MALIGNANT-LYMPHOMA IN THAILAND - CHANGES IN THE FREQUENCY OF MALIGNANT-LYMPHOMA DETERMINED FROM A HISTOPATHOLOGIC AND IMMUNOPHENOTYPIC ANALYSIS OF 425 CASES AT SIRIRAJ-HOSPITAL
S. Sukpanichnant et al., MALIGNANT-LYMPHOMA IN THAILAND - CHANGES IN THE FREQUENCY OF MALIGNANT-LYMPHOMA DETERMINED FROM A HISTOPATHOLOGIC AND IMMUNOPHENOTYPIC ANALYSIS OF 425 CASES AT SIRIRAJ-HOSPITAL, Cancer, 83(6), 1998, pp. 1197-1204
BACKGROUND. Analysis of malignant lymphoma in a single institution at
different periods of time can determine the changing status of the dis
ease in the region. METHODS. To compare with the large series of 1095
lymphoma cases reported between 1957-1971 at Siriraj Hospital, the lar
gest hospital in Thailand, a similar study was performed through histo
pathologic evaluation of 425 lymphoma cases diagnosed consecutively at
the same institution between August 1993 and October 1995. Phenotypic
analysis was performed by paraffin section-immunoperoxidase studies.
RESULTS. A striking increase in lymphoma cases was noted from 73 cases
/year in the first series to 189 cases/year in the second series (an i
ncrease of 158.9%). Lymphoma occurred in all age groups, with a peak i
ncidence at the seventh decade of life. The male to female ratio decre
ased from 2:1 in 1957-1971 to 1.3:1 in the more recent series. The inc
idence of Hodgkin's disease (HD) was found to have decreased from 28.9
% to 8.5%. There were 36 cases (8.5%) of HD and 389 cases (91.5%) of n
on-Hodgkin's lymphoma (NHL) reported in the second series. The subtype
s of HD included 16 cases of mixed cellularity, 13 cases of nodular sc
lerosis, 6 cases of lymphocyte depletion, and 1 case of lymphocyte pre
dominance. According to the Working Formulation, the 389 NHL cases inc
luded low grade (14.1%), intermediate grade (57.3%), high grade (11.3%
), and miscellaneous groups (17.2%). They were classified as small lym
phocytic (9.5%), follicular (11.1%), diffuse (50.9%), immunoblastic (4
.1%), small noncleaved (4.4%), lymphoblastic (2.8%), anaplastic large
cell (9.0%), mycosis fungoides (1.8%), hairy cell leukemia (0.3%), tru
e histiocytic (0.5%), and extramedullary plasmacytoma (1.0%). The immu
nophenotypes of the 359 NHL cases available for paraffin section-immun
operoxidase studies were B-cell (71.0%), T-cell (24.5%), histiocyte (0
.6%), and undetermined phenotypes (3.9%). CONCLUSIONS. The incidence o
f malignant lymphoma is increasing in Thailand, with a high frequency
of intermediate to high grade NHL of B-cell phenotype reported. (C) 19
98 American Cancer Society.