Malignant lymphoma pathological and biochemical study

number: 
549
English
department: 
Degree: 
Imprint: 
Medicine
Author: 
Suhb Salem Al-Mudallal
Supervisor: 
Dr. Raji H..Al-Hadithi
Dr. Marwan S. Al-Nimer
year: 
1994
Abstract:

A total of 42 patients with malignant lymphoma were included in this study . , 23 patients with NHL , and 19 patients with HD . Additionaly , 19 subjects were served as a control group . These patients were attending ithe Institute of Nuclear Medicine , Baghdad and the Teaching Hospital of Saddam College of Medicine . All patients were newly diagnosed , and hadn't received any therapy The following tests were performed : 1- Lymphocytes trace elements , Cu and Znj were estimated using flammable atomic absorption spectrophotometer. 2- Serum ADA was estimated usina a spectrophotometer. 3- Complete blood picture , for estimation of Hb , WBC and differential blood count. 4- Histopathological examination! of the tumors . The tumors were classified according to N.C.I., Working Formulation for the NHL cases, and Rye's classification for HD cases. High and intermediate grades of NHL were the most common types (43.5%) and (47.8%) respectively.The mixed cellularity type of HD, was the most common type (73.3%). Serum ADA was significantly high in NHL patients when compared to control group ,and this rise was well correlated with the grading of the tumor. Although the serum ADA was high in HD patients , but it didn't reach the level of significance , and didn't correlate with the histological types of HD. Therefore , we had concluded that serum ADA could be used as a diagnostic and prognostic marker in patients with NHL , and that the behaviour of HD differs from NHL regarding serum ADA . Moreover, it was found that there was no significant correlation between serum ADA and the number of circulating lymphocytes . Thus , serum ADA cannot be used to monitor the possible changes in the peripheral blood of the patients (i.e) leukaemic transformation . Lymphocytes Cu was significantly high in patients with HD and NHL , when compared to control group , and was well correlated with the grading of the tumors in NHL. Although the lymphocytes Zn in malignant lymphoma (HD and NHL) were low as compared 'with control values , but it was statistically insighificant . Moreover, they didn't correlate with the grades of NHL or the histological types of HD. However , the lymphocytes Cu / Zn ratio was significantly high , as compared to control group , in patients with malignant lymphoma (HD and NHL) . Whereas; , this rise in Cu / Zn ratio did not correlate with the grades of NHL or the histdilogical types of HD. Therefore, we may conclude that the estimation of lymphocytes Cu and Cu / Zn ratio rather than lymphocytes Zn , may be used as a diagnostic marker alongside other biological indices . Moreover, lymphocytes Cu may be used as a prognostic marker, to detect early relapse and to monitor the patients response to therapy . Whereas lymphocyte Zn and Cu / Zn ratio were found to be of no significance in monitoring the disease activity . There was a decline in the intracellular Cu and Zn with the increase in the number of separated lymphocytes , which may reflect changes in the lymphocyte functions , that may effect the immune system A total of 42 patients with malignant lymphoma were included in this study . , 23 patients with NHL , and 19 patients with HD . Additionaly , 19 subjects were served as a control group . These patients were attending ithe Institute of Nuclear Medicine , Baghdad and the Teaching Hospital of Saddam College of Medicine . All patients were newly diagnosed , and hadn't received any therapy The following tests were performed : 1- Lymphocytes trace elements , Cu and Znj were estimated using flammable atomic absorption spectrophotometer. 2- Serum ADA was estimated usina a spectrophotometer. 3- Complete blood picture , for estimation of Hb , WBC and differential blood count. 4- Histopathological examination! of the tumors . The tumors were classified according to N.C.I., Working Formulation for the NHL cases, and Rye's classification for HD cases. High and intermediate grades of NHL were the most common types (43.5%) and (47.8%) respectively.The mixed cellularity type of HD, was the most common type (73.3%). Serum ADA was significantly high in NHL patients when compared to control group ,and this rise was well correlated with the grading of the tumor. Although the serum ADA was high in HD patients , but it didn't reach the level of significance , and didn't correlate with the histological types of HD. Therefore , we had concluded that serum ADA could be used as a diagnostic and prognostic marker in patients with NHL , and that the behaviour of HD differs from NHL regarding serum ADA . Moreover, it was found that there was no significant correlation between serum ADA and the number of circulating lymphocytes . Thus , serum ADA cannot be used to monitor the possible changes in the peripheral blood of the patients (i.e) leukaemic transformation . Lymphocytes Cu was significantly high in patients with HD and NHL , when compared to control group , and was well correlated with the grading of the tumors in NHL. Although the lymphocytes Zn in malignant lymphoma (HD and NHL) were low as compared 'with control values , but it was statistically insighificant . Moreover, they didn't correlate with the grades of NHL or the histological types of HD. However , the lymphocytes Cu / Zn ratio was significantly high , as compared to control group , in patients with malignant lymphoma (HD and NHL) . Whereas; , this rise in Cu / Zn ratio did not correlate with the grades of NHL or the histdilogical types of HD. Therefore, we may conclude that the estimation of lymphocytes Cu and Cu / Zn ratio rather than lymphocytes Zn , may be used as a diagnostic marker alongside other biological indices . Moreover, lymphocytes Cu may be used as a prognostic marker, to detect early relapse and to monitor the patients response to therapy . Whereas lymphocyte Zn and Cu / Zn ratio were found to be of no significance in monitoring the disease activity . There was a decline in the intracellular Cu and Zn with the increase in the number of separated lymphocytes , which may reflect changes in the lymphocyte functions , that may effect the immune system