Title: Non-Hodgkin’s Lymphoma: A Clinical autopsy case report with review of literature

Authors: Dr M A Sameer, Dr Rohit Mangal

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.78

Abstract

We report a clinical autopsy case in a 32 year-old female who was admitted to our hospital in pulmonary medicine with chief complaints of breathlessness dyspnea, fever since 1 month and clinically diagnosed as pulmonary tuberculosis (PTB) defaulter. Ultrasonography (USG) revealed mild hepatomegaly with fatty changes.Patient died on third day of treatment, so her autopsy was performed. The findings of autopsy examination was pale and congested lungs at places, kidney, small and large intestine, liver, uterus bilateral adnexa, shows multiple white nodule of size 0.5X0.5cm.The wall of large intestine was thickened and multiple patches of 5cm were noted. Also we found congested spleen and mild spleenomegaly. Brain and heart was unremarkable. Histopathology examination showed non Hodgkin’s lymphoma with bilateral infiltration of tumor in lung, liver, kidneys, intestine, ovaries and fallopian tubes. Most commonly primary may be the large intestine.There was no effect on any foci of PTB on p.m. examination or in histopathology.

Keywords: Autopsy, Pulmonary tuberculosis (PTB), Ultrasonography (USG), Histopathology, Immunohistochemistry (IHC), Non Hodgkin’s Lymphoma.

References

  1. Roosen J, Frans E, Wilmer A, Knockaert DC, Bobbaers H. Comparison of premo-rtem clinical diagnoses in critically ill patients and subsequent autopsy findings. Mayo Clin Proc. 2000; 75:562-567.
  2. Kleiner DE, Emmert-Buck MR, Liotta LA. Necropsy as a research method in the age of molecular pathology. Lancet. 1995; 346:945-948.
  3. Rosenbaum GE, Burns J, Johnson J, et al. Autopsy consent practice at US teaching hospitals: results of a national survey. Arch Intern Med. 2000; 160:374-380.
  4. Hyman CB, Bogle JM, Brubaker CA, Williams K, Hammond D. Central nervous system involvement by leukemia in children. I. Relationship to systemic leuke-mia and description of clinical and labora-tory manifestations. Blood 1965; 25:1‑
  5. Non-Hodgkin’s Lymphoma A histopathologic and prognostic evaluation. http:// www.biooncology.com/researcheducation/bcell/downloads/GA10000083900_ NHL_Primer.pdf
  6. Boffetta P. Epidemiology of adult non-Hodgkin lymphoma. Ann Oncol. 2011; 22(4):27-31.
  7. Yeole BB. Trends in the incidence of Non-Hodgkin’s lymphoma in India. Asian Pac J Cancer Prev. 2008; 9(3): 433-436.
  8. Gokalp Oner, TuncayOzgun, Bulent Ozcelik, SerdarSerin, FigenOzturk. Primary Ovarian Burkitt’s lymphoma mimicking an Advanced Ovarian Tumour: A case report. Erciyes Tip Dergisi online 2010; 32:283-286.
  9. Bellido MC, Martino R, Martinez C, Sureda A, Brunet S. Extrapulmonary tuberculosis and non-Hodgkin’s lymph-oma: coexistence in an abdominal lymph node. Haematologica 1995; 80(5):482-483.
  10. Kaplan MH, Armstrong D, Rosen P. Tuberculosis complicating neoplastic disease. A review of 201 cases. Cancer 1974; 33(3):850-858.
  11. Costa LJ, Gallafrio CT, Franca FO, Del Giglio A. Simultaneous occurrence of Hodgkin disease and tuberculosis: report of three cases. South Med J 2004; 97(7):696-698.
  12. Tavani A, La Vecchia C, Franceschi S, Serraino D, Carbone A. Medical history and risk of Hodgkin’s and non-Hodgkin’s lymphomas. Eur J Cancer Prev 2000; 9(1):59-64.
  13. Askling J, Ekbom A. Risk of non-Hodgkin’s lymphoma following tuberc-ulosis. Br. J. Cancer 2001; 84(1):113-115.
  14. Ruiz-Arguelles GJ, Mercado-Diaz MA, De Ponce-Leon S, et al. Studies on lympho-mata III: lymphomata, granulomata and tuberculosis. Cancer 1983;52:258–262.
  15. Rao SI. Role of immunohistochemistry in lymphoma.Indian J Med Paediatr Oncol.2010;31(4):145–147.
  16. Higgins RA, Blankenship JE, Kinney MC. Application of immunohistochemistry in the diagnosis of non-Hodgkin and Hodgkin lymphoma.Arch Pathol Lab Med.2008; 132(3):441–461. 

Corresponding Author

Dr Rohit Mangal

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.