Abstract
Context: Diagnosis of lymphoma constitutes a difficult task in context to subtyping. Accurate diagnosis is essential because the treatment options, responses to therapy and prognosis vary widely depending on the diagnosis. However to make a definitive diagnosis of a lymphoma based solely on the H & E light microscopy, findings may be exceedingly difficult because of frequent absence of distinguishing features. IHC represents a tool that can provide a clear distinction among the different types of lymphoma. The purpose of IHC is to categorize the patient in order to ensure appropriate and specific treatment, as well as to identify tumours at higher risk of recurrence and fatal outcomes.
Aims: To study histomorphology of different lymphomas and correlation of it with immunohistochemical findings.
Settings and Design: The present study is a retrospective as well as prospective study of lymphoma cases diagnosed based on routine histopathology as well as correlation of it with immunohistochemistry in surgical pathology section of the Central Diagnostic Laboratory, Shree Krishna Hospital, Karamsad from September 2010 to August 2015.
Materials and Methods: A detail clinical history, nature of specimen and other investigations were noted in the proforma. Macroscopic and microscopic findings or any incidental findings were documented in the final report.
Results: Total 47 cases of lymphoma were diagnosed in study period among them 42 cases were of B cell lymphoma and 7 cases were of T cell lymphoma. All B cell lymphoma were positive immunihistochemically for CD 20 and LCA. Out of 47 cases 25(53.19%) were of lymphoid origin and 22(46.81%) were of extralymphoid site.
Conclusion: From this study it was concluded that:
- In all the cases diagnosis of hematoxyllin and eosin stained sections were correlated with immunohistochemical findings
- Non Hodgkin's Lymphoma were most common than Hodgkin's lymphoma
Lymphnodes are the most common site of origin.
References
- Bashyal R et al: Role of immunohistochemistry in the diagnosis of malignant small round cell tumours, Journal of Pathology of Nepal, 2011; Vol. 1, 87-91.
- David Dsbbs: Diagnostic Immunohistoc-hemistry: Theranostic and Genomic Applications, Elsevier, 3rd edition,2010.
- Juan Rosai: Rosai and Ackerman‘s Surgical Pathology, Elsevier, 9th edition, 2009.
- MM Patel et al: Role of Immunohistochemistry in Differential Diagnosis of Round Cell Tumour, Paripex - Indian Journal Of Research, Volume: 3, Issue: 5, June 2013.
- Glass, A. G., Karnell, L. H. and Menck, H. R. (1997), The national cancer data base report on non-hodgkin's lymphoma. Cancer, 80: 2311–2320.
- Das et al: Profile of Malignant Lesions Amongst Children in North Bengal, indian pediatrics, volume 31-october 1994.
- Frank D.; Linet, Martha S.; Travis, Lois B.; and Devesa, Susan S., "Cancer Surveillance Series: Non-Hodgkin‘s Lymphoma Incidence by Histologic Subtype in the United States From 1978 Through 1995" (2000)
- Lawrence D‘cruze : The Role of Immunohistochemistry in the Analysis of the Spectrum of Small Round Cell Tumours at a Tertiary Care Centre, J Clin Diagn Res. 2013 July; 7(7): 1377–1382.
- Padhi S, Paul TR, Challa S, Prayaga AK, Rajappa S, Raghunadharao D et al., Primary Extra Nodal Non Hodgkin Lymphoma: A 5 Year Retrospective Analysis. Asian Pacific J Cancer Prev. 2012: 13(10): 4889-4895.
- Mushtaq S, Akhtar N, Jamal S, Mamoon N, Khadim T, Sarfaraz T et al., Malignant lymphomas in Pakistan according to the WHO classification of lym phoid neoplasms. Asian Pac J Cancer Prev. 2008; 9(2): 229-32.
- Bhardwaj A, Kishore S, Morphological Typing of Lymphomas with Immunohistochemistry. Indian Medical Gazette — APRIL 2015
- Manisha Sharma, Rahul Mannan, Mohit Madhukar, Sanjay Navani, Mridu Manjari, Tejinder Singh Bhasin, Karamjit Singh Gill,J Clin Diagn Res. 2014 January; 8(1): 46–49. Published online 2014 January 12. Doi: 10.7860/JCDR/2014/8173.3988: PMCID: PMC3939585.
- Shah, S. H., Soomro, I. N., Siddiqui, M. S., Pervez, S., Hassan, S. H. (1999). Immunohistochemical evaluation of small round cell Tumours of childhood. Journal of Pakistan Medical Association, 49(4), 87-89.
- Naresh KN, Srinivas V, Soman CS. Distribution of various subtypes of non- Hodgkin‘s lymphoma in India: a study of 2773 lymphomas using R.E.A.L. and WHO Classifications. Ann Oncol. 2000; 11 (Suppl 1): 63-7.
- Konrad P et al: Differential diagnosis of small round cell tumours (SRCT), fluorescence in situ hybridization (FISH) and Immunohistochemistry study, Pot, J. Pathology, 2009:4:151-162
- Sigma-Aldrich, methyl green pruning stain, procedure no. HT70, AR-MED Ltd. Runnymede Malthouse, Egham TW20 9BD United Kingdom, 2003-09.
- Bashyal R et al: Role of immunohisto-chemistry in the diagnosis of malignant small round cell tumours, Journal of Pathology of Nepal, 2011; Vol. 1, 87-91.
- Markku: Modern soft tissue pathology, Tumours and non-neoplastic conditions, Tokyo Cambridge university press, 2010.
- Hirose et al: Olfactory Neuroblastoma An Immunohistochemical, Ultrastructural, and Flow Cytometric Study, CANCER July 2,2995, Volume 76, No. 1,1-16
- Roy A, Kar R, Basu D, Badhe BA. Spectrum of histopathologic diagnosis of lymph node biopsies: A descriptive study from a tertiary care center in South India over 5½ years. Indian J Pathol Microbiol. 2013; 56: 103-8.
- Kalyan K, Basu D, Soundararaghavan J. Immunohistochemical typing of non- Hodgkin‘s lymphoma-comparing working formulation and WHO classification. Indian J Pathol Microbiol. 2006; 49(2): 203-7.
- George: Special stains and H & E, DAKO Corporation, March 2010, vol. 14.
- Bahrami et al: Undifferentiated tumour – true identity by immunohistochemistry, Arch Pathol Lab Med. March 2008; Vol 132,132:329
- Weiss & Goldblum: Enzinger and Weiss's Soft Tissue Tumours, 5th edition, China, Mosby Elsevier, 2008.
- Andreas F. Mavrogenis, Extraskeletal Myxoid Chondrosarcoma of the perineum, Orthopedics, March 2009- Volume 32: Issue 3.
- Natasha Rekhtman: Quick Reference Handbook for Surgical Pathologists, New York, Springer, 2011;
- Silverberg: principles and practice of surgical pathology and cytopathology, 4th Edition, Elsevier‘s publication, 2006, Vol 1.
Corresponding Author
Sujaya Manvi
Dermatologist, Civil Hospital Palampur, District Kangra, Himachal Pradesh
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.30
