Diffuse large B cell lymphoma (DLBCL) in Pakistan: an emerging epidemic?

There has been a recent concern among oncological clinicians and pathologists of our region regarding the disproportionate increase in the number of patients presenting with diffuse large B cell lymphoma (DLBCL). This prompted us to conduct a thorough, hospital-based epidemiological study in a major referral center of Pakistan. A total of 780 specimens were collected over last half decade from cases classified as adult Non Hodgkin's lymphoma (NHL). Out of these 780, 596 (76.4 %) were diagnosed as DLBCLs. The gender ratio was 2.3:1 (M:F) and the median age was 47.2 years, with an age range of 15-85 years. Nodal-NHLs constituted 42.2 % of all adult NHLs, with the cervical lymph nodes as the most frequent nodal site of presentation. The most frequent extranodal site was the gastro-intestinal tract (GIT), followed by the head and neck. In conclusion, we document an astonishingly high number of DLBCL amounting to an emerging epidemic in Pakistan, with a consideration of probable etiopathogenetic factors.