PRESENTATION, STAGING AND DIAGNOSIS OF LYMPHOMA: A CLINICAL PERSPECTIVE
AbstractBackground: Due to lack of awareness among health professionals, lymphoma is often misdiagnosed.This study was done to evaluate the clinical features and histopathologic subtypes of lymphoma.Methods: Sixty diagnosed cases of lymphoma were selected (aged 12–65 years) from medical units ofCivil Hospital Karachi, during 1993 to 1998. Clinical history, physical examination and basiclaboratory investigations including imaging procedures were done in all the patients. The diagnosis oflymphoma was based on histology, following the International Working Formulation classificationsystem. This included lymph node biopsy and in some cases, biopsy of the bone marrow. The AnnArbor Staging Classification was used to classify the extent of disease. Results: Out of 60 cases oflymphoma, 81.6% (49 cases) were diagnosed as non-Hodgkin’s lymphoma and 18.3% (11 cases) asHodgkin’s disease, with an overall male predominance. Both categories exhibited a bimodal agedistribution. Lymphadenopathy was the commonest presenting features in both the types oflymphomas; however, patients with Hodgkin’s disease had a prominence of ‘B’ symptoms, whereasabdominal signs and symptoms were more common in non-Hodgkin’s lymphoma. On histopathology,majority of non-Hodgkin’s lymphomas (91.8%) showed a diffuse pattern, while mixed cellularity wasthe commonest type seen in Hodgkin’s disease (81.8%). Conclusion: Non-Hodgkin’s lymphoma was 4times more common than Hodgkin’s disease. The vast clinical spectrum of lymphoma sometimesdelays its diagnosis, leading to its eventual presentation in late stages. A general awareness is hencerequired among the health professionals regarding its varied clinical presentations.Keywords: Non-Hodgkin’s lymphoma, Hodgkin’s disease, Lymphadenopathy, Hepatomegaly,Splenomegaly
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