Extranodal lymphomas which present in the nasal cavity and/or the paranasal sinuses are rare. Thirty-eight patients with disease that was clinically limited to the head and neck (Ann Arbor Stages IE-IIE) were admitted between 1947 and 1983. Twenty-eight patients were treated with radiotherapy alone and 10 received combination chemotherapy in addition. The overall 5-year survival figure was 56%. The corresponding result for Stage IE was 67%. No patient with Stage IIE disease survived 5 years. Extent of the extranodal disease also influenced results for Stage IE patients who were treated with radiotherapy only. When the extranodal disease was staged using the American Joint Committee TNM system, the 5-year disease-free survival for T1 and T2 patients was 78% as compared with 19% for patients with T3 and T4 disease. The addition of combination chemotherapy improved results for patients with T3 and T4 lesions. Cancer 56:814-819, 1985. YMPHOMAS originating in the nasal cavity and/or L the paranasal sinuses are very uncommon. Gall and Mallory' reported only 2 cases from a series of 6 18 malignant lymphomas (0.3%) and Freeman et al.' cited 33 cases in a series of 1467 non-Hodglun's lymphomas (2%). Wong er al.' in a previous study of 128 patients with extranodal lymphomas of the head and neck found 16 (1 3%) cases. The incidence of lymphoma in relation to other malignant tumors of the nasal cavity and associated sinuses is also low representing less than Also, lymphomas presenting in this region are almost exclusively non-Hodgkin's lymphomas. The diffuse large cell variety is by far the most common.

Sixty‐five patients presenting to M. D. Anderson Hospital and Tumor Institute with Stages IE and IIE primary tonsillar lymphoma between 1954 and 1981 were reviewed. All cases were non‐Hodgkin's lymphomas, with the majority being diffuse large cell lymphoma (85%). Initial therapy was radiotherapy alone in 54 patients, radiotherapy combined with chemotherapy in 8 patients, and chemotherapy alone in 3 patients. Stage was the most important prognostic factor, with 86% and 41% 5‐year survivals for Stages IE and IIE, respectively (P = 0.006). Lymphangiography was crucial in staging patients with clinically positive cervical lymph nodes because 94% of clinically staged IIE patients developed recurrent disease, in comparison with only 50% of lymphangiogram‐staged IIE patients. The incidence of large cell lymphoma was so high as to preclude analysis of survival by histologic type. From this limited series, radiotherapy alone would appear to be sufficient initial therapy for Stage IE patients, whereas Stage IIE patients probably benefit from the addition of prophylactic chemotherapy. Relapses were most common in nonirradiated lymph‐node‐bearing areas, with the majority presenting in the first 2 years following initial therapy. The salvage of relapsing patients has been disappointing, with the best hope residing in combination chemotherapy. Cancer 53:86‐95, 1984.

Seventy‐nine patients with Stages IE and IIE non‐Hodgkin's lymphomas of the stomach were treated between 1953 and 1980. The histopathologic classification was as follows: diffuse large cell, 61 (of which 23 were immunoblastic sarcomas [plasmacytoid]); diffuse well‐differentiated lymphocytic, 6; diffuse mixed, 1; undifferentiated non‐Burkitt's, 1; nodular, 9; and unclassifiable, 1. Thirty‐five patients had Stage IE disease and 44 had Stage IIE. Treatment modalities included surgery, radiotherapy, chemotherapy, and combinations thereof. Sixty‐six patients had a laparotomy for diagnosis and/or management. Of these, only 42 had a gastrectomy. The stomach was considered to be unresectable in the other 24 patients. There were 5 postoperative deaths among 31 patients who had a laparotomy or gastrectomy at our institution. The overall 5‐year actuarial survival was 56%; the disease‐free survival was 54%. For patients with Stage IE disease the survival was 76%, and for those with Stage IIE, 42%. Promising results were obtained in 13 patients who were treated on a multimodality program consisting of four cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus bleomycin (Bleo), which was alternated with involved field radiotherapy. All 13 patients had no evidence of disease as of this report. Only one patient had a relapse (Waldeyer's ring), and he was salvaged with radiotherapy. Six of these 13 were diagnosed by endoscopic biopsy and did not have a laparotomy, 3 were found to have unresectable disease at laparotomy, and 4 had a resection. Biopsy with the flexible fiberscope and treatment with CHOP‐Bleo and radiotherapy can avoid the morbidity and mortality of gastrectomy.

Hospitalized patients with anorexia nervosa (N = 17) or bulimia (N = 11) were given a standard liquid meal containing 400 calories. Using analogue scales, bulimic patients were found to have greater anxiety, lower mood, lower sexual arousal, and more fear of fatness than either control or anorectic patients. This finding of increased general "dysphoria" in bulimic patients persisted after the meal without any significant premeal to postmeal changes. Anorectic patients also differed from controls, but less than the bulimic patients. Some measures of anxiety correlated significantly with body mass index before the meal in bulimic patients, whereas in anorectic patients the correlation was significant only after the meal.