Extranodal non-Hodgkin's lymphoma of the head and neck. A clinicopathologic study in the kyoto-nara area of japan

Shima, Nobuyuki; Kobashi, Yoichiro; Tsutsui, Kazushige; Ogawa, Katsuhiko; Maetani, Shunzo; Nakashima, Yasuaki; Ichijima, Kunio; Yamabe, Hirohiko

doi:10.1002/1097-0142(19900915)66:6<1190::aid-cncr2820660619>3.0.co;2-u

Cited by 94 publications

(63 citation statements)

References 37 publications

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“…In this study, stage I and stage II patients had a better prognosis and overall survival. This is in accordance with another study in which Stage 1 and II patients had a good prognosis and advanced stage patients had a poor prognosis 16 .…”

Section: Survivalsupporting

confidence: 93%

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Head and Neck Lymphomas: Tip of the Iceberg?

Babu¹,

K²,

Kc³

et al. 2015

ijSciences

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Background: Lymphomas comprise around 5% of all head and neck neoplasms and is the second most common extra nodal non hodgkin's lymphoma (NHL). However there is sporadic data on this entity from the subcontinent and hence we undertook this study.Methodology: This retrospective observational study was conducted at a tertiary care oncology center in India on diagnosed cases of NHL between January 2007 and December 2013. All patients were diagnosed based on histopathology and immunohistochemistry. Staging work up was done in all patients. Patients were considered as primary Head and Neck lymphomas if there was head and neck as the predominant site with or without regional lymph node involvement.Results: A total of 39 patients were studied. The age at presentation ranged from 29 to 78 years. The most common site of presentation was oral cavity (26%; n=10), followed by parotid and thyroid (18% each; n=7), eye (12%, n=5), maxilla (8%; n=3), paranasal sinuses (8%; n-=3) cheek (8%, n=3), and nasal cavity (2%, n=1). 41% (n=16) cases were in stage I, 43% (n=17) in stage II, 3% (n=1) in stage III, and 13% (n=5) were in stage IV. Most common histology was DLBCL (71%; n=28), followed by plasmablastic (10%; n=4), marginal zone (8%, n=3), mantle cell (3%; n=1), follicular lymphomas (5%; n=2), and NK/T cell lymphoma (3%; n=1). Most of the patients were of low risk (67%; n=26), followed by intermediate (23%; n=9), and high risk (10%; n=4). Patients were treated with anthracycline based chemotherapy +/-radiotherapy. In this study, stage I and stage II patients had a better prognosis and overall survival, median OS 28 months and 11 months, respectively. In stage III and IV, it was 7 and 3 months, respectively. According to site, the best median overall survival was seen with parotid (27 m), paranasal sinus (26m), and oral cavity (23 m), followed by thyroid (18 m) nasal cavity (17 m), maxilla (11 m), eye (8 m), and cheek (7 m).

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Section: Survivalsupporting

confidence: 93%

“…Median age was 58 years with male:female ratio of 1.4:1. In another study, median age was 56.7 and male:female ratio was 1.5:1 16 .…”

Section: Survivalmentioning

confidence: 91%

Head and Neck Lymphomas: Tip of the Iceberg?

Babu¹,

K²,

Kc³

et al. 2015

ijSciences

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“…The most common presenting symptoms of extranodal NHL in the head and neck region include local swelling, pain and discomfort in the region of involvement [19]. Clinical signs included unilateral enlargement of face, localized swelling, destruction of hard and soft tissue, cavitation and ulceration and/or sessile soft tissue mass formation.…”

Section: Discussionmentioning

confidence: 99%

Primary Diffuse Large B-Cell Lymphoma of the Oral Cavity: Germinal Center Classification

Bhattacharyya

Chehal

Cohen

et al. 2010

Head and Neck Pathol

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Primary lymphomas of the oral cavity are rare and the most frequent type is diffuse large B-cell lymphoma (DLBCL). Recently, several reports have highlighted the value of classifying DLBCL into prognostically important subgroups, namely germinal center B-cell like (GCB) and non-germinal center B-cell like (non-GCB) lymphomas based on gene expression profiles and by immunohistochemical expression of CD10, BCL6 and MUM-1. GCB lymphomas tend to exhibit a better prognosis than non-GCB lymphomas. Studies validating this classification have been done for DLBCL of the breast, CNS, testes and GI tract. Therefore we undertook this study to examine if primary oral DLBCLs reflect this trend. We identified 13 cases (age range 38-91 years) from our archives dating from 2003-09. IHC was performed using antibodies against germinal center markers (CD10, BCL6), activated B-cell markers (MUM1, BCL2) and Ki-67 (proliferation marker). Cases were sub-classified as GCB subgroup if CD10 and/or BCL6 were positive and MUM-1, was negative and as non-GCB subgroup if CD10 was negative and MUM-1 was positive. Immunoreactivity was noted in 2/13 cases for CD10, in 12/13 for BCL6, in 8/13 for MUM-1, and in 6/13 for BCL2. Therefore, 8/13 (58%) were sub-classified as non-GCB DLBCLs and 5/13 (42%) as GCB subgroup. All tumors showed frequent labeling with Ki-67 (range 40-95%). Four of the 8 patients with non-GCB subgroup succumbed to their disease, with the mean survival rate of 16 months. Two patients in this group are alive, one with no evidence of disease and another with disease. No information was available for the other 3 patients in this group. Four of the 5 patients in the GCB subgroup were alive with no evidence of disease and one patient succumbed to complications of therapy and recurrent disease after 18 months. In conclusion, our analysis shows that primary oral DLBCL predominantly belongs to the non-GCB subgroup, which tends to exhibit a poorer prognosis. These findings could allow pathologists to provide a more accurate insight into the potential aggressive behavior and poorer prognosis of these lymphomas.

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“…The head and neck region is one of the most common sites of extranodal NHL with the Waldeyer's ring being the most frequent localization [35][36][37]. Primary lymphomas arising in the oral cavity are rare and represent less than 10% of cases of lymphomas of the head and neck [38].…”

Section: Discussionmentioning

confidence: 99%