Pattern of Diffuse Large B cell Lymphoma (DLBCL) in Aden, Yemen.

UNLABELLED: DLBCL is part of aggressive lymphomas with limited survival in the absence of effective treatment. AIM: The aim of this study was to determine the frequency and the pattern of presentation of DLBCL in patients diagnosed in Aden. METHODS AND MATERIAL: It was conducted prospectively in Aden, at Al-Amal Oncology Unit of Al-Gamhouria Modern General Hospital. All patients confirmed to have NHL by histopathology were selected from Jan. 1st to Dec. 31st, 2009. They were clinically examined and investigated for clinical staging and classification. DATA ANALYSIS: DATA ANALYSIS was conducted by the SPSS 18 program, using the Chi square, Fisher Exact, hypothesis test (Z-test) and student t-tests. RESULTS: The frequency of DLBCL was 35%. In DLBCL, the median age was 51.5 years, with male to female ratio of 3.67:1. Clinically, most patients were nodal and B symptoms were present in 64.3% of them; weight loss and sweating were reported more than in the other subtypes of NHL. Investigations showed that 64.3% were anemic, 35.7% with high ESR and high ß2 microglobulin, 21.4% with low albumin and high uric acid. Half of them presented in stage III and IV disease and according to the IPI scoring, 64.3% presented with intermediate to high risk disease. Comparison with other NHL subtypes was performed and showed that DLBCL is associated with aggressive pattern of presentation. CONCLUSION: This study concluded that DLBCL is an aggressive NHL at presentation and needs immediate diagnosis and intervention to improve the outcome. KEYWORDS: DLBCL, NHL, Lymphoma, Pattern, Aden, Aggressive.

Late presentation of breast cancer in Aden, Yemen.

UNLABELLED: The aim of this study is to determine the frequency and characteristics of patients who presented with late stage breast cancer at Al-Amal Oncology Unit in Aden. It was conducted retrospectively in Aden, at Al-Amal Oncology Unit of Al-Gamhouria Modern General Hospital, by reviewing all records of breast cancer patients at any stage and attended with histopathologically documented breast cancer from the time of establishment of the unit on December 1, 2007 to December 31, 2009. The total number of documented breast cancer patients was 197 and classified according to the stage at presentation and after the exclusion of 21 patients who were not staged. 118 patients with late inoperable stages were selected and carefully evaluated of their demographic characteristics and was found that they represented 67.0% of the total staged breast cancer patients. Most of these patients are in the reproductive age and residents of Aden governorate and neighboring governorates. Metastasis was mainly evident at the lymph nodes, bones, liver and lungs. The case fatality rate for late stage breast cancer is 8.5 per 100 patients. This study concludes that a high percentage of Yemeni patients in Aden presented with late stage breast cancer which led to the failure of possible curative surgical intervention and resulted to high metastatic disease and fatality rate. KEYWORDS: Late Presentation, Aden, Yemen, Breast Cancer, Stages.

Pattern of head and neck cancer in Yemen.

Head and neck cancer constitutes one of the commonest malignancies in Yemen. There may be a role for the use of Shamma and Zarda and Khat for the increase of HNC in Yemen. This study was conducted retrospectively with an overall aim to describe the pattern of head and neck cancers among Yemeni patients attending the Oncology Department of Al-Gamhouria Teaching Hospital, Aden, for the period from Jan. 2001 to Dec. 2004. The study included 183 patients with head and neck cancers (Lymphoma and thyroid were excluded), 134 were males (73.2%) and 49 were females (26.8%) , with male to female ratio of 2.7:1. The mean age was 51.3 +/- 14.9 years (range: 3 - 82 years). Statistically, there is significant difference between the mean age of male (49.5 +/- 15.1 years) and female (45.4 +/- 16.3 years) patients with head and neck cancers [t= 2.1, p: 0.03]. The common types of head and neck cancers in this study are cancers of the oral cavity (31.7%), followed by pharyngeal (22.9%) and laryngeal (19.1%). In relation to sex, there is a significant statistical relationship between certain head and neck cancers and sex (p: 0.0000). In males, the common cancers are oral cavity cancers (22.7%), laryngeal (22.1%) and pharyngeal cancers (20.8%). The common histopathological type of head and neck cancers in this study is the well differentiated squamous cell carcinoma (70.5%). This study concluded that head and neck cancers are among the common health problems affecting Yemeni patients and recommended further wide national studies to determine the real incidence and the risk factors associated with such cancer.