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Immunohistochemical analysis of hodgkin's disease in Kampala, Uganda


LK Tumwine

Abstract

Background: Histopathological examination remains crucial for diagnosis and classification of Hodgkin's disease (HD) but poses problems when characteristic features of HD are not present and hence the value of immunohistochemistry. Experience with immunohistochemistry in developing countries is limited due to cost.


Objective: To describe the immunophenotypic and histologic types of Hodgkin's disease in Kampala, Uganda


Design: A cross-sectional study.


Setting: Makerere University Medical School, Department of Pathology.


Methodology: Two hundred formalin fixed, paraffin- embedded biopsies, which had been previously diagnosed as Hodgkin's disease in the Makerere University, Department of Pathology from 1980-2000, were re-assessed with haematoxylin and eosin. The sections were then subjected to immunohistochemistry using monoclonal antibodies: leucocyte common antigen (CD45), antibodies to Reed-Sternberg cells (CD15, CD30) and to B cells (CD20).


Results: Of the 200 biopsies, 171 (71.3%) were diagnosed as Hodgkin's disease using immunohistochemistry. The mean age of the 171 cases was 26.1(SD 16.2) years; mode 20.0; median 22.5 years. The 15-24 year age group was most affected (47.2%). There were more males (65.9%) than females and most were Baganda who are the main tribe in the central region of Uganda. Mixed cellularity (35.7%) and lymphocyte depleted (24.6%) HD were the commonest histological types. Classic HD (CD30, CD 15, CD20, CD45) was the most commonest (77.8%) immunophenotype.


Conclusion: Classic Hodgkin's disease (CD30, CD 15, CD20 and CD45) is the most commonest immunophenotype in Kampala, Uganda, and mixed cellularity and Iymphocyte depleted are the main histologic subtypes.


East African Medical Journal Vol.81(8) 2004: 384-387

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eISSN: 0012-835X