Original Article
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Peripheral T-cell lymphoma: Frequency and distribution in a tertiary referral center in South India Deepak K. Burad, Manipadam M. Therese, Sheila Nair Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, India Address for correspondence: Dr. Deepak K. Burad, Department of General Pathology, 4th floor, ASHA block, Christian Medical College Hospital, Ida Scudder Road, Vellore, Tamil Nadu, India. E-mail:
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ABSTRACT
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Background and Aim: Peripheral T/NK-cell lymphomas are uncommon types of non-Hodgkin’s lymphoma (NHL) with a higher frequency in Far East countries as compared to the West. This study was undertaken to ascertain the frequency and distribution pattern of peripheral T-cell lymphomas (PTCLs) diagnosed in a tertiary care center in South India. Materials and Methods: This retrospective study was carried out in Department of General Pathology, Christian Medical College, Vellore. The time period was for 2 years from 1st January 2008 till 31st December 2009. All PTCLs were reviewed and classified according to the World Health Organization (WHO) 2008 classification. Results: Of a total of 1032 cases of NHL, 180 cases were PTCL, which accounted for 17.4% cases of all the NHLs. Of these, PTCL, not otherwise specified (PTCL, NOS) was the most common subtype (48 cases, 26.1%), followed by anaplastic large cell lymphoma (41 cases, 22.8%), mycosis fungoides (21 cases, 11.7%), angioimmunoblastic T-cell lymphoma (16 cases, 8.9%), subcutaneous panniculitis like T-cell lymphoma (15 cases, 8.4%), extranodal NK/T-cell lymphoma, nasal type (12 cases, 6.7%), and hepatosplenic T-cell lymphoma (10 cases, 5.6%). The most common primary site of presentation was nodal accounting for 42% followed by cutaneous (34%), upper aerodigestive sites (8.9%), spleen (6.7%), and gastrointestinal tract (GIT; 3.3%). Conclusions: This is the largest single study on PTCLs in India and we document that its frequency is higher than that reported in Western literature and previous Indian studies and almost similar to that reported in some Far East studies. The frequency of mycosis fungoides, subcutaneous panniculitis like T-cell lymphoma, and hepatosplenic T-cell lymphoma was higher than that reported in the World literature and previous Indian studies. The frequency of extranodal NK/T-cell lymphoma and angioimmunoblastic T-cell lymphoma was much lower than that reported in the Far East literature. KEY WORDS: Lymphomas, non-Hodgkin’s lymphoma, peripheral T-cell lymphomas
INTRODUCTION Peripheral T-cell lymphomas (PTCLs) are uncommon types of non-Hodgkin’s lymphomas (NHLs) and constitute 4–12% in Western studies[1-3] and 12–26% in Far East studies.[1,4-7] Earlier Indian studies have shown a frequency of 9–12% which is similar to that in the West.[8,9] These studies show that a considerable variation exists in the frequency and distribution of PTCLs across the world. The present study was undertaken to ascertain the frequency and distribution of PTCLs in southern India as there are no large studies documented in literature from this region. MATERIALS AND METHODS This retrospective study was carried out in Department of General Pathology, Indian Journal
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Pathology
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Christian Medical College, Vellore. The time period of the study was 2 years from 1st January 2008 till 31st December 2009. This study included biopsy material of patients registered within the hospital and referral biopsies from outside. All tissue samples were fixed in 10% buffered formalin. Then, 4 µm sections were cut and the slides were stained with Hematoxylin and Eosin (H and E). Immunohistochemistry (IHC) was done for all cases with appropriate positive control using the Envision technique developed with diaminobenzidine (DAB) subjected to pretreatment by heating in a Pascal pressure cooker in 0.01 M citrate buffer (pH 6)/1 mM ethylenediaminetetraacetic acid (EDTA) buffer (pH 8) or to the proteolytic enzyme trypsin, depending on the antibody used [Table 1]. Appropriate panel of antibodies was chosen after morphological evaluation of the cases. All the cases were classified according to the World Health Organization (WHO) 2008 classification.[10] Data entry and all statistical analyses were done using epiinfo software. Descriptive statistics such as frequency and percentage were used. Categorical variables were analyzed using χ2 test with Yates’s continuity correction
Microbiology - 55(4), October-December 2012
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and Fischer’s exact test. A P value of
