Document Type

Article

Department

Pathology and Microbiology

Abstract

Objective: To observe the spectrum of non-Hodkin’s lymphomas involving the central nervous system including morphological subtypes and immunophenotypic status.

Setting: Retrospective analysis of eleven years (1986 to 1996) data from surgical pathology files of Department of Pathology.

Results: orty-three cases of non-Hodgkin’s lymphomas were diagnosed during the period of eleven years (from 1986 to 1996), all of which were diffuse types. A total of 1177 Central Nervous CNS biopsies were examined, out of which 937 cases were diagnosed as CNS neoplasms, the remaining were non-neoplastic in nature. Among 937 CNS neoplasms, 43 cases (4.6%) were reported as non-Hodgkin’s lymphomas. As most of the cases were outside referrals, the primary or secondary nature of the lymphomatous process could not he assessed. Seventeen cases were intracranial, while 26 cases were spinal in location. Majority of the intracranial Eymphomas were hiopsied from the cereherum (12 cases). Male to female ratio was 1:2. The median age for intracranial lvmphomas was 50 years and for spinal lymphomas 29 years. There were 16 cases (37%) of diffuse large cell lymphomas; 7 cases (16%) of diffuse mixed small and large cell lymphomas; 3 cases (7%) of diffuse large cell immunoblastic lvmphomas; 2 cases (4.6%) of lymphoblastic lymphomas and diffuse small non-cleaved cell lymphomas and one case of small Iyrnphocytic lymphoma and diffuse small cleaved cell Ivmphoma. One case of T cell rich B cell lvmphoma was also diagnosed in the thoracic spine as primary extranodal lymphoma. Eight cases were unclassifiable and in 2 cases the features were suggestive of lymphoma. Immunophenotypic analysis was performed in 20 cases, however, in 2 cases the results were inconclusive. Fifteen cases (83%) showed immunoreactivity for B cell markers and 3 cases showed T cell phenotype out of which one case was lymphoblastic lymphoma.

Conclusion: CNS lymphomas were uncommon tumors and comprised 4.6% of the total CNS neoplasms in our study. Moreover, these CNS lymphomas accounted for 2.2% of the total non-Hodgkin’s lvmphomas, including both nodal and extranodal. There was a higher incidence of location of these lymphomas within the spinal cord than brain. Most of the lymphomas were of intermediate or high grade (75%) according to the working phenotype in 84% 3f the lymphomas, in which it was formulation. lmmunophenotypical status revealed B-cell tested

Publication

Journal of Pakistan Medical Association

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