Background. Lymphomas are a heterogeneous group of the lymphoid and hematopoietic system tumors. Neoplastic process often develops in head and neck area, including the integumentary tissues, orbit, nasal cavity, paranasal sinuses, oral cavity, pharynx, salivary glands, thyroid gland, as well as neck lymph nodes. The difficulties of head and neck lymphomas diagnosis are significant, since very often there is a combined non-tumor pathology. The high heterogeneity of lymphomas in the head and neck area requires structuring knowledge about their epidemiology and clinical manifestations.Objective: to study the epidemiological and clinical features of the head and neck lymphoproliferative diseases, which will lead to an improvement in diagnostic quality of this nosology’s.Materials and methods. The frequency of head and neck lymphoproliferative diseases detection was estimated based on the study of epicrisis and clinical data of 174 patients hospitalized at the N.N. Blokhin National Medical Research Center of Oncology in the period from 2000 to 2020.Results. Taking into account the modern clinical and morphological classification of lymphomas of the World Health Organization (2017), information about the features of localization, characteristic signs of extranodal foci and lymph nodes is presented. Detection frequency of various subtypes non-Hodgkin’s and Hodgkin’s lymphomas were determined on a sufficient cohort of patients.Conclusion. Based on the analysis of clinical and morphological features of head and neck lymphomas, epidemiological and clinical features are described in detail, and differences in the symptoms and clinical manifestations of non-Hodgkin’s and Hodgkin’s lymphomas with a predominant head and neck involvement are revealed.
Introduction. Lymphomas are a heterogenic group of tumors of the lymphatic and hematopoietic systems, and in many cases tumor process develops in the area of the head and neck including skin and mucosa, orbit, nasal cavity and paranasal sinuses, oral cavity, oropharynx, salivary glands, thyroid, and cervical lymph nodes. Differential diagnosis of lymphomas of the head and neck is complicated because it can be accompanied by another non-tumor pathology. High heterogeneity of lymphomas of the head and neck requires structurization of knowledge on their epidemiological and clinical manifestations.The study objective is to optimize early diagnosis as it allows to significantly increase cancer alertness in local practitioners, oncologists, diagnosis specialists and, in turn, to decrease verification frequency in generalized disease processes. Study of clinical characteristics of lymphoproliferative disorders of the head and neck leads to increased quality of differential diagnosis.Materials and methods. A study of lymphoproliferative disorders affecting head and neck was performed. Study material consisted of data on 174 patients hospitalized at the N.N. Blokhin National medical Research Center of Oncology between 1999 and 2020.Results. Based on the current clinical and morphological classification of lymphoproliferative disorders, data on location of lesions, characteristic signs of extranodal lesions and cervical lymph nodes involvement, as well as methods of diagnosis of lymphomas of the head and neck, are presented.Conclusion. The obtained data helps solve problems of diagnosis of lymphoproliferative disorders affecting the head and neck and serve as a basis for successful, predictable treatment of lymphomas.
Background. Extramedullary plasmacytoma (EP) of soft tissues, which in most cases affects the organs of the head and neck region, is a relatively rare malignant tumor. Until now, there are no consensus approaches to the diagnosis and treatment of EP. Differentiating EP from other types of non-Hodgkin’s lymphomas is difficult. There are difficulties in the differential diagnosis of EP and carcinomas in the head and neck region. Given the rare occurrence of this nosological form, the frequency of diagnostic errors is quite high, which dictates the need for a thorough description of each head and neck EP case.Objective of the study: analysis of possible difficulties and reasons for incorrect interpretation of diagnostic data, and treatment for head and neck EP.Materials and methods. Clinical and morphoimmunological data of 97 primary patients with B-cell non-Hodgkin’s lymphomas (B-NHLs) of the head-neck region were analyzed.Results. In our cohort we identified 2 tumor cases of a plasma cell nature, which amounted to 2 % among all B-NHLs. In one case, the process was located in the nasal cavity and clinically manifested itself with nosebleeds. The second case is a lesion of the mouth floor, primarily with the ulcer formation. In the first cases, at diagnosis, the immunohistochemistry (IHC) test was performed after patient’s chemotherapy and radiation treatment, which distorted the tumor immunophenotype. In the second cases with extensive process in maxillary sinuses, a complete and very detailed IHC test was carried out; however the data did not allow for a definitive diagnosis. Difficulties apparently arose in the interpretation of CD38 expression – main marker of plasmacytic line cells, as well as due to the unusual morphology.Conclusion. The described diagnostic situations dictate the need for a comprehensive algorithm in the diagnosis of head and neck tumors. It is advisable to perform an extended morpho-immunophenotypic study of the tumor (IHC, immunocytology, flow cytometry, etc.), if a tumor of a plasma cell nature is suspected, a morpho-immunological study of the bone marrow is indicated.
Статья посвящена клиническому наблюдению местно-распространенного метастатического высокодифференцированного рака щитовидной железы. Освещены вопросы диагностики и хирургического лечения данной патологии на основе опыта нашей клиники.
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