Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Reliable cell and tissue morphology-based diagnosis of endemic Burkitt lymphoma in resource-constrained settings in Ghana

Research output: Contribution to journalJournal articleResearchpeer-review

  1. PD-L1 expression is low in large B-cell lymphoma with MYC or double-hit translocation

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Annexin A2 and S100A10 as Candidate Prognostic Markers in Epithelial Ovarian Cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Looking for Needles in the Plasmodial Haystack

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

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.

Original languageEnglish
JournalBMC Cancer
Issue number1
Pages (from-to)1270
Publication statusPublished - 30 Dec 2019

ID: 59090218