Study of extra-nodal lymphoma with special reference to histomorphology, immunohistochemistry, and topographical distribution

Background: Primary extra-nodal lymphomas (ENLs) are rare neoplasm but can affect many organ systems of body. Proper and timely diagnosis and justified treatment of primary ENL are often affected due to variety of lymphoma types and the relative rarity of many of these tumor types. They are mainly of Non-Hodgkin lymphoma which further consists of many subtypes having variation of epidemiology and clinical presentation along with geographic distribution. Aim and Objectives: Aim and objectives of the study were to find out topographical distribution and histological patterns of ENL along with their immunohistochemical character in a tertiary care hospital of Eastern India. Materials and Methods: All the cases from April 2015 to March 2018 diagnosed as ENL by histopathological examination were included in this descriptive cross-sectional study for further immunohistochemical analysis for CD45 Life-cycle assessment (LCA), CD3 and CD 20 to identify the cell of origin (B cell vs. T cell). Results: Out of total 31 cases, 67.74% were male and the most common age group was 51–60 years. Gastrointestinal tract was the most common organ system (61.29% of cases) affected and stomach (29.03%) followed by Ileum (9.67%) were the most common sites affected by ENL. Histomorphologically diffuse large cell lymphoma was the most common pattern while immunohistochemistry study revealed all the cases were B cell type with LCA and CD 20 positive and CD3 negative. Conclusion: This study revealed the topographical pattern along with predominant histomorphological and immunohistochemical character of ENL in study population. However, further studies with meta- analysis can enlighten these characters more comprehensively.

A Case of Recurred Follicular Lymphoma in Sublingual Gland after Complete Remission / 대한이비인후과학회지

Non-Hodgkin's lymphoma (NHL) is a group of neoplasm affecting the lymphoid system. Follicular lymphoma is typically a slow-growing, indolent form of NHL that accounts for 1/3 of all NHL. It is one of the B-cell lymphomas, generally characterized by multiple relapses after responses to a variety of therapies. When lymphoma relapses, it may occur in the same or a different part of the body from where it occurred originally. Recurrence in the primary site is most common but recurrence in other parts is rarely observed. We experienced a rare case of 70-year-old woman who complained of swelling in the left mouth floor and was diagonosed with a recurrent NHL. It recurred in the sublingual gland after a complete remission of the follicular lymphoma.

Mainly Adrenal Gland Involving NK/T-Cell Nasal Type Lymphoma Diagnosed with Delay due to Mimicking Adrenal Hemorrhage

A 29-yr-old man, presented with abdominal pain and fever, had an initial computed tomography (CT) scan revealing low attenuation of both adrenal glands. The initial concern was for tuberculous adrenalitis or autoimmune adrenalitis combined with adrenal hemorrhage. The patient started empirical anti-tuberculous medication, but there was no improvement. Enlargement of cervical lymph nodes were developed after that and excisional biopsy of cervical lymph nodes was performed. Pathological finding of excised lymph nodes was compatible to NK/T-cell lymphoma. The patient died due to the progression of the disease even after undergoing therapeutic trials including chemotherapy. Lymphoma mainly involving adrenal gland in the early stage of the disease is rare and the vast majority of cases that have been reported were of B-cell origin. From this case it is suggested that extra-nodal NK/T-cell lymphoma should be considered as a cause of bilateral adrenal masses although it is rare.

Primary non-hodgkin's lymphoma of bone: Experience of a decade.

Objective: To study the prevalence and characterization of primary non Hodgkin's lymphoma of bone in a major referral center of Pakistan. Methodology: All cases of primary non Hodgkin's lymphoma of bone, diagnosed at a referral center in Pakistan from January 1998 to July 2008 have been included. Patients with diagnosis of lymphoma at some other site prior to diagnosis in bone biopsy were excluded from the study. Results: Sixty cases of primary non Hodgkin's lymphoma of bone were received, with a male to female ratio of 7: 3 (42 males and 18 females). Overall, 52/60 (86.6 %) patients were diagnosed with Diffuse large B-cell non-Hodgkin's lymphoma. The largest fraction of patients was found in the pediatric group i.e. 33/60(55%) followed by elderly group i.e.15/60 (15%) and adults i.e. 12/60 (20%). The commonest sites of involvement were femur (28.3 %), hip bone (16.6%) and humerus (10%). Conclusion: Diffuse large B-cell lymphoma is the commonest type of primary non Hodgkin's lymphoma of bone in the Pakistani population. It is common in all ages. The sites most often involved are femur followed by hip bone. Primary non Hodgkin's lymphoma of bone appears to be more common in males. Our results are comparable to international data with various studies also showing that diffuse large B cell non Hodgkin lymphoma is the commonest primary bone lymphoma. However, primary Bone Lymphoma is more common in children and young adults.