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Non-hodgkin’s lymphoma: immunohistochemical analysis with clinicopathological correlation

Author: 
Dr. Vipul Gupta, Dr. Sunita Singh, Dr. Yashika Bhatia, Dr. Shruti Bansal, Dr. Sandeep Yadav, Dr. Rajeev Sen and Dr Anisha
Subject Area: 
Health Sciences
Abstract: 

Objective: Histomorphology and immunohistochemistry are essential tools for evaluation and classification of lymphoid malignancies. The present prospective study was conducted with the aim to categorize various Non-Hodgkin lymphoid malignancies in lymph node and extranodal biopsies using routine H and E staining and IHC markers based on WHO Classification system 2016 and to study their clinicopathological correlation. Material and methods: The present study was conducted in Department of Pathology at Pt. B D Sharma PGIMS, Rohtak. Hundred cases of Non Hodgkin’s lymphoid malignancy (lymph node and extranodal biopsies) were included in the study. Various histomorphological changes were examined on routine H&E. Cases with provisional diagnosis of lymphoma were further submitted to immunohistochemical staining for a panel of lymphoma markers and classified accordingly. Results: Maximum number of patients were in the age group of 61-70 years (26%). Males were more commonly affected (55%) with a male: female ratio of 1.2:1. Study included 57 cases with nodal and 43 cases with extranodal involvement. Among nodal, cervical (40.4%) was the most common site and among the extranodal, GIT was (27.9%) the most affected site. A significant association was found between presence of B symptoms with male gender and extranodal sites (p<0.05). B Cell type was the commonest type of Non Hodgkin’s lymphoid malignancy observed in the study (80%). The most consistent IHC marker for B cell lymphoma was PAX5 followed by CD20 and CD19 whereas CD5 was the most consistent IHC marker for T cell lymphoma followed by CD3. Conclusion: The distribution of NHL subtypes in India shows important differences with those from the rest of the world. PAX 5 can be used as a universal single pan B cell marker and CD5 as a pan T cell marker in resource poor setting.

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