Distribution of lymphoid neoplasms in Northeast Turkey: A retrospective analysis of 1136 cases according to the World Health Organization classification

Abstract

Objective: Malignant lymphoma is one of the most common cancer type around the world. In this study, the distribution and demographic characteristics of the histologic subgroups of mature lymphoid neoplasms in Northeast Turkey were investigated.

Methods: The study consists of 1136 patients diagnosed as mature lymphoid neoplasm between 2008 and 2014. The demographic data of the patients were analysed and histological subgrouping was performed according to the World Health Organization classification.

Results: Mature B-cell neoplasms accounted for 79.2% (n=900) of all lymphoid neoplasms, Hodgkin lymphoma (HL) for 10.9% (n=124), mature T/natural killer-cell neoplasms for 9% (n=102), and histiocytic and dendritic cell neoplasms for 0.9% (n=10). In our study, the most common subtypes of lymphoid neoplasms were as follows: diffuse large B-cell lymphoma (n=261; 23%), plasma cell myeloma (n=252; 22.2%), chronic lymphocytic leukemia/small lymphocytic lymphoma (n=230; 20.2%), mycosis fungoides (MF) (n=66; 5.8%) and nodular sclerosing type classical HL (n=63; 5.5%). Only 2.9% of the cases of non-Hodgkin lymphoma (NHL) were follicular lymphoma. All patients with HL were diagnosed by a lymph node biopsy. However, 48.1% of the patients with NHL arose from extranodal sites.

Conclusion: This is the first study investigating the distribution of lymphoid neoplasms in Northeast Anatolia region with the review of the literature. The present study showed that the epidemiologic features similar to those reported in Western and Asian countries, whereas some subtypes showed distinct features. The high frequency of MF and the low frequency of follicular lymphoma are interesting findings of this study.

Keywords

• lymphoma
• lymphoid neoplasms
• WHO classification
• subtype
• distribution

Türkiye’nin Kuzeydoğusundaki Lenfoid Neoplazm Vakalarının Dağılımı:1136 Vakanın Dünya Sağlık Örgütü Sınıflamasına Göre Retrospektif İncelenmesi

Abstract

Amaç:Malign lenfoma dünyada en sık görülen kanser tiplerinden biridir. Bu çalışmada, Türkiye’ ninkuzeydoğusundaki matür lenfoid neoplazm vakalarının histolojik alt gruplarının dağılımları ve demografik özellikleri incelenmiştir.Gereç ve Yöntem: Bu çalışmada 2008 ve 2014 yılları arasında matür lenfoid neoplazm tanısı almış 1136 hasta yer almaktadır. Hastaların demografik verileri araştırılıp Dünya Sağlık Örgütü sınıflamasına göre histolojik alt grupları tespit edilmiştir.Bulgular: Tüm lenfoid neoplazilerin %79.2’ si (n=900) matür B hücreli neoplaziler, %10.9’ u (n=124) Hodgkin lenfoma (HL), %9’ u (n=102) matür T/natural killer hücreli neoplaziler, %0.9’ u (n=10) histiyositik ve dendritik hücreli neoplazilerden oluşmaktadır. Çalışmamızda lenfoid neoplazilerin en sık görülen alt tipleri şöyledir: diffüz büyük B hücreli lenfoma (n=261; %23), plazma hücreli miyelom (n=252; %22.2), kronik lenfositik lösemi/ küçük lenfositik lenfoma (n=230; %20.2), mikozis fungoides (MF) (n=66; %5.8) ve nodular sklerozan tip HL (n=63; %5.5). Non-Hodgkin lymphoma (NHL) tanılı vakaların yalnızca %2.9’ u folliküler lenfoma tanılıdır. HL hastalarının tümü lenf nodu biyopsisinden tanı almıştır. Bununla birlikte NHL vakalarının %48.1’ i ekstranodal bölge yerleşimlidir.Sonuç: Bu çalışma Kuzeydoğu Anadolu’ daki lenfoid neoplazilerin dağılımını literatürverileriyle karşılaştırarak inceleyen ilk çalışma niteliğindedir. Çalışmamızda batı ve Asya ülkeleri ile benzer epidemiyolojik veriler elde edilmesine rağmen bazı alt gruplarda farklılıklar dikkati çekmektedir. MF’ in sıklıkla görülmesi ve folliküler lenfomanın nadir izlenmesi bu çalışmanın çarpıcı bulgularıdır

Keywords

• Lenfoma
• Lenfoid neoplaziler
• WHO sınıflaması
• Alt tip
• Dağılım

References

1. Swerdlow SH, Campo E, Harris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2008.
2. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-90.
3. Yoon SO, Suh C, Lee DH, et al. Distribution of lymphoid neoplasms in the Republic of Korea: analysis of 5318 cases according to the World Health Organization classification. Am J Hematol 2010;85(10):760-4.
4. Jaffe ES. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2001.
5. Yang QP, Zhang WY, Yu JB, et al. Subtype distribution of lymphomas in Southwest China: analysis of 6,382 cases using WHO classification in a single institution. Diagn Pathol 2011;6:77.
6. Morton LM, Turner JJ, Cerhan JR, et al. Proposed classification of lymphoid neoplasms for epidemiologic research from the Pathology Working Group of the International Lymphoma Epidemiology Consortium (InterLymph). Blood 2007;110(2):695-708.
7. Szumera-Cieckiewicz A, Galazka K, Szpor J, et al. Distribution of lymphomas in Poland according to World Health Organization classification: analysis of 11718 cases from National Histopathological Lymphoma Register project - the Polish Lymphoma Research Group study. Int J Clin Exp Pathol 2014;7(6):3280-6.
8. Chen WL, Tsai WC, Chao TY, et al. The clinicopathological analysis of 303 cases with malignant lymphoma classified according to the World Health Organization classification system in a single institute of Taiwan. Ann Hematol 2010;89(6):553-62.

9. Lee MY, Tan TD, Feng AC, et al. Clinicopathological analysis of 598 malignant lymphomas in Taiwan: seven-year experience in a single institution. Am J Hematol 2006;81(8):568-75.
10. Sharma M, Mannan R, Madhukar M, et al. Immunohistochemical (IHC) Analysis of Non-Hodgkin's Lymphoma (NHL) Spectrum According to WHO/REAL Classification: A Single Centre Experience from Punjab, India. J Clin Diagn Res 2014;8(1):46-9.
11. Gross SA, Zhu X, Bao L, et al. A prospective study of 728 cases of non-Hodgkin lymphoma from a single laboratory in Shanghai, China. Int J Hematol 2008;88(2):165-73.
12. Mondal SK, Mandal PK, Roy SD, et al. Malignant lymphoma in Eastern India: a retrospective analysis of 455 cases according to World Health Organisation classification. J Cancer Res Ther 2014;10(2):354-8.
13. Sukpanichnant S. Analysis of 1983 cases of malignant lymphoma in Thailand according to the World Health Organization classification. Hum Pathol 2004;35(2):224-30.
14. Isikdogan A, Ayyildiz O, Buyukcelik A, et al. Non-Hodgkin's lymphoma in southeast Turkey: clinicopathologic features of 490 cases. Ann Hematol 2004;83(5):265-9.
15. Anderson JR, Armitage JO, Weisenburger DD. Epidemiology of the non-Hodgkin's lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin's Lymphoma Classification Project. Ann Oncol 1998;9(7):717-20.
16. Sant M, Allemani C, Tereanu C, et al. Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood 2010;116(19):3724-34.
17. Laurini JA, Perry AM, Boilesen E, et al. Classification of non-Hodgkin lymphoma in Central and South America: a review of 1028 cases. Blood 2012;120(24):4795-801.
18. Chiu BC, Dave BJ, Blair A, et al. Agricultural pesticide use and risk of t(14;18)-defined subtypes of non-Hodgkin lymphoma. Blood 2006;108(4):1363-9.
19. Schroeder JC, Olshan AF, Baric R, et al. Agricultural risk factors for t(14;18) subtypes of non-Hodgkin's lymphoma. Epidemiology 2001;12(6):701-9.
20. Mushtaq S, Akhtar N, Jamal S, et al. Malignant lymphomas in Pakistan according to the WHO classification of lymphoid neoplasms. Asian Pac J Cancer Prev 2008;9(2):229-32.
21. Yaqo RT, Hughson MD, Sulayvani FK, et al. Malignant lymphoma in northern Iraq: a retrospective analysis of 270 cases according to the World Health Organization classification. Indian J Cancer 2011;48(4):446-51.
22. Naresh KN, Srinivas V, Soman CS. Distribution of various subtypes of non-Hodgkin's lymphoma in India: a study of 2773 lymphomas using R.E.A.L. and WHO Classifications. Ann Oncol 2000;11 Suppl 1:63-7.
23. Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin 2010;60(5):277-300.
24. Chakrabarti S, Sarkar S, Goswami BK, et al. Hodgkin's and Non-Hodgkin's lymphomas in an indian rural medical institution: comparative clinicopathologic analysis. Asian Pac J Cancer Prev 2010;11(6):1605-8.
25. Aoki R, Karube K, Sugita Y, et al. Distribution of malignant lymphoma in Japan: analysis of 2260 cases, 2001-2006. Pathol Int 2008;58(3):174-82.
26. Au WY, Gascoyne RD, Klasa RD, et al. Incidence and spectrum of non-Hodgkin lymphoma in Chinese migrants to British Columbia. Br J Haematol 2005;128(6):792-6.
27. Zucca E, Cavalli F. Extranodal lymphomas. Ann Oncol 2000;11 Suppl 3:219-22.
28. Di Leonardo G, Ginaldi L, De Martinis M, et al. [Extranodal localizations of lymphoma. Clinico-epidemiologic study of 353 cases]. Recenti Prog Med 2000;91(10):500-6.
29. Grogan TM, Jaramillo MA, Miller TP. Natural history, diagnosis, and staging of the non-Hodgkin' s lymphomas. Haskell CM, editor. Philadelphia, WB Saunders, 2001.
30. Zucca E, Roggero E, Bertoni F, et al. Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol 1997;8(8):727-37.
31. Economopoulos T, Papageorgiou S, Dimopoulos MA, et al. Non-Hodgkin's lymphomas in Greece according to the WHO classification of lymphoid neoplasms. A retrospective analysis of 810 cases. Acta Haematol 2005;113(2):97-103.
32. Chuang SS, Lin CN, Li CY. Malignant lymphoma in southern Taiwan according to the revised European-American classification of lymphoid neoplasms. Cancer 2000;89(7):1586-92.
33. Ho FC, Todd D, Loke SL, et al. Clinico-pathological features of malignant lymphomas in 294 Hong Kong Chinese patients, retrospective study covering an eight-year period. Int J Cancer 1984;34(2):143-8.
34. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29(1):252-60.
35. Kadin ME, Berard CW, Nanba K, et al. Lymphoproliferative diseases in Japan and Western countries: Proceedings of the United States--Japan Seminar, September 6 and 7, 1982, in Seattle, Washington. Hum Pathol 1983;14(9):745-72.