The Role of Immunohistochemistry in Differentiating Subtypes of Lymphomas: A Diagnostic Accuracy Study
1Babar Shahzad, 2Umar Tipu, 3Mansoor Musa, 4Qamar Abbas, 5Dr.Huma Riaz, 6Dr Yasmin Wahid
Submission: 12 January 2026 | Acceptance: 04 February 2026 | Publication: 05 March 2026,
1UHS, Lahore
2PIMS Islamabad
3UHS Lahore
4PIMS Islamabad
5Associate professor Hematology , MBBS DCP, FCPS Hematology Hayatabad Medical Complex MTI Peshawar
6Bashir Dental college, Islamabad
Corresponding Author:
Dr.Huma Riaz,
Associate professor Hematology , MBBS DCP, FCPS Hematology Hayatabad Medical Complex MTI Peshawar.
ABSTRACT:
Background: Lymphomas are a histologically diverse group of hematological neoplasms that can be classified into Hodgkin and non-Hodgkin lymphomas with numerous subtypes. Correct classification forms the basis for treatment choice and prognosis. Conventional histopathology is often inadequate to distinguish between lymphoma subtypes on the basis of morphological features, which overlap. Immunohistochemistry has become an interesting adjuvant in the diagnostic work-up.
Objective: To analyze the diagnostic value of immunohistochemistry in distinguishing different types of lymphomas.
Methodology: This diagnostic accuracy study was carried out at the Department of Pathology, Pakistan Institute of Medical Sciences (PIMS), Islamabad from May 2024 to April 2025. One hundred and ten cases with a diagnosis of lymphoma by histopathology were analyzed retrospectively and prospectively. Immunohistochemical staining with a panel of antibodies (CD20, CD3, CD15, CD30, BCL2, BCL6, and Ki-67 and others) allowed for the distinction between Hodgkin and non-Hodgkin lymphoma entities. Final diagnoses were correlated with expert review by hematopathology as the reference standard.
Results: Of the 110 cases, 61.8% (68/110) were non-Hodgkin lymphomas, and 38.2% (42/110) were Hodgkin lymphomas. Immunohistochemistry substantially increased diagnostic accuracy, achieving 94.1% sensitivity and 91.7% specificity in the subclassification of lymphomas. In non-Hodgkin lymphomas, diffuse large B-cell lymphoma was the most common (44.1%), and classical Hodgkin lymphoma, nodular sclerosis variant, was most commonly in cases of Hodgkin lymphomas (34%). IHC also clarified 14 former dubious cases and contributed to an increased overall correct diagnosis rate.
Conclusion: Immunohistochemistry greatly contributed to the precise discrimination and subtyping of the lymphomas. Its incorporation in day-to-day diagnostic work at PIMS remarkably improved the diagnostic precision leading to sound clinical judgment and patient’s care.
Keywords: Lymphoma, Immunohistochemistry, Diagnostic Accuracy, Subtyping, Non-Hodgkin Lymphoma, Hodgkin Lymphoma, PIMS Islamabad.