7 and that of non-Hodgkin lymphoma (NHL) according to Rappaport 8 and the working formulation. 9 The results were compared by r-test and contingency tables were analyzed by χ 2 test with Yale's correction. ResultsOut of the total of 139 cases included in this study (136 Saudis, three non-Saudis), 87 (62.6%) patients had NHL and 52 had HD (37.4%).Age distribution: Shown in Figures 1 and 2. The age ranged from two to 99 years. The mean age for HD was lower than for NHL (27.9±21.2 years versus 46.8±27.60 years, t=2.3, P<0.05). Patients with the nodular sclerosis (NS) type of HD presented at an earlier age than other types of HD (mean age 21±13.5 versus 33.7±24.9 years, t=2.3, P<0.05).Sex ratio: The male to female ratio of 60:27 (2.2:1) in NHL was higher than 33:19 (1.7:1) in HD (χ 2 =0.23, P>0.5). The NS type of HD was more common in females with a male to female ratio of 1:1.3 (χ 2 =6.33, P<0.05). Histological types: Tables 1 and 2 show the age-related histological types of HD and NHL. In HD, lymphocytic predominant (LP) and NS were more common (57.7%) than mixed cellularity (MC) and lymphocytic depletion (LD) combined (42.3). The majority of NHLs were aggressive lymphomas (Table 3).Presenting symptoms: Awareness of a peripheral Jump was the most common symptom with which our patients presented (93/139, 66.9%), being more common in HD (47/52, 90.4%) than in NHL (46/87, 52.9%) (χ 2...

The analysis of pathological findings for cervical lymph node biopsies in eastern Saudi Arabia

“…Carcinoma was the second most common finding in adults. This finding is in agreement with other studies [3,19].…”

Correlation Hematological Malignancies in the Hadhramout Sector Pattern and Distribution

“…NHL was the most frequent common HM (37.8%) in this study, resembles finding in cancer registries of Sana [17], and most Asian countries like Saudi Arabia [18,20,34], Jordan [35], Korea [7] , and Morocco and other African countries [8,[24][25][26], while in United States, Australia, and Bangladesh, leukemia cases were the most frequent HM [6,22,32,36] . NHL was more common in men than in women with a male to female ratio of 1.7:1 and this was similar to a previous study in lymphomas in Hadhramout [37] and other studies in Saudi Arabia but less ratio (1.2:1) was found in Oman [21,38]. We observed that the median age of NHL was 44 years which was similar to studies done in Sana, Saudi Arabia, Oman, and Jordan [17,35,39].…”

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“…Al-Qassim is an arid desert with patches of oasis which is located in the central region of Saudi Arabia, and it has a population of about one million. 19 There are about 120 primary health-care centers (PHC) in Al Qassim city. The 11 PHCs were selected based on how they apply the quality measures, volume, and location.…”