Clinicopathologic profile of non-Hodgkin's lymphoma in a rural medical college.

A prospective study was done at North Bengal Medical College, Sushrutanagar, Darjeeling, West Bengal over a period of two years. All patients diagnosed as non-Hodgkin's lymphoma were analysed for clinical presentation, classified according to the Working Formulation and staged according to Ann Arbor staging system. A lower median age (39.94 years) of onset and higher male to female ratio (3.22:1) as compared to western countries were observed. We found neck swelling was the commonest presenting symptom (65.79%) and peripheral lymphadenopathy was the commonest sign (94.74%). "B symptoms" were noted in 63.16% cases. Cervical lymph nodes were commonly involved (78.95%), followed by axillary (55.26%). Thoracic lymph nodes were enlarged in 31.58% cases and abdominal lymph nodes in 18.42% cases. We found diffuse mixed variant was the commonest (31.58%) followed by diffuse large cell (18.42%). At presentation most of the cases were of intermediate grade (55.26%) and in stage III (44.74%). We conclude that there is a distinct geographical pattern of non-Hodgkin's lymphoma in respect of age, sex, grade and stage of the disease which is distinctly different from those of western countries.

Hodgkin's and Non-Hodgkin's lymphomas in an indian rural medical institution: comparative clinicopathologic analysis.

In this prospective, hospital-based two year study, we comparatively evaluated clinicopathologic features of Hodgkin's lymphoma (HL, n = 48) and Non-Hodgkin's lymphoma (NHL, n = 76) in an Indian rural medical institution. A lower median age of onset (28.1 versus 39.9 years) and and higher male to female ratio (3.8:1 versus 3.2:1) were noted for HL compared to NHL. The commonest symptom was neck swelling (58.3% versus 65.8%) while peripheral lymphadenopathy was the commonest sign (83.3% versus 94.7%). The commonest lymph-node group involved was cervical (79.2% versus 79.0%). Bone marrow involvement was lower in HL (8.33% versus 18.4%). The commonest histological subtype was mixed cellularity (45.8%) in HL and diffuse mixed variant (31.6%) in NHL. Most cases presented at advanced stage (54.2% in HL, 71.1 % in NHL). Hence a distinct clinicopathologic profile was noted in HL and NHL that are comparable to other Indian studies but different from Western studies. Recognition of such characteristic features should assist in providing appropriate diagnosis and suitable management in rural communities having limited access to sophisticated medical services.

Carcinoma in situ of true vocal cord in a nonsmoker adolescent female.

Carcinoma in situ (precancerous lesion) of true vocal cord in a nonsmoker adolescent female without any history of prior neck irradiation is rare. A 16-year-old female patient without any of the known risk factors presented with history of gradual-onset hoarseness of voice unrelieved by symptomatic treatments for 1 year. Contrast-enhanced CT scan of neck and laryngoscopy and histopathology of the tissue from irregular lesions along the medial margin of the left vocal cord diagnosed it as a case of carcinoma in situ of vocal cord. Absence of known risk factors and very young age of the patient made this case a rarity and hence the case is being reported.

Clinico-pathologic profile of Hodgkin's lymphoma in a rural medical college.

PURPOSE OF STUDY: A prospective study was done at North Bengal Medical College and Hospital (NBMCH), Darjeeling, West Bengal, which caters predominantly to the rural and hilly population. All patients diagnosed as Hodgkin's lymphoma (HL) were analyzed for clinical presentation, histological classified and staging. RESULTS: Total of 48 cases reported for HL were studied (n=48). A lower median age of onset (28.1year) and higher male to female ratio (3.8:1) as compared to western countries were observed. We found neck swelling was the commonest presenting symptom (58.28%) and peripheral lymphadenopathy was the commonest sign (83.33%). "B symptoms" was noted in 79.17% cases. Cervical lymph nodes were commonly involved (79.17%), followed by inguinal (45.83%) and axillary (29.17%). Thoracic lymph nodes and abdominal lymph nodes were enlarged in 29.17% of the cases and 25% of the cases respectively. Eosinophilia was noted in 29.17% of cases. Marrow involvement by neoplastic process was observed in 8.33% of cases and reactive changes in the marrow were observed in 12.5% of cases. We found mixed cellularity subtypes was the commonest (45.83%) followed by nodular sclerosis subtypes (33.33%). At presentation 54.17% of cases were of advanced stage of disease (stage III and IV). CONCLUSION: We noticed a distinct geographical pattern of HL in respect of age, sex, presentation, histological typing and staging of the disease, which is comparable to some other Indian studies but is noticeably different from patterns noted in Western countries.