Role of Immunohistochemistry in Differential Diagnosis of Lymphoma (A Study of 200 Cases)
Keywords:Lymphoid malignancies, hodgkin disease, non- hodgkin lymphoma, immunohistochemistry
Introduction: The Lymphomas are a heterogeneous group of lympho-proliferative malignancies, with distinct causes and showing distinctive patterns of behaviour and responses to treatment. World Health Organization broadly classifies lymphomas into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Non-Hodgkin lymphoma is further subclassified based on the stage of maturation and cell of origin [B cell, T cell, or natural killer cell (NK) cell]. The panel of markers is decided based on morphologic differential diagnosis (no single marker is specific) which includes leukocyte common antigen (LCA), B-cell markers (CD20 and CD79a), T-cell markers (CD3 and CD5) and other markers like CD23, bcl-2, CD10, cyclinD1, CD15, CD30, ALK-1, CD138 (based on cyto-architectural pattern).
Aims & Objectives
• To Study Distribution and Frequency of lymphoma by Age and Gender.
• To Study Incidence and Histopathological Grading of HL and NHL in population.
• To Correlate the Histopathological Diagnosis and Immunohistochemistry Diagnosis.
• To Study the Role & Significance of Immunohistochemistry in confirmation of diagnosis and accurate typing of Lymphoma.
Material and Method:
This study was conducted at a tertiary centre in B.J.medical collage, civil hospital & GCRI ,
ahemdabad, asarwa and included a total of 200 cases of lymphoid malignancies . As a part of this study, 200 surgical specimens were received from January 2016 to september 2017. As a part of this study, 200 surgical specimens were received from January 2016 to september 2017. Specimens were studied with keeping the following features in mind: Age, Sex and site of tumours. All age and sex groups were included in this study. Histopathological diagnosis was made on all the sections studied. Immunohistochemistry was done for all these cases and final diagnosis was made.
Result: Amongst the 200 patients enrolled 127 (63.5%) were males and 73 (36.5%) were females. The male to female ratio was 1.73:1. Maximum patients were belonged to the age group of 51-60 years. Non Hodgkins Lymphoma :157(78.5%) is much more common than Hodgkins Lymphoma :43(21.5%). Among NHL Group Diffuse Large B cell Lymphoma is the Predominant type followed by, follicular Lymphoma, Precursor Lymphoblastic Lymphoma. IHC in HL shows CD30 positivity is more as compared to CD15 positivity.
Conclusion: Immunohistochemistry is required for confirmation, Typing, prognosis and Treatment. Single IHC mrker is not sufficient for confirmation of diagnosis. Further, the immunophenotyping of lymphoid tumors is now considered to be vital for better management, prognosis and for routine pathological evaluation of lymphoproliferative disorders.