CLINICAL SPECTRUM AND SUBTYPE DISTRIBUTION OF NON-HODGKIN'S LYMPHOMA BASED ON THE WORLD HEALTH ORGANIZATION CLASSIFICATION OF TUMORS OF LYMPHOID TISSUES (2017): AN ANALYSIS FROM A TERTIARY CARE CENTER IN WESTERN INDIA

Objective: The subtype distribution and clinical profile of Non-Hodgkin's Lymphoma (NHL) show a wide variation in the different geographical locations. There is paucity of data regarding this from Western India. This study was aimed to evaluate the clinical spectrum and distribution of NHL subtypes at a tertiary care hos-pital of Western India.Patients and Methods: This prospective observational study was conducted over a period of 2 years among 178 NHL patients of all ages. Clinical evaluation and investigations including histopathological ex-amination and immunohisto-chemistry of involved tissue, bone marrow examination, and other relevant tests were performed. Cases were categorized according to World Health Organization classification of tumours of lymphoid tissues (2017). Results: There was a male preponderance (66.3%), and the commonest age group affected was 41-50 years (24.1%). The predominant symptom was neck swelling (51.1%), and the commonest sign was lymphad-enopathy (70.2%), cervical lymph nodes being the most commonly involved (51.1%). Extra -nod-al in-volvement was seen in 37.6% patients, the head-and-neck being the most commonly involved site (16.3%). Majority of the NHLs were B-cell lymphomas (75.3%). Diffuse large B-cell lymphoma was the commonest subtype (36.5%) followed by peripheral T-cell lymphoma, not otherwise specified (10.7%). Pediatric NHL comprised of 11.2% of NHL, T-cell lymphoblastic lymphoma (T-LBL) being the com-monest subtype (25%).Conclusions: Our analysis confirmed findings of various previous studies from India with few key differences. Mantle cell lymphoma had marginally higher frequency than follicular lymphoma, and was the second common-est B-cell NHL. Burkitt's lymphoma had lower frequency than T-LBL in children, and was the second commonest childhood NHL.