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Adomako J, Abrahams AOD, Dei-Adomakoh YA. Immunophenotypic characterisation of non-Hodgkin lymphomas at a tertiary hospital in Ghana. Ecancermedicalscience 2022; 16:1458. [PMID: 36405938 PMCID: PMC9666277 DOI: 10.3332/ecancer.2022.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of clonal lymphoid tumours originating from lymphocytes. They constitute about 90% of an estimated 3%-4% worldwide distribution of malignant lymphomas among various cancers. Despite the continuous rise and associated deaths, research on NHLs, and in particular the area of immunophenotypic spectrum is limited in Ghana and sub-Saharan Africa. METHODS A retrospective, descriptive study in which archived tissue blocks of histologically diagnosed NHLs at a tertiary hospital in Accra, Ghana, were used. Antigenic phenotypes were determined by immunohistochemistry. RESULTS A total of 66 cases of NHLs, with a mean age of 50.2 ± 16.1 years, were selected for the study. Among the targeted markers, cluster of differentiation 20 (CD20) was the most commonly expressed in 89.4% (59) cases. Immunohistochemistry studies revealed a greater proportion of B cell lymphomas of 89.4%. Five subtypes were successfully identified, of which diffuse large B cell lymphoma constitutes the predominant group (40.9%). A significant association was observed between phenotypic cell types and outcomes of NHLs (p = 0.011). CONCLUSION Adult NHLs were mostly due to the malignant transformation of B cells with diffuse large B cell lymphoma being the commonest subtype. The present study therefore serves as preliminary data for further research towards the adoption of an improved treatment regimen and management of NHLs.
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Affiliation(s)
- Joseph Adomako
- G2 Medical Laboratory Services, 37, Accra, GA-007-6041, Ghana
| | - Afua O D Abrahams
- Department of Pathology, University of Ghana Medical School, University of Ghana, Accra, GA-221-9384, Ghana
| | - Yvonne A Dei-Adomakoh
- Department of Haematology, University of Ghana Medical School, University of Ghana, Accra, GA-221-9384, Ghana
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Polepole P, Mudenda VC, Munsaka SM, Zhang L. Spectrum of common Hodgkin lymphoma and non-Hodgkin lymphomas subtypes in Zambia: a 3-year records review. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:37. [PMID: 34425908 PMCID: PMC8383350 DOI: 10.1186/s41043-021-00261-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/04/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Lymphomas usually present with different occurrence patterns across different geographical locations, but their epidemiology in Zambia is yet to be extensively explored. OBJECTIVES To study the spectrum of lymphoma subtypes prevalent within the Zambian population. METHODS Histopathological records with suspected lymphoma at the University Teaching Hospital (UTH) in Lusaka from the year 2014 to 2016, diagnosed based on the 2008 World Health Organization (WHO) criteria were reviewed. The analysis was done in terms of type, sex, age, and site of biopsy; and Fisher's exact test was used for significance testing. RESULTS During the study period (2014-2016), there were more B cell neoplasms {222 (92.5%)} than T cell neoplasms {18 (7.5%)}. Non-Hodgkin's lymphoma (NHL) was seen in 191 (79.6%) whereas classic Hodgkin's lymphoma (CHL) was seen in 39 (16.3%). Burkitt's lymphoma (BL) and diffuse large B cell lymphoma (DLBCL) showed equal proportions {17.5% of all lymphoma cases (42/240) each}, as the most prevalent subtypes of NHL whereas marginal zone B cell lymphoma was the rarest subtype with 1.4% (4/240). For CHL, mixed cellularity and lymphocyte rich subtypes (4.6% of all lymphoma cases) were the most common subtypes. There was a statistically significant difference in the occurrences of lymphoma subtypes across different age categories (p = 0.002). CONCLUSION Zambia has a diverse lymphoma subtypes population, affecting a relatively young population. The data from this study will serve as a baseline for improved health care provision and more robust future studies.
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Affiliation(s)
- Pascal Polepole
- Department of Biomedical Sciences, University of Zambia School of Health Sciences, P.O. BOX 50110, Ridgeway, Lusaka, Zambia
| | - Victor C. Mudenda
- Department of Pathology and Microbiology, University Teaching Hospital, P.BAG RW1X, Lusaka, Zambia
| | - Sody M. Munsaka
- Department of Biomedical Sciences, University of Zambia School of Health Sciences, P.O. BOX 50110, Ridgeway, Lusaka, Zambia
| | - Luwen Zhang
- School of Biological Sciences, Nebraska Center for Virology, University of Nebraska, Lincoln, Nebraska 68588 USA
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Fitzpatrick MJ, Sayed S, Moloo Z, Kayembe MKA, Roberts DJ, Pham TA, Xi L, Raffeld M, Louissaint A, Sohani AR. Clinicopathologic Features of Peripheral T-Cell Lymphoma in Sub-Saharan Africa. Am J Clin Pathol 2021; 156:42-55. [PMID: 33527979 DOI: 10.1093/ajcp/aqaa201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Peripheral T-cell lymphomas (PTCLs) are heterogeneous, clinically aggressive, and rare. Subtype distribution varies by geographic location; however, data from sub-Saharan Africa (SSA) are lacking. We sought to elucidate clinicopathologic features of PTCL in SSA. METHODS We reviewed PTCL consultation cases from three SSA countries. PTCL subtype was determined per 2017 World Health Organization classification. Cases with sufficient material were evaluated by polymerase chain reaction for human T-cell leukemia virus type 1 (HTLV-1) and T-cell receptor γ (TCRG) rearrangement. RESULTS Among 32 cases, median age was 45 years and male-to-female ratio was 1.7. Thirty (94%) of 32 cases required additional workup for subclassification. PTCL, not otherwise specified (PTCL-NOS) was the most common subtype (13/32, 41%), followed by PTCL with T-follicular helper phenotype (6/32, 19%) and systemic anaplastic large cell lymphoma (6/32, 19%). Four (16%) of 25 cases were Epstein-Barr virus positive (EBV+) (2/2 extranodal natural killer/T-cell lymphoma, 1/13 PTCL-NOS, and 1/4 angioimmunoblastic T-cell lymphoma with EBV+ immunoblasts). Two (15%) of 13 patients with PTCL-NOS were human immunodeficiency virus positive. No cases with evaluable DNA (0/15) were HTLV-1 positive, and 9 of 10 showed clonal TCRG rearrangements. CONCLUSIONS In comparison to Western studies, PTCLs from SSA show similar subtype distribution and male predominance but a younger age at diagnosis. Appropriate diagnosis of PTCL requires extensive ancillary testing not readily available in low-income countries, including much of SSA.
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Affiliation(s)
- Megan J Fitzpatrick
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Shahin Sayed
- Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
| | - Zahir Moloo
- Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
| | | | - Drucilla J Roberts
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Thu-Anh Pham
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Liqiang Xi
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Raffeld
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Abner Louissaint
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Aliyah R Sohani
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Uzoma IC, Taiwo IA, Granai M, Di Stefano G, Sorrentino E, Mannucci S, Durosinmi MA, Lazzi S, Leoncini L, Akinloye O. Distinct pattern of lymphoid neoplasms characterizations according to the WHO classification (2016) and prevalence of associated Epstein-Barr virus infection in Nigeria population. Infect Agent Cancer 2021; 16:36. [PMID: 34030716 PMCID: PMC8142647 DOI: 10.1186/s13027-021-00378-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background The present study aimed to classify lymphoid neoplasms according to the latest World Health Organization (WHO) classification and outlining the distribution in Nigeria of different entities. Additionally, the study describes the prevalence of lymphoid neoplasms associated with Epstein-Barr virus (EBV) infection in the Nigerian population. Methods We collected 152 formalin-fixed paraffin-embedded (FFPE) tissues diagnosed as lymphoma from 2008 to 2018, coming from three different institutions located within three geopolitical zone in Nigeria. These institutions included the University College Hospital (UCH), Ibadan, Oyo State, the Enugu State University of Science and Technology Teaching Hospital (ESUTH), Enugu, Enugu State, and the Meena Histopathology and Cytology Laboratory (MHCL), Jos, Plateau State. Results From the total 152 cases retrieved, 50 were excluded due to insufficient tissue materials or inconclusive antigen reactivity. We confirmed 66 (64.7%) cases as lymphomas out of the remaining 102 FFPE with a male to female ratio of 2:1 and a mean age of 44.4 years. Ten entities were identified, and of these, chronic lymphocytic leukemia (CLL) was the most prevalent category (34.8%). For the diffuse large B-cell lymphomas not otherwise specified (DLBCL, NOS), the germinal centre B–cell type was the most common (71.4%). Ten lymphoma cases (15.2%) were positive for Epstein-Barr virus (EBV), most of which were Hodgkin lymphoma (HL). CLL was common in the Hausa ethnic group, HL in the Yoruba ethnic group, while the Igbo ethnic group had an equal distribution of CLL, HL, and DLBCL diagnosis. Conclusion Although the distribution of lymphomas in Nigeria shares some similarities with those of other countries, we described distinct features of some subtypes of lymphomas. Also, the study underscores the need for a more precise diagnosis and classification of lymphoid neoplasms in Nigeria using the latest WHO classification. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-021-00378-z.
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Affiliation(s)
- Ijeoma C Uzoma
- Molecular-Haematology Laboratory, Department of Medical Laboratory Science, College of Medicine, College of Medicine, University of Nigeria Nsukka, Enugu Campus, Enugu, Nigeria.,Genetics Laboratory, Department of Cell Biology and Genetics, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Idowu A Taiwo
- Genetics Laboratory, Department of Cell Biology and Genetics, Faculty of Science, University of Lagos, Lagos, Nigeria.,Centre for Genomics of Non-communicable Diseases and Personalized Healthcare (CGNPH), University of Lagos, Lagos, Nigeria
| | - Massimo Granai
- Institute of Pathology, University Hospital of Tübingen, Tübingen, Germany
| | - Gioia Di Stefano
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Ester Sorrentino
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Sussana Mannucci
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Muheez A Durosinmi
- Department of Haematology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - Stefano Lazzi
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Lorenzo Leoncini
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy.
| | - Oluyemi Akinloye
- Centre for Genomics of Non-communicable Diseases and Personalized Healthcare (CGNPH), University of Lagos, Lagos, Nigeria. .,Clinical Chemistry and Molecular Diagnostics Laboratory, Department of Medical Laboratory Sciences, Faculty of Basic Medical Centre, College of Medicine, University of Lagos, Lagos, Nigeria.
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