Immunophenotypic patterns of Lymphomas in a tertiary Hospital, Lagos, Nigeria
The Nigerian Postgraduate Medical Journal,
Aims and Objectives: This study aims to classify the various types of lymphomas seen in our center bymorphology and immunopenotyping using basic antibody panel. Materials and Methods: Using 3-5 member antibody panels in sequential batches as primary, secondaryand tertiary antibodies selected from the list of available antibodies), immunohistochemical staining weredone on 110 cases of formalin- fixed paraffin-embedded lymphoma tissue blocks from the archive. A priormicroscopic assessment of the hematoxylin-eosin-stained sections of each tissue block was done. All caseswere diagnosed and sub typed by their morphology and pattern of antigen immunoreactivity.Results; of the 110 cases of lymphoma, non Hodgkin lymphoma (NHL) constituted 84.5 % (93 of 110 cases),while Hodgkin lymphoma (HL) was 15.5 % (17 of 110 cases). The B cell NHL was 65.5 % (71 of 110 cases) andT cell NHL was only 20 % (22 of 110 cases).Of the B cell NHL, Diffuse large B cell lymphoma (DLBL) constituted 45.1 % (32 of 71 cases), while Smalllymphocytic lymphoma (SLL) and Follicular lymphoma (FL) were 21.1 % (15 of 71) and 10.0 % (7 of 71)respectively. Burkitt lymphoma (BL) was only 7.0 % (5 of 71); while 5 (7.0 %) and 3 (4.2 %) cases of Mantle celllymphoma (MCL) and Mantle zone lymphoma (MZL) were seen respectively. Only 3 (4.2 %) and 1 (1.4 %) casesof MALTOMA and precursor B cell lymphoma were seen respectively.T / NK –cell lymphomas constituted 31 % (22/110) of all the lymphomas and 20 % of NHL and 36.4% (8/22)were extranodal. Peripheral T cell lymphoma (PTCL) constituted 45.5 % (10 of 22) of the T cell lymphomas.Precursor T cell lymphoma (pre TCL) constituted 22.7% (5 of 22), while 18.2% (4 of 22) and 13.6% (3 of 22)were cases of mycosis fungoides (MF) and anaplastic large cell lymphoma (ALCL) respectivelyThe overall male: female ratio was 1.4:1 while the mean age for adult and childhood NHL were 46 and 9years respectively. All the cases of lymphomas in our study could be diagnosed and classified using CD 20or CD79a, CD5, CD 23, CYCLIN D1, CD 10, BCL6, and Ki - 67 for mature B cell lymphoma, includingDLBCL. CD 15, CD30, CD45, pancytokeratin, EMA, ALK 1 are useful for cases with large cell morphologywhile CD 3, CD7, CD4, CD8, PD1, CD25, CD10, and CD23 are required for mature T cell lymphomas. Aconsideration for Acute lymphoma / leukemia will require in addition to B and T cell markers (CD3,CD79a),CD 34 and Tdt and differentiating between reactive and malignant lymphoproliferative lesions requiresBCL 2, CD 43, CD56, and ALK -1.Conclusion: This study further underscored the importance of immunohistochemistry in diagnostic haemato-lymphoid oncology. Starting with the availability of at least 10 antibodies (CD20, CD 79a, CD5, CD10,BCL 6, Tdt / CD34, CD15, CD 30, ALK-1, CYCLID D1, Ki67, CD3, pancytokeratin) and good diagnosticskill, most of the tertiary hospitals in developing countries will be able to perform, to a large extent,meaningful diagnosis of most of the common lymphomas. The list can be expanded with time as demanded. More detailed studies will be necessary to find out the potential infective aetiological factors in thedevelopment of high grade B-cell lymphomas in the environment.
Lymphoma , Immunohistochemistry , Subtyping , Research Subject Categories::ODONTOLOGY
Akinde OR, Osunkalu VO, Anunobi CC, Oguntunde OA, Afolayan MO, Akanmu AS (2015). Immunophenotypic patterns of Lymphomas in a tertiary Hospital, Lagos, Nigeria. Nigerian Postgraduate Medical Journal, 22(1):61-69.