Nidhi Goel

Abstract

Introduction: Lymphoma constituting 55.6% of hematological malignancy, its prognosis depends on the correct diagnosis and stage of the disease, which is established after examination of peripheral blood film (PBF), bone marrow aspiration (BMA) and bone marrow biopsy (BMB) along with other parameters. Objective: The objective is to find out the percentage and pattern of bone marrow involvement, along with peripheral blood changes in lymphoma. Material and Methods: PBF, BMA and BMB findings studied in 60 lymphoma patients during a period of 3 years. The PBF and aspiration smears stained with Leishmann’s stain, while the trephine biopsy processed and stained with Haematoxylin and eosin (H & E) stain and Reticulin stain. The results were scrutinized, compared and evaluated. Results: The male to female ratio was 1.4:1, including 53(88.3%) cases of NHL and 7(11.7%) cases of HL. Most common age group involved in NHL was 51-60 years and in HL was 31-40 years. 19/60 (31.7%) cases showed leucocytic lymphocytosis on PBF examination. Percentage lymphocytes in marrow differential count was increased in 16(26.7%) cases and were reported with bone marrow involvement on BMA and BMB and 1 case having borderline percentage lymphocyte count on BMA was reported as bone marrow involved case, only after examining the BMB. The diffuse pattern of involvement was most common in 7(41.2%), followed by paratrabecular pattern in 6(35.3%) cases. Conclusion: Thus to conclude bone marrow examination give valuable information in lymphoma, about disease burden, percentage of involvement, pattern of involvement and baseline involvement prior to therapy. Keywords: Lymphoma, Bone marrow aspiration, Bone marrow biopsy, Bone marrow involvement.

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Abstract

Introduction: Granulomatous inflammation of skin and subcutaneous tissue are common in India. An identical histological picture is produced by several causes. Present study aims at classifying infectious granulomas based on histomorphology and special staining and developing a proper approach for making a specific etiological diagnosis. Aims: To classify the granulomatous dermatitis and a simple diagnostic histological approach has been worked out based on morphology of granuloma, presence of caseous necrosis, palisading necrosis, location of the granuloma and use of special stains. Materials and Methods: A prospective study of skin biopsies with granulomatous inflammation over a period of 2 years is done. Histologically lesions were divided into six subtypes:-Tuberculoid, foreign body type, histoid, necrobiotic, suppurative and sarcoidal type. On basis of morphological features and special staining each type was further subclassified and a specific diagnosis was given. Results: Among 580 skin biopsies, 175 cases (30.17%) were of granulomatous skin lesions. On histopathological typing Tuberculoid type of granuloma was the most common type (62/175 cases, 35.43%) of which leprosy (40/62 cases, 64.52%) was the commonest etiology identified. Infections form an important etiology of granulomatous skin inflammation (120/175 cases, 68.57%) of which leprosy (82/120 cases, 68.33%) is the leading etiology in our study. Conclusion: Adequate clinical work-up in combination with pathological resources help in correctly approaching a granulomatous skin lesion and reaching a specific etiologic diagnosis. Keywords: Granuloma, Skin lesion, Approach, Special stains.

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