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Reliable cell and tissue morphology-based diagnosis of endemic Burkitt lymphoma in resource-constrained settings in Ghana
- Source :
- BMC Cancer, Vol 19, Iss 1, Pp 1-7 (2019), BMC Cancer, Smith-Togobo, C, Pedersen, M Ø, Jensen, S G, Duduyemi, B, Gyasi, R K, Ofori, M F, Paintsil, V, Renner, L, Nørgaard, P & Hviid, L 2019, ' Reliable cell and tissue morphology-based diagnosis of endemic Burkitt lymphoma in resource-constrained settings in Ghana ', BMC Cancer, vol. 19, 1270 . https://doi.org/10.1186/s12885-019-6488-1
- Publication Year :
- 2019
- Publisher :
- BMC, 2019.
-
Abstract
- Background Endemic Burkitt lymphoma (eBL) is an aggressive B-cell lymphoma, which is a common childhood cancer in areas with intense transmission of Plasmodium falciparum parasites. Early and accurate diagnosis is a prerequisite for successful therapy, but it optimally involves advanced laboratory investigations. These are technologically demanding, expensive, and often difficult to implement in settings where eBL is prevalent. Diagnosis is thus generally based on clinical assessment and morphological examination of tumour biopsies or fine-needle aspirates (FNAs). Methods The purpose of the present study was to assess the accuracy of eBL diagnosis at two tertiary hospitals in Ghana. To that end, we studied FNAs from 29 eBL patients and 21 non-eBL lymphoma patients originally diagnosed in 2018. In addition, we examined 111 archival formalin-fixed and paraffin-embedded (FFPE) biopsies from Ghanaian patients originally diagnosed as eBL (N = 55) or non-eBL (N = 56) between 2010 and 2017. Availability-based subsets of samples were subjected to haematoxylin-eosin or Giemsa staining, C-MYC immunohistochemistry, and fluorescence in situ hybridisation (FISH) analysis of c-myc rearrangements. Results We found a good correlation between original diagnosis and subsequent retrospective assessment, particularly for FNA samples. However, evidence of intact c-myc genes and normal C-MYC expression in samples from some patients originally diagnosed as eBL indicates that morphological assessment alone can lead to eBL over-diagnosis in our study area. In addition, several FFPE samples could not be assessed retrospectively, due to poor sample quality. Therefore, the simpler FNA method of obtaining tumour material is preferable, particularly when careful processing of biopsy specimens cannot be guaranteed. Conclusion We conclude that the accuracy of eBL diagnostic tools available in Ghana is generally adequate, but could be improved by implementation of additional pathology laboratory investigations. Improved attention to adequate preservation of archival samples is recommended.
- Subjects :
- 0301 basic medicine
Adult
Male
Cancer Research
medicine.medical_specialty
Adolescent
Endemic Diseases
Resource constrained
Plasmodium falciparum
Genes, myc
Diagnostic tools
Ghana
Diagnostic accuracy
lcsh:RC254-282
Giemsa stain
03 medical and health sciences
Young Adult
0302 clinical medicine
Biopsy
Genetics
medicine
Humans
Malaria, Falciparum
Child
Retrospective Studies
Gene Rearrangement
medicine.diagnostic_test
business.industry
Infant
Reproducibility of Results
Tissue morphology
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Burkitt Lymphoma
Lymphoma
Sample quality
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
In situ hybridisation
Child, Preschool
Endemic Burkitt lymphoma
Female
Radiology
business
Research Article
Morphology, C-MYC immunohistochemistry, c-myc FISH
Subjects
Details
- Language :
- English
- ISSN :
- 14712407
- Volume :
- 19
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Cancer
- Accession number :
- edsair.doi.dedup.....373db64f62a0c9c1d77ce3e2bc97ea78