Identification of the spectrum of lymphomas, specific subtypes, and the limitations in the diagnosis; a descriptive study at two tertiary care centres in Sri Lanka

[摘要] Background: According to the National Cancer Registry of 2019, lymphoma was the eighth commonestmalignancy in males and the tenth commonest malignancy in females in Sri Lanka. There is only onepreviously published study on the distribution of lymphoma subtypes in the Sri Lankan population.Objectives: The objectives of this study were to describe the morphological spectrum and the patterndistribution of subtypes of lymphomas in a cohort of Sri Lankan patients according to the latest WorldHealth Organization (WHO) classification 2016, and to identify the limitations encountered in theprocess of laboratory diagnosis.Method: This was a descriptive, cross-sectional study carried out in Departments of Histopathology ofthe National Hospital of Sri Lanka, Faculty of Medicine, University of Colombo and Apeksha Hospital,Maharagama.Results: Four hundred and forty-four cases of lymphomas were analysed and studied. The majority ofpatients were in the seventh decade (21.8%,97) and the mean age at diagnosis was 49 (+/-19) years.There was a slight male preponderance (57.7%,256). Non-Hodgkin lymphomas comprised 76.6%(340), the commonest subtype being diffuse large B-cell lymphoma (39.1%,174). The commonest typeof Hodgkin lymphoma was the nodular sclerosis type (13.7%, 61). Complete subtyping of 45.4%(202/444) of lymphomas, including diffuse large B-cell lymphoma, mantle cell lymphoma, high-gradelymphoma, (NOS), follicular lymphoma and classic Hodgkin lymphoma, were compromised due tolimited availability of immunohistochemistry and molecular markers.Conclusions: Although there were no major discrepancies in the diagnosis, the lack ofimmunohistochemistry markers and molecular and genetic studies led to diagnostic difficulties insome cases, and possibly underdiagnosis of certain lymphoma subtypes. Therefore, to maintaindiagnostic accuracy, immunohistochemistry markers and molecular markers should be more widelyand readily available in the government sector reference laboratories.

[学科分类] 生理学与病理学

[关键词] lymphoma;morphological spectrum;cross-sectional study