Clinicopathological Features of Malignant Lymphoma in Japan: The Miyagi Study

Abstract

The Miyagi Study is an epidemiological study of malignant lymphoma, including immunological and genetic analyses, constructed by a population-based registration system covering Miyagi prefecture, Japan. A total of 1,552 newly diagnosed cases in Miyagi between 2002 and 2008 were enrolled in this study; 75% were B-cell lymphomas, 19% were T-cell and natural killer-cell (T/NK-cell) lymphomas, and 5% were Hodgkin's lymphomas. The most frequent subtype of B-cell lymphoma is diffuse large B-cell lymphoma, followed by follicular lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (51%, 24% and 8%, respectively). Thus, follicular lymphoma accounts for 18.2% of newly diagnosed cases in Miyagi; unexpectedly, its frequency is similar to that reported in Western countries. The common subtypes of T/NK-cell lymphoma are peripheral T-cell lymphoma, angioimmunoblastic T-cell lymphoma, and adult T-cell leukemia/lymphoma (30%, 15% and 14%, respectively). Most of the data are similar to those reported in Asian countries, except for follicular lymphoma. We also analyzed the CD20 expression in B-cell lymphomas by flow cytometry for the cell membrane expression and by immunohistochemistry for the cytoplasmic expression. The cell membrane expression of CD20 protein may determine the susceptibility of B-cell lymphomas to anti-CD20 antibody therapy. The lack of CD20 expression was confirmed by both methods in 4 cases of 585 newly diagnosed cases (0.7%) and in 5 of 67 recurrent cases (7.5%). Furthermore, 23 cases (6.5%) showed the discrepancy of CD20 expression between both methods. The Miyagi Study has revealed the latest epidemiological features of malignant lymphoma in Japan.

Follicular lymphoma in Taiwan: a low frequency of t(14;18), with grade 3A tumours more closely related to grade 3B than to low‐grade tumours

“…The relative frequency of FL in Taiwan has been increasing in the past decade, and it has become the second most common NHL type after diffuse large B‐cell lymphoma (DLBCL) . The same trend of an increasing frequency of FL has been observed recently in Japan . In our previous study using a polymerase chain reaction (PCR)‐based method, only one‐third of FL cases were positive for translocation involving the major breakpoint region (MBR) of BCL2 , indicating that the frequency of this translocation of FL in Taiwan is lower than that in the West .…”

“…4,19,20 The same trend of an increasing frequency of FL has been observed recently in Japan. 21,22 In our previous study using a polymerase chain reaction (PCR)-based method, only one-third of FL cases were positive for translocation involving the major breakpoint region (MBR) of BCL2, indicating that the frequency of this translocation of FL in Taiwan is lower than that in the West. 23 However, PCR is less sensitive than fluorescence in-situ hybridization (FISH) for the detection of this translocation.…”

Anatomic distribution of hematolymphoid malignancies in the head and neck: 7 years of experience with 122 patients in a single institution

“…HL of the head and neck typically occurs in the lymph nodes of middle-aged men and rarely occurs in extranodal sites, including Waldeyer's ring, with an incidence ratio of 1-2% of all HL [8]. In contrast to the rarity of HL in Japan (4-7% of all ML), the incidence ratio of HL in Western countries has been reported to be approximately 40-45% [3]. In addition, a higher incidence ratio of T/NK-cell lymphoma to all NHL in Asia (15-20%) has been reported compared with that in Western countries (5-10%) [9].…”

“…According to recent large-scale surveys of ML in the whole body in Japan, 65-75% of ML were Bcell neoplasms, 19-25% were T/NK-cell lymphomas, and 4-7% were HL [3,10,11]. These data were roughly similar to our present results in the head and neck in which B-cell neoplasms, T/NK-cell neoplasms, and HL accounted for 77.9%, 18.0%, and 3.3%, respectively.…”

“…Previous studies have reported that there is a considerable geographic variation in the incidence of ML subtypes worldwide [3]. Therefore, head and neck surgeons in each respective region should be well acquainted with the anatomic site-specific characteristics of hematolymphoid malignancies in order to differentiate them from other malignancies or various benign lesions.…”