Clinicoepidemiological profile of extranodal lymphoma: The experience of a tertiary care center in India

Introduction: Lymphoma is a neoplastic proliferation of lymphoid cells at various stages of differentiation and affects lymph nodes, with infiltration into the bone marrow, spleen, and thymus, which form the primary lymphatic organs. Extranodal lymphoma, by definition, involves sites other than lymph nodes, spleen, thymus, and the pharyngeal lymphatic ring. Extranodal involvement is less common with Hodgkin lymphoma (HL) than with non-Hodgkin lymphoma (NHL). Materials and Methods: A single-center retrospective observational study was conducted over the period of 2017–2019. Age, gender, histologic type, location, type of clinical presentation, histologic diagnosis, and presence of specific symptoms were recorded, as were the specialty of the physician initially consulted and of the physician taking the diagnostic sample. Results: Twenty-seven cases of extranodal lymphoma were diagnosed: 12 (44.4%) were male and 15 (56.6%) were female patients. The median age for males was 49.6 years and for females was 45.7 years. In this study, we had varied presentations of the lymphoma with involvement of various structures. We had few patients with very rare site of involvement like an elderly female patient presented with firm swelling over the right forearm which on excision turned out to myeloid sarcoma. Similarly, an elderly woman had presented with pyrexia of unknown origin that was later diagnosed as having primary bone Hodgkin lymphoma (HL) which is a very rare diagnosis and rarely has been described in world literature. The most common site of extranodal lymphoma was gastrointestinal tract (7 out of 27 patients; 25.9%); the other sites reported were testis (14.8%), breast (7.4%) thyroid, and ovary. Few rare sites reported were bone, central nervous system, and mediastinum. We report an extremely rare patient who had presented with anterior chest wall swelling, and on evaluation was detected to have primary mediastinal B cell lymphoma. Conclusion: Extranodal lymphoma is the rare presentation of NHL and extremely rare for HL. As it is a very rare disease, there are very limited studies available for its staging and management. We have presented a case series of extranodal lymphoma with few very rare presentations.