22Mar 2019

RETROSPECTIVE ANALYSIS OF PRIMARY EXTRANODAL NON HODGKINS LYMPHOMA- 3 YEARS STUDY AT A TERTIARY CARE INSTITUTE.

  • Senior resident, Deptt. of Pathology, S.G.P.G.I.M.S, Lucknow.
  • Associate professor, Deptt. of Pathology, S.G.P.G.I.M.S, Lucknow.
  • Junior resident, Deptt. of Pathology, S.G.P.G.I.M.S, Lucknow.
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Backgound: A variable number of non-Hodgkin lymphomas (NHLs) arise primarily from sites other than lymph nodes or the bone marrow and even from sites which normally contain no native lymphoid tissue. Indeed, extranodal lymphomas can arise in almost every organ. The incidence of primary extranodal lymphomas is increasing substantially all over the world. Methods: The study was carried out in the Department of Pathology, S.G.P.G.I.M.S, Lucknow. A total of 231 cases of non hodgkins lymphoma were registered over a period of 3 years. The demographic and clinical features, laboratory parameters, imaging findings, histopathology, and immunophenotyping were documented. The lymphomas were grouped as extranodal and nodal. The data were tabulated in a Microsoft Excel sheet, and descriptive analysis was done. Results: Primary extranodal NHLs constituted 43% (100/231) of all NHLs. The B symptoms were less common in pENL compared to nodal NHL. Gastrointestinal tract (GIT) constituted the most common extranodal site (40/100, 40%), and diffuse large B-cell lymphoma (DLBCL) was the most common histological subtype. Majority (99/100, 99%) of the patients with pENL were immunocompetent. Conclusions: Primary extranodal NHL constituted nearly half of patients diagnosed to have NHL at our center with the GIT being the most common site of presentation and DLBCL being the most common histology. A strong suspicion of NHL at an extranodal site with appropriate pathological and immunophenotyping evidence is needed to establish the diagnosis of a pENL.


  1. James O Armitage, Randy D Gascoyne, Matthew A Lunning, Franco Cavalli. Non-Hodgkin lymphoma. Lancet 2017; 390: 298?310.
  2. Zucca E, Roggero E, Bertoni F, et al. Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol 1997;8:727-37.
  3. Zucca E, Roggero E, Bertoni F, et al. Primary extranodal non-Hodgkin's lymphomas. Part 2: Head and neck, central nervous system and other less common sites. Ann Oncol 1999;10:1023-33.
  4. Dawson IM, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis. Br J Surg 1961;49:80-9.
  5. d?Amore F, Christensen BE, Brincker H, et al. Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Danish LYFO Study Group. Eur J Cancer 1991;27:1201-8.
  6. Groves FD, Linet MS, Travis LB et al. Cancer surveillance series: non-Hodgkin?s lymphoma incidence by histologic subtype in the United States from 1978 through 1995. J Natl Cancer Inst 2000; 92: 1240?1251.
  7. Dawson IM, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis. Br J Surg 1961;49:80-9.
  8. Krol AD, le Cessie S, Snijder S, Kluin-Nelemans JC, Kluin PM, Noordijk EM. Primary extranodal non-Hodgkin?s lymphoma (NHL): The impact of alternative definitions tested in the Comprehensive Cancer Centre West population-based NHL registry. Ann Oncol 2003;14:131-9.
  9. Pai A, Kannan T, Balambika R G, Vasini V. A study of clinical profile of primary extranodal lymphomas in a tertiary care institute in South India. Indian J Med PaediatrOncol 2017;38:251-5.
  10. Mishra P, Das S, Kar R, Jacob SE, Basu D. Primary extranodal non-Hodgkin lymphoma: A 3-year record-based descriptive study from a tertiary care center in Southern India. Indian J PatholMicrobiol 2015;58:296-300.
  11. Sandhu DS, Sharma A, Kumar L. Non-Hodgkin's lymphoma in Northern India: An analysis of clinical features of 241 cases. Indian J Med PaediatrOncol 2018;39:42-5.
  12. Singh D, Kumar L, Goyal H, Raina V, Bijlani L, Wadhwa J. Primary extranodal non-Hodgkin's lymphoma in northern India. Proc Am SocClinOncol 2003;22:2457.
  13. 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 Pac J Cancer Prev 2012;13:4889-95.
  14. Jayanti Mehta, Monil P Thakrar ,MatadeenMeena , Alka Mittal , Karuna Gupta. Primary Extranodal Non-Hodgkin Lymphoma: A 2-Year Retrospective Analysis from a Tertiary Care Centre in Rajasthan. Int J Med Res Prof.2016; 2(4); 76-80.
  15. Biagi JJ, Seymour JF. Insights into the molecular pathogenesis of follicular lymphoma arising from analysis of geographic variation. Blood 2002;99:4265-75.
  16. Kakoti, Dr. Sharma Jagannath, KalitaManoj, Dr. SarmaAnupam, Dr. Ahmed Shiraj, Dr. Das Sawmik et al. Extranodal lymphoma: An Experience from a tertiary care centre in North-east India. Asia Pacific Journal of Research 2018; 2(87):6-9.
  17. Nagi AH, Al Minawy L, Naseem N, Henna SN, Naveed IA. A study of the morphological patterns of extranodal non-Hodgkin lymphoma in Pakistani and Saudi populations. Biomedica 2010;26:118-23.
  18. Yang QP, Zhang WY, Yu JB, Zhao S, Xu H, Wang WY,?et al.Subtype distribution of lymphomas in Southwest China: Analysis of 6,382 cases using WHO classification in a single institution. DiagnPathol 2011;6:77.
  19. Arora N, Manipadam MT, Pulimood A, Ramakrishna BS, Chacko A, Kurian SS,?et al.Gastrointestinal lymphomas: Pattern of distribution and histological subtypes: 10 years experience in a tertiary centre in South India. Indian J PatholMicrobiol 2011;54:712-9.
  20. Raina V, Sharma A, Vora A, Shukla NK, Deo SV, Dawar R. Primary gastrointestinal non Hodgkin's lymphoma chemotherapy alone an effective treatment modality: Experience from a single centre in India. Indian J Cancer 2006;43:30-5.
  21. Chandran RR, Raj EH, Chaturvedi HK. Primary gastrointestinal lymphoma: 30-year experience at the Cancer Institute, Madras, India. J SurgOncol 1995;60:41-9.
  22. Cavalli F. Extranodal lymphomas. In: Magrath IT, editor. The non-Hodgkin′s Lymphomas. 2?nd London: Arnold; 1997. p. 1007-27.

[Soma yadav, Ritu verma, Valli priya and Ranjana S. ranade. (2019); RETROSPECTIVE ANALYSIS OF PRIMARY EXTRANODAL NON HODGKINS LYMPHOMA- 3 YEARS STUDY AT A TERTIARY CARE INSTITUTE. Int. J. of Adv. Res. 7 (Mar). 948-956] (ISSN 2320-5407). www.journalijar.com


Soma Yadav


DOI:


Article DOI: 10.21474/IJAR01/8721      
DOI URL: https://dx.doi.org/10.21474/IJAR01/8721