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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

Authors:

N. J. Asanthi ,

Teaching Hospital Anuradhapura, LK
About N. J.
Department of Histopathology
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M. V. C. de Silva,

University of Colombo, LK
About M. V. C.
Department of Pathology, Faculty of Medicine
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K. Dissanayake,

National Hospital of Sri Lanka, Colombo, LK
About K.
Department of Histopathology
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M. Jayawickrama,

National Hospital of Sri Lanka, Colombo, LK
About M.
Department of Histopathology
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S. R. Constantine,

National Hospital of Sri Lanka, Colombo, LK
About S. R.
Department of Histopathology
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R. Goonesinghe

Apeksha Hospital, Maharagama, LK
About R.
Department of Histopathology
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Abstract

Background: According to the National Cancer Registry of 2019, lymphoma was the eighth commonest malignancy in males and the tenth commonest malignancy in females in Sri Lanka. There is only one previously 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 pattern distribution of subtypes of lymphomas in a cohort of Sri Lankan patients according to the latest World Health Organization (WHO) classification 2016, and to identify the limitations encountered in the process of laboratory diagnosis. 

 

Method: This was a descriptive, cross-sectional study carried out in Departments of Histopathology of the 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 of patients 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 type of 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-grade lymphoma, (NOS), follicular lymphoma and classic Hodgkin lymphoma, were compromised due to limited availability of immunohistochemistry and molecular markers.  

 

Conclusions: Although there were no major discrepancies in the diagnosis, the lack of immunohistochemistry markers and molecular and genetic studies led to diagnostic difficulties in some cases, and possibly underdiagnosis of certain lymphoma subtypes. Therefore, to maintain diagnostic accuracy, immunohistochemistry markers and molecular markers should be more widely and readily available in the government sector reference laboratories.
How to Cite: Asanthi, N.J., de Silva, M.V.C., Dissanayake, K., Jayawickrama, M., Constantine, S.R. and Goonesinghe, R., 2021. 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. Journal of Diagnostic Pathology, 16(2), pp.1–10. DOI: http://doi.org/10.4038/jdp.v16i2.7795
Published on 31 Dec 2021.
Peer Reviewed

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