Multifocal Extranodal Lymphomas: An Expression of Homing Phenomenon

Advani, Suresh H.; Iyer, R. S.; Gopal, R; Nair, Chandrika N.; Saikia, Tapan; Dinshaw, K A; Kurkure, Purna; Pai, Sunil

doi:10.1159/000226844

Cited by 12 publications

(7 citation statements)

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“…The reason for multifocal extranodal lymphomas or the preferential involvement of specific extranodal sites at recurrence is not clear, but it is likely that this is closely linked to the homing process regulated by homing receptors or lymphoid cells and ligands on high endothelial venules [16]. This tropism for specific sites has been particularly noticeable for the tonsils and stomach [17,18], testis and nasopharynx, and skin and bone [16,19].…”

Section: Discussionmentioning

confidence: 99%

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Multifocal Extranodal Non-Hodgkin Lymphoma: A Clinicopathologic Study of 37 Cases in Greece, a Hellenic Cooperative Oncology Group Study

et al. 2005

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The purpose of this retrospective study was to illustrate the clinicopathological features of patients presenting with multifocal extranodal non-Hodgkin lymphoma (NHL). Among 810 patients with NHL, 37 cases (4.2%) were found to have multiple extranodal involvement (two or more sites). There were 24 men and 13 women, with a median age of 63 years. The majority of these cases (n = 26) had gastric or intestinal (GI) involvement with or without other extranodal sites. Lung along with another extranodal site was relatively common in the present series. Stratification of the 37 cases according to the International Prognostic Index (IPI) showed that 89% of the patients belonged to the high-risk groups. Diffuse large-B-cell lymphoma (DLBCL) accounted for 62%, and mucosa-associated lymphoma tissue (MALT) lymphoma accounted for 27% of all cases. After induction treatment with anthracycline-based regimens, complete remission was achieved in 21 patients (57%), partial remission was achieved in six patients (16%), and seven patients (19%) had no response, while three patients (8%) were nonevaluable. In conclusion, multifocal extranodal NHL is a heterogeneous group of diseases. The majority of them arise at various sites in the GI tract. DLBCL was the most frequent histological subtype followed by MALT lymphoma. Risk group, as defined by the IPI, was predictive of survival. The Oncologist 2005;10:734-738

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Section: Discussionmentioning

confidence: 99%

“…This tropism for specific sites has been particularly noticeable for the tonsils and stomach [17,18], testis and nasopharynx, and skin and bone [16,19].…”

Section: Discussionmentioning

confidence: 99%

Multifocal Extranodal Non-Hodgkin Lymphoma: A Clinicopathologic Study of 37 Cases in Greece, a Hellenic Cooperative Oncology Group Study

et al. 2005

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“…Marginal zone lymphoma, derived from lymphocytes with specific mucosal homing properties,25 might be expected to spread preferentially to extranodal sites, but this was not observed for adnexal MZL, which like LPL and FCL, spread mainly to lymph nodes (Table 3). Despite limitations in differentiating LPL from MZL in small biopsies, a few of the patients classified as LPL in this study may truly have had MZL.…”

Section: Discussionmentioning

confidence: 99%

Histological features of ocular adnexal lymphoma (REAL classification) and their association with patient morbidity and survival

Jenkins

2000

British Journal of Ophthalmology

211

135

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Background-The histological characteristics of ocular adnexal lymphomas have previously provided only a limited guide to clinical outcome for aVected patients. This clinicopathological relation was reexamined using the Revised European American Lymphoma (REAL) system to classify the tumours in a large cohort of patients. Methods-The biopsies and clinical follow up data for 192 patients with ocular adnexal lymphoma were reviewed, the biopsies being regraded in accordance with the REAL classification. For each of five histological groups, logistic regression analysis was used to determine the odds ratios (OR) for the presence of systemic disease at the time of orbital diagnosis and Cox regression analysis was used to assess the hazard ratios (HR) for disseminated disease and lymphoma related death. For 108 patients in whom extraorbital spread occurred, the histological category of lymphoma was compared with the sites of dissemination. Results-At presentation, the frequency of previous or concurrent extraorbital disease increased from marginal zone lymphoma (OR 1.0), diVuse lymphoplasmacytic/lymphoplasmacytoid lymphoma (OR 2.3), follicle centre lymphoma (OR 3.8), diVuse large B cell lymphoma (OR 4.0) to other histological lymphoma variants (OR 26.8). For all histological types, the estimated risk of extraorbital disease and lymphoma related death continued for many years and the proportion of patients with at least one extraorbital recurrence after 5 years was 47% for MZL, 48% for LPL, 64% for FCL, 81% for DLCL, and 95% for other lymphoma variants. The corresponding estimated rates for 5 year lymphoma related mortality were 12%, 19%, 22%, 48%, and 53% respectively. Conclusions-Patients with ocular adnexal lymphoma can be classified by REAL into five distinct groups, which show a progressive increase in the risks of extraorbital disease at diagnosis, of disease dissemination with time, and of tumour related death. (Br J Ophthalmol 2000;84:907-913)

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“…In contrast, 6 of 12 patients subsequently developed clinical GI tract involve ment and 2 more patients lung involvement. This behavior may be an expression of the homing phenomenon [ 16], but the exact mechanism remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Primary Extranodal Non-Hodgkin’s Lymphoma of the Head and Neck

Economopoulos

Asprou²,

Stathakis³

et al. 1992

Oncology

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Among 387 cases of non-Hodgkin’s lymphoma (NHL) treated in our units between January 1977 and December 1990, 52 (13.4%) had primary extranodal (PE) NHL of the head and neck. The median age was 55 years with a M:F ratio of 1.9:1. The most frequent primary site was the tonsil (28 cases), followed by oral cavity, parotid gland, orbit and other sites. The aggressive histological subtypes predominate. 55.2% of the patients were in stage I and 44.8% in stage II of disease. The CR rate was high (94.2%). The 5 years’ overall survival rate was 65% and it was influenced mainly by stage (stage I 82.5% vs. 48.7% in stage II). Sex, age and histology did not significantly affect survival rate. Patients with primary Waldeyer’s ring involvement (WR group) did not differ significantly from the other primary sites analyzed as a group (non-WR group) in respect to median age, sex distribution, histology and CR rates. They differed, however, in: (1) stage distribution with stage II disease more frequent in the WR group; (2) overall survival and disease-free survival both of which were significantly better in the non-WR group; and (3) the high incidence of GI tract involvement as initial manifestation of relapse in the WR group. It is concluded that the behaviour of the Waldeyer’s ring PE-NHL is rather distinctive and should be considered separately from the other PE-NHL of the head and neck.

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Multifocal Extranodal Lymphomas: An Expression of Homing Phenomenon

Cited by 12 publications

References 7 publications

Multifocal Extranodal Non-Hodgkin Lymphoma: A Clinicopathologic Study of 37 Cases in Greece, a Hellenic Cooperative Oncology Group Study

Multifocal Extranodal Non-Hodgkin Lymphoma: A Clinicopathologic Study of 37 Cases in Greece, a Hellenic Cooperative Oncology Group Study

Histological features of ocular adnexal lymphoma (REAL classification) and their association with patient morbidity and survival

Primary Extranodal Non-Hodgkin’s Lymphoma of the Head and Neck

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