Clinical Analysis Of 319 Cases Of Malignant Lymphoma

Objective:To investigate the clinical and pathological features of malignant lymphoma in our hospital,we analyzed the clinical data of malignant lymphomas in order to guide the early diagnosis and effective treatment.The patients were diagnosed and classified according to the 2001 World Health Organization(WHO) classification.Materials and methods:319 patients with ML initially treated from August 2000 to December 2007 in Shandong Provincial Hospital were enrolled and analyzed.All the cases were diagnosed by the pathological and immunohistochemical features, according to the 2001 World Health Organization(WHO)classification.The specimens were all identified by HE-staining and immunohistochemical staining. Serum LDH was tested by fully automatic biochemical detector,and serumβ2-MG was tested by radioimmunoassay.A retrospective study was carried out to analyze the clinical manifestations, pathological classification,clinical stage,bone marrow invasion and laboratory investigations.The clinical data were analyzed by SPSS 11.5.A P value less than 0.05 was considered statistically significant.Results:Of the 319 cases studied,males were in the majority.The average age of patients was 42.7 years old.Out of 319 ML cases,158 cases(49.5%)were classified as nodal lymphoma,and the most common nodal sites of which were in the cervical and supraclavicular parts;155 cases(48.6%)were classified as extranodal lymphoma, and the commonest extranodal sites of which were gastrointestinal tract,followed by Waldeyer-ring,nasal cavity,nasal sinuses,bone and soft tissue.The initial symptoms depended on the different involved sites.Among 319 cases,26 cases(8.2%)were confirmed to be Hodgkin lymphoma(HL),of which the commonest subtype was nodular sclerosis(65.4%),next with mixed cellularity(19.2%),while 293 cases (91.8%)belonged to non-Hodgkin lymphoma(NHL),of which B-cell lymphoma was 59.4%and T/NK-cell lymphoma 37.2%.Overall,6 subtypes including diffuse large B-cell lymphoma(DLBCL,34.5%),peripheral T-cell lymphoma(PTCL,13.3%), follicular lymphoma(FL,9.6%),extranodal marginal zone B-cell lymphoma of MALT type(MALT,8.5%),extranodal NK/T-cell lymphoma,nasal-type(NK/TCL, 7.2%)and T-lymphoblastic lymphoma(T-LBL,6.8%)were among the commonest subtypes.In children,the commonest subtypes were LBL,PTCL,FL and BL,while in the old were DLBCL,FL,MALT and PTCL.The incidence of bone marrow invasion was 12.7%.The rate of abnormal levels of serum lactic acid dehydrogenas(LDH)andβ2-microglobulin(β2-MG)were 40.1%and 83.7%,respectively.The levels of them in stagesⅢ-Ⅳwere higher than those in stagesⅠ-Ⅱ(P＜0.05).Conclusion:ML of our country differs from that of overseas countries in the clinical feature and pathology.The incidence of ML in male is higher than in female,and the incidence between nodal lymphoma and extranodal lymphoma is similar,with B-cell lymphoma in majority.The bone marrow invasion in children occurs early.The 2001 WHO classification of lymphoma is practical,and easily applicable in guiding the diagnosis and management of ML,combining with clinical features.