Forensic Science, Medicine and Pathology

, Volume 14, Issue 3, pp 327–331 | Cite as

Lymphoma in autopsy cases

  • Ahmad AlkhasawnehEmail author
  • Aysha Mubeen
  • Arun Gopinath
Original Article


Lymphoproliferative disorders cause significant morbidity and mortality, either related to the disease itself or therapy complications. Some cases of lymphoma may have vague clinical presentation, especially in the absence of lymphadenopathy, and a clinical work up may not be conclusive. Our study focuses on autopsy cases of lymphoma patients, emphasizing clinically unsuspected cases. Autopsy records from the last 20 years at our institution were searched, and the clinical parameters were recorded. Fifteen cases of lymphoma were identified, and 5 cases were diagnosed at the time of autopsy. Most B-cell lymphoma cases were mainly nodal disease, while T-cell lymphoma cases had widespread extra-nodal disease. Most deaths in B-cell lymphoma are due to infection/therapy induced immunosuppression, whereas T-cell lymphoma deaths are due to organ infiltration by lymphoma. Postmortem examination may reveal clinically unsuspected lymphoma, especially in rapidly deteriorating patients with vague presentation such as skin rash, bowel obstruction/bleeding or pacemaker malfunction.


Autopsy Lymphoma Lymphadenopathy Immunosuppression 


Author contributions

Aysha Mubeen: writing abstract and data collection. Arun Gopinath: writing abstract and data collection.

Compliance with ethical standards

Financial support

No supports was received by all authors.

Conflict of interest

No conflict of interest for all authors.

Ethical approval

IRB201601803 UF Health Jacksonville.

Informed consent

Not needed/ retrospective study.


  1. 1.
    Teras LR, DeSantis CE, Cerhan JR, Morton LM, Jemal A, Flowers CR. 2016 US lymphoid malignancy statistics by World Health Organization subtypes. CA Cancer J Clin. 2016;66:443–59.CrossRefGoogle Scholar
  2. 2.
    Podduturi V, Guileyardo JM, Soto LR, Krause JR. A case series of clinically undiagnosed hematopoietic neoplasms discovered at autopsy. Am J Clin Pathol. 2015;143:854–60.CrossRefPubMedGoogle Scholar
  3. 3.
    Saraf SR, Naphade NS, Kalgutkar AD. An analysis of autopsy cases of non-Hodgkin lymphoma with special reference to those masquerading as acute febrile illness. J Cancer Res Ther. 2016;12:763–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Bairey O, Bar-Natan M, Shpilberg O. Early death in patients diagnosed with non- Hodgkin’s lymphoma. Ann Hematol. 2013;92:345–50.CrossRefPubMedGoogle Scholar
  5. 5.
    Bluhm EC, Ronckers C, Hayashi RJ, et al. Cause- specific mortality and second cancer incidence after non-Hodgkin lymphoma: a report from the childhood cancer survivor study. Blood. 2008;11:4014–21.CrossRefGoogle Scholar
  6. 6.
    Favier O, Heutte N, Stamatoullas-Bastard A, et al. Survival after Hodgkin lymphoma: causes of death and excess mortality in patients treated in 8 consecutive trials. Cancer. 2009;115:1680–91.CrossRefPubMedGoogle Scholar
  7. 7.
    Maurer MJ, Ellin F, Srour L, et al. International assessment of event-free survival at 24 months and subsequent survival in peripheral T-cell lymphoma. J Clin Oncol. 2017;35:4019–26.CrossRefPubMedGoogle Scholar
  8. 8.
    Zaorsky NG, Churilla TM, Egleston BL, et al. Causes of death among cancer patients. Ann Oncol. 2017;28:400–7.PubMedGoogle Scholar
  9. 9.
    Dendle C, Gilbertson M, Spelman T, et al. Infection is an independent predictor of death in diffuse large B cell lymphoma. Sci Rep. 2017;7:4395.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Kuderer N, Dale D, Crawford J, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106:2258–66.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Avgerinos DV, Björnsson J. Malignant neoplasms: discordance between clinical diagnoses and autopsy findings in 3,118 cases. APMIS. 2001;109:774–80.CrossRefPubMedGoogle Scholar
  12. 12.
    Somers GR, Smith CR, Perrin DG, et al. Sudden unexpected death in infancy and childhood due to undiagnosed neoplasia: an autopsy study. Am J Forensic Med Pathol. 2006;27:646–9.CrossRefGoogle Scholar
  13. 13.
    Hoyert DL. The changing profile of autopsied deaths in the United States, 1972–2007. NCHS Data Brief. 2011;67:1–8.Google Scholar
  14. 14.
    Loughrey MB, McCluggage WG, Toner PG. The declining autopsy rate and clinicians’ attitudes. Ulster Med J. 2000;69:83–9.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Nemetz PN, Tangalos E, Sands LP, Fisher WP, Newman WP, Burton EC. Attitudes toward the autopsy – an 8-state survey. MedGenMed. 2006;8:80.PubMedPubMedCentralGoogle Scholar
  16. 16.
    The decline of the hospital autopsy: a safety and quality issue for healthcare in Australia. Med J Aust. 2004;180(6):281–5.Google Scholar
  17. 17.
    Tavora F, Crowder CD, Sun CC, Burke AP. Discrepancies between clinical and autopsy diagnoses: a comparison of university, community, and private autopsy practices. Am J Clin Pathol. 2008;129:102–9.CrossRefPubMedGoogle Scholar
  18. 18.
    O’Grady G. Death of the teaching autopsy. BMJ. 2003;327:802–3.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Parajuli S, Aneja A, Mukherjee A. Undiagnosed fatal malignancy in adult autopsies: a 10- year retrospective study. Hum Pathol. 2016;48:32–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Roulson J, Benbow EW, Hasleton PS. Discrepancies between clinical and autopsy diagnosis and the value of post mortem histology; a meta- analysis and review. Histopathology. 2005;47:551–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Gordon MJ, Danilova O, Spurgeon S, Danilov AV. Cardiac non-Hodgkin’s lymphoma: clinical characteristics and trends in survival. Eur J Haematol. 2016;97:445–52.CrossRefPubMedGoogle Scholar
  22. 22.
    Chinen K, Izumo T. Cardiac involvement by malignant lymphoma: a clinicopathologic study of 25 autopsy cases based on the WHO classification. Ann Hematol. 2005;84:498–505.CrossRefPubMedGoogle Scholar
  23. 23.
    Alfsen GC, Mæhlen J. The value of autopsies in determining the cause of death. Tidsskr Nor Laegeforen. 2012;132:147–51.CrossRefPubMedGoogle Scholar
  24. 24.
    Gonzalez-Franco MV, Ponce-Camacho MA, Barboza-Quintana O, et al. Discrepancies between clinical and autopsy diagnosis: a study of 331 autopsies performed over a 7 year period. Med Univ. 2012;14:16–22.Google Scholar
  25. 25.
    Pastores SM, Dulu A, Voigt L, Raoof N, Alicea M, Halpern NA. Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients. Crit Care. 2007;11:R48.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Dierksen J, Buja JM, Chen L. Clinicopathologic findings of hematological malignancy: a retrospective autopsy study. Ann Clin Lab Sci. 2015;45:565–73.PubMedGoogle Scholar
  27. 27.
    Mosunjac MB, Sundstrom JB, Mosunjac MI. Unusual presentation of anaplastic large cell lymphoma with clinical course mimicking fever of unknown origin and sepsis: autopsy study of five cases. Croat Med J. 2008;49:660–8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ahmad Alkhasawneh
    • 1
    Email author
  • Aysha Mubeen
    • 1
  • Arun Gopinath
    • 1
  1. 1.Department of Pathology and Laboratory MedicineUniversity of Florida College of Medicine – JacksonvilleJacksonvilleUSA

Personalised recommendations