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Tatsis D, Niakou A, Paraskevopoulos K, Papadopoulou S, Vahtsevanos K. Is There an Association between a Tonsillar Diffuse Large B-Cell Lymphoma Arising after a Neck Squamous Cell Carcinoma of Occult Primary? A Case Report and Extensive Literature Review. Hematol Rep 2024; 16:260-269. [PMID: 38804279 PMCID: PMC11130887 DOI: 10.3390/hematolrep16020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The aim of this review is to focus on the possibility of patients with squamous cell carcinoma to develop a second primary disease such as DLBCL, perhaps because of the irradiation of the head and neck area. MATERIALS AND METHODS A case of an 89-year-old man is reported, who initially underwent surgical and complementary treatment for neck squamous cell carcinoma of occult primary and later for tonsillar diffuse large B-cell non-Hodgkin lymphoma. RESULTS The second primary was considered a recurrence in the neck of the original cancer of unknown primary, so a new surgical management was decided. The final pathology report described a diffuse large B-cell non-Hodgkin lymphoma. CONCLUSIONS The importance of maintaining follow-ups for patients with occult primary cancers who are at an elevated risk of developing a metastasis or a second primary carcinoma outbreak is highlighted.
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Affiliation(s)
- Dimitris Tatsis
- Department of Oral and Maxillofacial Surgery, Aristotle University, 57010 Thessaloniki, Greece; (A.N.); (K.P.); (S.P.); (K.V.)
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Ma W, Hong R, Lou P, Yao M, Wu S, Lin C, Wang C, Chang C, Cheng A, Kuo S. Improved outcomes of localized diffuse large B-cell lymphoma at the Waldeyer ring in comparison to the sinonasal area in the rituximab era. Cancer Med 2024; 13:e6851. [PMID: 38148602 PMCID: PMC10807621 DOI: 10.1002/cam4.6851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) of the head-and-neck area primarily involves the Waldeyer ring (WR) and sinonasal area (SN). However, the differential clinical outcomes between patients with WR-DLBCL and those with SN-DLBCL in the rituximab era remain unclear. METHODS To avoid confounding factors contributed by advanced DLBCL with WR and SN involvement, we assessed the clinical outcomes of patients with stage I/II WR-DLBCL and SN-DLBCL and compared them with those having corresponding stages of DLBCL in the lymph nodes but without other extranodal involvement (LN-DLBCL) in the same period. We compared the patients' clinical characteristics, treatment modalities, event-free survival (EFS), and overall survival (OS) among the three subgroups. RESULTS We analyzed 67, 15, and 106 patients with WR-DLBCL, SN-DLBCL, and LN-DLBCL, respectively, between January 2000 and December 2019. All patients received front-line rituximab-based regimens, and > 80% received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone-based regimens. More patients with SN-DLBCL had revised International Prognostic Index (R-IPI) score 3 (27%) when compared with those with WR-DLBCL (7%) and those with LN-DLBCL (10%, p = 0.181). Patients with WR-DLBCL, LN-DLBCL, and SN-DLBCL had 5-year EFS and OS rates of 80.7%, 59.5%, and 41.9% (p = 0.021) and 83.7%, 70.8%, and 55.8% (p = 0.032), respectively. Compared to patients with LN-DLBCL, those with WR-DLBCL also had a significantly favorable 5-year EFS rate (p = 0.021) and 5-year OS rate (p = 0.023). Three of the 15 patients with SN-DLBCL experienced lymphoma recurrence in the brain after front-line treatment. In multivariate analyses, R-IPI scores of 1-2 and 3 served as significantly poor prognostic factors for patients with poor EFS and OS. CONCLUSIONS Compared to patients with LN-DLBCL, patients with WR-DLBCL receiving front-line rituximab-based treatments had favorable clinical outcomes; however, patients with SN-DLBCL had worse clinical outcomes. Further studies on molecular prognostic factors and treatment strategies for SN-DLBCL are warranted.
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Affiliation(s)
- Wei‐Li Ma
- Department of OncologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
- Cancer Research CenterNational Taiwan University College of MedicineTaipei CityTaiwan
- Graduate Institute of OncologyNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Ruey‐long Hong
- Department of OncologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
- Department of Medical OncologyNational Taiwan University Cancer Center, National Taiwan University College of MedicineTaipei CityTaiwan
| | - Pei‐Jen Lou
- Department of OtolaryngologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
| | - Ming Yao
- Department of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
| | - Shang‐Ju Wu
- Department of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
| | - Chung‐Wu Lin
- Department of PathologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
- Department of Pathology and Laboratory MedicineKoo Foundation Sun Yat‐Sen Cancer CenterTaipei CityTaiwan
| | - Chun‐Wei Wang
- Department of OncologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
- Cancer Research CenterNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Chin‐Hao Chang
- Department of Medical ResearchNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
| | - Ann‐Lii Cheng
- Department of OncologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
- Graduate Institute of OncologyNational Taiwan University College of MedicineTaipei CityTaiwan
- Department of Medical OncologyNational Taiwan University Cancer Center, National Taiwan University College of MedicineTaipei CityTaiwan
- Department of Internal MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
| | - Sung‐Hsin Kuo
- Department of OncologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipei CityTaiwan
- Cancer Research CenterNational Taiwan University College of MedicineTaipei CityTaiwan
- Graduate Institute of OncologyNational Taiwan University College of MedicineTaipei CityTaiwan
- Department of Radiation OncologyNational Taiwan University Cancer Center, National Taiwan University College of MedicineTaipei CityTaiwan
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Bernardo PS, Hancio T, Vasconcelos FDC, Nestal de Moraes G, de Sá Bigni R, Wernersbach Pinto L, Thuler LCS, Maia RC. Primary diffuse large B-cell lymphoma of the head and neck in a Brazilian single-center study. Oral Dis 2023; 29:968-977. [PMID: 34905288 DOI: 10.1111/odi.14104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Lymphomas represent around 10% of head and neck neoplasms, among which the diffuse large B-cell lymphoma (DLBCL) is the most common histologic subtype. In the present study, we characterized demographic parameters, anatomical sites, and survival rates of patients in a Brazilian cancer center. MATERIALS AND METHODS Single-center retrospective epidemiological study of 243 head and neck DLBCL patients. Demographic characteristics, tumor localization, HIV status, lactate dehydrogenase (LDH) activity, and treatment modality were obtained from electronic medical records. RESULTS The most common primary head and neck tumor location in patients with DLBCL was Waldeyer's ring. Interestingly, age above 80 years, male gender, high LDH levels, and HIV positivity were significantly associated with shorter overall survival (OS) rates and increased risk of death. We further demonstrated that treatment had a protective effect, improving OS, and reducing risk of death. Notably, we found no benefit of combination of chemotherapy and radiotherapy versus isolated treatment modalities. CONCLUSION The study showed that primary head and neck DLBCL is more incident in middle age and elderly patients with a small male patients' majority in a Brazilian population. Moreover, we observed a 3-year OS rate of almost 60% and multivariate analysis showed that treatment was the only protective factor.
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Affiliation(s)
- Paula Sabbo Bernardo
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Thaís Hancio
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Flavia da Cunha Vasconcelos
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Gabriela Nestal de Moraes
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | | | - Raquel Ciuvalschi Maia
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
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Sorrentino A, Ferragina F, Barca I, Arrotta A, Cristofaro MG. Extra-Nodal Lymphomas of the Head and Neck and Oral Cavity: A Retrospective Study. Curr Oncol 2022; 29:7189-7197. [PMID: 36290843 PMCID: PMC9601190 DOI: 10.3390/curroncol29100566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 01/13/2023] Open
Abstract
Disease Overview: Lymphomas, both Hodgkin's and non-Hodgkin's lymphomas, are one of the most common cancers in the head and neck area. The extra-nodal variant of lymphoma is rare, but it is the most common non-Hodgkin's lymphoma (ENHL). Furthermore, it is difficult to diagnose due to its non-specific clinical and radiological features, which can mimic other benign or malignant clinical manifestations. The study: This retrospective study involved 72 patients affected by head and neck ENHL in the period between 2003 and 2017. All patients underwent a diagnostic-therapeutic procedure according to the guidelines, and a 5-year follow-up. Based on the location of the swelling at the time of diagnosis, patients were divided into two groups: oral and non-oral ENHLs. Statistical analysis was performed using Kaplan-Meier analysis with the log-rank test. In addition, Fisher's exact test was applied to the two groups to evaluate and compare variances (the acceptable significance level was set at p < 0.05). Conclusion: ENHL with oral localization is much more aggressive than ENHL with non-oral localization, with a death rate of 40% (versus 4.76 for the non-oral one). In fact, between the two groups, there is a statistically significant difference in mortality, with a p-value of 0.0001 and 0.0002, respectively.
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Affiliation(s)
- Alfonso Sorrentino
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Unit of Maxillofacial Surgery, University Hospital of Naples “Federico II”, 80131 Napoli, Italy
| | - Francesco Ferragina
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-0961-364-7271; Fax: +39-0961-364-7229
| | - Ida Barca
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
| | - Antonella Arrotta
- Department of Medicine and Surgery Sciences, Magna Graecia University, Viale Europa, 88100 Catanzaro, Italy
| | - Maria Giulia Cristofaro
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
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Said RHM, Hussein FF, El-Deeb AM. Immunohistochemical Expression of Programmed Death Ligand 1 in Oral Extranodal Diffuse Large B Cell Lymphoma. Eur J Dent 2022. [PMID: 35944575 DOI: 10.1055/s-0042-1747951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE Lymphomas are the third most common cancer after squamous cell carcinoma and salivary gland tumors. Extranodal diffuse B cell lymphoma (DBCL) represents 30 to 58% of non-Hodgkin's lymphoma. One of the major problems of DBCL is the high likelihood of disease relapse following treatment. A recent trend in the treatment of diffuse large B cell lymphoma (DLBCL) is blockage of an immune checkpoint inhibitor that targets the programmed death of cell ligand 1 receptors (PD-L1). PD-L1 activation results in negative regulatory signals that induce apoptosis and inhibit tumor antigen-specific T cells allowing immune evasion of the tumor.The aim of this aim is to measure the expression level of PD-L1 on oral tissue samples from DLBCL patients using immunohistochemistry. MATERIALS AND METHODS This current study was performed at the Faculty of Dentistry, Tanta University, Egypt. Ethical approval was conducted from Faculty of Dentistry, Tanta University. Tissue samples were collected from 13 patients diagnosed with oral extranodal DLBCL) nongerminal center B cell like subtype. Both hematoxylin and eosin and immunohistochemical staining (The avidin-biotin-complex procedure) was performed with anti-PD-L1 antibody (clone number: 28-8, Abcam, Cambridge, Massachusetts, United States).Cytoplasmic and/or membranous positive intensity was graded as follows: very mild staining, mild staining, moderate staining, and intense staining using Image J, 1.41a (National Institutes of Health, United States) image analysis software. The mean area fraction of the stained cells was calculated by counting immunostained cells in three fields of each case by two pathologists. Data was entered in SPSS program for analysis. RESULTS PD-L1 was overexpressed on tumor cells of oral extranodal DLBCL than control cells from lesion free areas of oral tissues of the same patient.
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Affiliation(s)
- Rania Hanafi Mahmoud Said
- Department of Oral Pathology, Faculty of Dentistry, Suez Canal University, El Salam District Ismailia Governorate, Egypt.,Department of Oral Pathology in Faculty of Dentistry, Umm Al Qura University, Kingdom of Saudi Arabia
| | - Fatma F Hussein
- Department of Oral Medicine, Oral Diagnosis and Periodontology, Faculty of Dentistry, Minia University, Minya, Menia Governorate, Egypt.,Faculty of Dentistry, Umm Al Qura University, Kingdom of Saudi Arabia
| | - Amal M El-Deeb
- Department of Oral Pathology in Faculty of Dentistry, Umm Al Qura University, Kingdom of Saudi Arabia.,Department of Oral Pathology, Faculty of Dentistry, Tanta University, Tanta, Gharbia Governorate, Egypt
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Primary Extra Nodal Diffuse Large B-Cell Lymphoma of the Maxillary Sinus with Symptoms of Acute Pulpitis. Case Rep Dent 2022; 2022:8875832. [PMID: 35433056 PMCID: PMC9010219 DOI: 10.1155/2022/8875832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/15/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Diffuse large B-cell lymphoma not otherwise specified (DLBCL-NOS) is a subtype of large B-cell non-Hodgkin lymphoma with various clinical and pathological manifestations. DLBCL-NOS which primarily arises from maxillary sinus is rare and hard to diagnose due to unique anatomy. Here, we present a case of DLBCL-NOS that developed in the left maxillary sinus of a 72-year-old male, who presented with severe toothache that resembled acute pulpitis. The lesion was diagnosed and treated based on radiographs, histological, immunohistological examinations, and PET-CT analysis. Despite its rare incidence, DLBCL-NOS should still be included in differential diagnoses to rule out malignancy in cases of endodontic disease.
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Diagnostic Interval in Extranodal Non-Hodgkin Head and Neck Lymphomas. J Clin Med 2022; 11:jcm11030853. [PMID: 35160304 PMCID: PMC8836384 DOI: 10.3390/jcm11030853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/25/2022] [Accepted: 02/03/2022] [Indexed: 11/30/2022] Open
Abstract
The aim of this study is to measure the diagnostic interval (DI) of primary extranodal non-Hodgkin lymphomas (PE-NHL) affecting the head and neck and to discover any associated factors. With this aim, we performed a retrospective observational study in northwestern Spain on patients diagnosed between 1 January 2005 and 1 January 2016. A search was made across the electronic health records of the public health system of this region (SERGAS). DI was used as the dependent variable, and different clinicopathological data of the corresponding patients and tumors were analyzed as exposure variables. PE-NHLs were mostly located in Waldeyer’s ring, and they presented a B phenotype and had a median DI of 65 days. Shorter diagnostic intervals were observed in (1) PE-NHL patients who had comorbidities (p = 0.02), (2) PE-NHL that caused symptoms of dysphagia (p = 0.04), (3) tumors with the highest proliferative activity (Ki67 > 80%) (p = 0.04), and (4) tumors diagnosed in the advanced stages of the disease (p = 0.004). Univariate analysis revealed a significant association between dysphagia and a shorter DI. We conclude that raising awareness about these neoplasms and warning about the presenting symptoms can contribute to earlier diagnoses of these tumors and to better outcomes.
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Flores-Hidalgo A, Bankhead A, Murrah V, Padilla R. Malignant Lymphoproliferative Disorders of the Oral and Maxillofacial Region: Report of Two Institutions. FRONTIERS IN ORAL HEALTH 2022; 3:802555. [PMID: 35187532 PMCID: PMC8850351 DOI: 10.3389/froh.2022.802555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Report of the incidence of malignant hematologic neoplasms in the oral cavity according to the experience of the two oral and maxillofacial pathology institutions in North Carolina, USA. Methods A 10-year retrospective review was carried out in the records of patients at ECU SoDM and UNC Adams SoD. Age, sex, location of the lesion, clinical impression, initial diagnosis, and the expression immunohistochemical and molecular markers were recorded for each subject. All diagnoses were reviewed according to the 2016 revision of the WHO classification of lymphoid neoplasms. Results A total of 318 records from both institutions were reviewed. Seventy males and 68 females with an average age of 60.7 comprised the study population. The most common neoplasm encountered was plasma cell myeloma, followed by diffuse large B-cell lymphoma, B-lymphoblastic lymphoma, and follicular lymphoma. We encountered primarily intraosseous tumors, with the posterior mandible and posterior maxilla being the most common locations. Twelve cases were identified initially as a periapical radiolucency. Conclusion Our findings are concurrent with the existing literature regarding epidemiologic data. However, the type and location of tumors encountered do not, as the most common lymphoma in the oral cavity is diffuse large B-cell lymphoma, typically present in soft tissue. To aid in diagnosis and treatment, the collection of data should continue over time so that eventually, a more specific diagnostic profile of North Carolina residents with these neoplasms can be made.
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Affiliation(s)
- Andres Flores-Hidalgo
- Department of Surgical Sciences, Division of Oral and Maxillofacial Pathology, East Carolina University School of Dental Medicine, Greenville, NC, United States
- *Correspondence: Andres Flores-Hidalgo
| | - Alec Bankhead
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Valerie Murrah
- Division of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, NC, United States
| | - Ricardo Padilla
- Division of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, NC, United States
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Höglund Wetter M, Mattsson U. Oral manifestations of extranodal lymphomas - a review of the literature with emphasis on clinical implications for the practicing dentist. Acta Odontol Scand 2022; 80:401-410. [PMID: 35108151 DOI: 10.1080/00016357.2021.2020896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Lymphoma is a heterogenous group of malignant tumours with proliferation of lymphoid cells or their precursors. Lymphomas in the head and neck region are usually found in Waldeyer's ring. Intraoral lymphomas are rare and the clinical presentation and roentgenological appearance may resemble other and benign conditions, entailing a risk for diagnostic delay. The objective of the present literature review was to identify subjective symptoms, clinical presentations and roentgenological appearances which should raise suspicion of lymphoma. MATERIALS AND METHODS The literature review identified 41 case series with head and neck lymphomas (n = 3880) and 384 case reports (n = 567 cases) of intraoral lymphomas. Information of demographics, clinical presentation, subjective symptoms and roentgenological appearance was registered. RESULTS The most common clinical presentation was a broad-based swelling or bulging mass with or without simultaneous ulceration, frequently with a relatively rapid growth pattern. Subjective symptoms varied considerably. Intraosseous lymphomas were frequently associated with paresthaesia or numbness. The most common roentgenological finding was a radiolucency with diffuse demarcation. CONCLUSIONS The clinical presentation, symptomatology and roentgenological appearance of intraoral lymphomas varied. Diagnostic delay was usually associated with a lymphoma initially misdiagnosed as a lesion of dental aetiology or a reactive lesion. Inadequate healing after tooth extraction or symptoms of numbness or pain without obvious dental origin should merit further clinical and roentgenological examination. Biopsy is indicated when there is the slightest doubt of the true nature of mucosal lesion.
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Affiliation(s)
| | - Ulf Mattsson
- Clinic of Medical Dentistry, Central Hospital, Karlstad, Sweden
- Department of Oral pathology, Faculty of Odontology, Malmö University, Sweden
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Kamiński B. Lymphomas of the head-and-neck region. J Cancer Res Ther 2021; 17:1347-1350. [PMID: 34916364 DOI: 10.4103/jcrt.jcrt_213_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Lymphomas of the head and neck are always a challenge for an ENT specialist whose goal is to make a quick diagnosis. Aim Accordingly, clinical and epidemiological analysis of head-and-neck lymphoma was performed to approximate diagnostic difficulties. Materials and Methods The diagnosed patients with head-and-neck lymphoma in our center were assessed in 2012-2019. Results The study group included 22 patients with head-and-neck lymphoma including 20 non-Hodgkin's lymphoma (NHL) and 2 Hodgkin's lymphoma (HL). NHL showed symptoms in the lymph nodes of the neck, tonsils, parotid gland, and the orbit. HL showed exclusive manifestation in the lymph nodes of the neck and tonsils. Conclusions Uncharacteristic symptoms of lymphoma are always a challenge for the ENT specialist whose task is to quickly determine the diagnosis that forms the basis for further treatment. Interview, physical examination, imaging, and laboratory tests can only be suggestions for the diagnosis or exclusion of lymphoma; always, the decisive test is histopathological examination of the lymph node or a fragment of the affected organ.
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Affiliation(s)
- Bartlomiej Kamiński
- Otolaryngology Ward, Maria Skłodowska-Curie District Hospital, Skarżysko-Kamienna, Poland
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Valente VB, de Castro TF, Takamiya AS, Callestini R, Xavier-Junior JCC, Cortopassi GM, Neto SC, Collado FU, Biasoli ÉR, Miyahara GI, Bernabé DG. Blastoid variant of mantle cell lymphoma in palatine tonsil. Oral Oncol 2021; 122:105552. [PMID: 34610523 DOI: 10.1016/j.oraloncology.2021.105552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 11/28/2022]
Abstract
Blastoid variant of mantle cell lymphoma (MCL) is an aggressive and extremely rare malignancy. MCL may be diagnosed in lymph nodes and/or extranodal sites exhibiting a poor prognosis. MCL with primary presentation in palatine tonsils has been rarely reported. Herein, we report the case of a 73-year-old man with a painless nodular mass on the right palatine tonsil. A biopsy was performed, and microscopic analysis revealed a neoplasm composed of small to medium sized lymphocytes with finely dispersed chromatin, roundish nucleus and many mitoses. The tumor cells were positive for CD20 (L26), CD5 (4C7), Cyclin D1 (EP12), Bcl2 (124) and Ki-67 (MIB-1; 90%), and negative for Bcl6 (PG-B6p), MUM1 (MUM1p) and CD3 (Polyclonal). These findings led to the diagnosis of blastoid variant of MCL. Diagnostic workup with computed tomography scan excluded other sites of disease. The patient was treated successfully with cyclophosphamide, doxorubicin, vincristine and prednisolone (mini-CHOP regimen). Although the blastoid variant of MCL is rare, it should be included in the differential diagnosis of rapid-growing masses in the palatine tonsil.
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Affiliation(s)
- Vitor Bonetti Valente
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - Tamara Fernandes de Castro
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - Aline Satie Takamiya
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - Renata Callestini
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - José Cândido Caldeira Xavier-Junior
- Pathology Institute of Araçatuba, Araçatuba, São Paulo, Brazil; School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, São Paulo, Brazil
| | | | - Sebastião Conrado Neto
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - Francisco Urbano Collado
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - Éder Ricardo Biasoli
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - Glauco Issamu Miyahara
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil
| | - Daniel Galera Bernabé
- Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, SP 15050-015 Araçatuba, São Paulo, Brazil.
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Marques JAS, Ferreira F, Melo DP, Santos M, Vaz RP. Palatine Tonsils Primary Presentation of Blastoid Variant of Mantle Cell Lymphoma: Case Report. Head Neck Pathol 2020; 15:588-592. [PMID: 33091144 PMCID: PMC8134596 DOI: 10.1007/s12105-020-01238-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
Head and neck lymphomas can present with a wide range of symptoms. Timely and accurate diagnosis is often challenging. The blastoid variant of mantle cell lymphoma (MCL) accounts for less than one-third of all MCL cases. Isolated primary presentation on the palatine tonsils is rare, and prognosis and outcome are seemingly unfavorable. An 81-year-old man presented with persistent odynophagia, dysphagia, and obstructive hypertrophic palatine tonsils with purulent exudate. The signs and symptoms were non-responsive to antibiotic therapy, and the tonsils were biopsied. The cellular morphology, immunophenotype, and genotype supported a diagnosis of the blastoid variant of MCL. After staging, the patient underwent chemotherapy with Rituximab-Bendamustine (R-Benda). The patient is in clinical remission more than two years after therapy. We report an exceedingly rare case of blastoid MCL that is prone to be misdiagnosed as tonsillitis. We review the literature and discuss treatment options of this uncommon malignancy.
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Affiliation(s)
- Joana A. S. Marques
- Department of Otorhinolaryngology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal ,Unit of Otorhinolaryngology - Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Fátima Ferreira
- Department of Clinical Haematology, Centro Hospitalar Universitário S. João, EPE, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Daniel P. Melo
- Department of Anatomic Pathology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal ,Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Margarida Santos
- Department of Otorhinolaryngology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal
| | - Ricardo P. Vaz
- Department of Otorhinolaryngology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal ,Unit of Anatomy - Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal ,Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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Coskunses FM, Cilasun Ü, Celik Topcu P, Tokuc B. Primary diffuse large B-cell lymphoma of the mandible: A case report. Gerodontology 2020; 37:307-311. [PMID: 32809252 DOI: 10.1111/ger.12470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/30/2020] [Accepted: 03/06/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Lymphomas are a heterogeneous group of malignant neoplasms of lymphocytes and their precursor cells. Lymphoma is seen 3.5% of all intraoral malignancies and is the second most common neoplasm after the squamous cell carcinoma in the head and neck region. Diffuse large B-cell lymphomas (DLBCL), which is a subtype of non-Hodgkin lymphoma, are seen mostly in the paraoral region. CASE PRESENTATION An 82-year-old woman was referred with a localised swelling of the mandibular buccal mucosa for 3 months. Excisional biopsy revealed the diagnosis of DLBCL in the mandible and chemotherapy regimen started immediately. However, patient died during treatment. CONCLUSIONS Non-Hodgkin's lymphomas would be late- or misdiagnosed in the perioral region that may result poor prognosis.
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Affiliation(s)
- Fatih Mehmet Coskunses
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Ülkem Cilasun
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cyprus Health and Social Sciences University, Morphou, Cyprus
| | - Pinar Celik Topcu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Berkay Tokuc
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Periodontol 2019; 89 Suppl 1:S28-S45. [PMID: 29926945 DOI: 10.1002/jper.17-0163] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/20/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Clin Periodontol 2019; 45 Suppl 20:S28-S43. [PMID: 29926497 DOI: 10.1111/jcpe.12938] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/16/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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Extranodal lymphoma arising within the maxillary alveolus: a systematic review. Oral Radiol 2018; 34:113-126. [PMID: 30147235 DOI: 10.1007/s11282-017-0309-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 10/19/2017] [Indexed: 11/27/2022]
Abstract
Objectives Extranodal lymphomas affecting the head and neck infrequently arise within the jaw bones. Although clinical examination and conventional radiography may initially suffice for such lesions arising within the mandible, those arising within the maxillary alveolus generally require cross-sectional imaging because of the complex anatomy of this region. This study was performed to determine the prevalence, demographic characteristics, and clinical presentations of these lesions and the imaging modalities used for their diagnosis. Study design A systematic review (SR) on case series and another SR on case reports were performed to investigate the demographic, clinical, and radiological features of extranodal lymphomas arising within the maxillary alveolus. Results Most case series were derived from just four nations, whereas the case reports were derived from a wider range of ethnicities. The more detailed case reports significantly reported at least one imaging modality. Most patients were aware of their lesions for nearly 2 months before presentation. The most frequent symptom was swelling. Most case reports included a provisional diagnosis, the most frequent of which was dental infection followed by squamous cell carcinoma. Discussion Extranodal lymphomas arising within the maxillary alveolus were sufficiently frequent in four communities to be reported in two or more case series, and the occasional single case report indicated that such lesions are more widespread globally. Although the SR on case series revealed differences in the relative period prevalence and maxillary/mandibular ratio, the SR on case reports revealed details of the clinical presentation and imaging modalities used.
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Oishi N, Bagán JV, Javier K, Zapater E. Head and Neck Lymphomas in HIV Patients: a Clinical Perspective. Int Arch Otorhinolaryngol 2017; 21:399-407. [PMID: 29018505 PMCID: PMC5629092 DOI: 10.1055/s-0036-1597825] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 10/31/2016] [Indexed: 12/13/2022] Open
Abstract
Introduction Because of the many HIV-related malignancies, the diagnosis and treatment of lymphoma in patients infected with human immunodeficiency virus are challenging. Objective Here, we review current knowledge of the pathogenesis, epidemiology, symptomatology, diagnosis, and treatment of head and neck lymphomas in HIV patients from a clinical perspective. Data Synthesis Although Hodgkin's lymphoma is not an AIDS-defining neoplasm, its prevalence is ten times higher in HIV patients than in the general population. NHL is the second most common malignancy in HIV patients, after Kaposi's sarcoma. In this group of patients, NHL is characterized by rapid progression, frequent extranodal involvement, and a poor outcome. HIV-related salivary gland disease is a benign condition that shares some features with lymphomas and is considered in their differential diagnosis. Conclusion The otolaryngologist may be the first clinician to diagnose head and neck lymphomas. The increasing survival of HIV patients implies clinical and epidemiological changes in the behavior of this disease. Early diagnosis is important to improve the prognosis and avoid the propagation of HIV infection.
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Affiliation(s)
- Natsuki Oishi
- ENT Department, Consorci Hospital General Universitari de Valencia, Valencia, Spain
- ENT Department, Universitat de Valencia Facultat de Medicina i Odontologia, Valencia, Comunitat Valenciana, Spain
| | - José Vicente Bagán
- Department of Stomatology, Consorci Hospital General Universitari de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Karla Javier
- Department of Haematology, Consorci Hospital General Universitari de Valencia, Valencia, Comunitat Valenciana, Spain
| | - Enrique Zapater
- ENT Department, Consorci Hospital General Universitari de Valencia, Valencia, Spain
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19
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Extranodal lymphoma arising within the maxillary alveolus: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2017. [DOI: 10.1016/j.oooo.2017.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Niemiec M, Stryjewska-Makuch G, Janik M, Kolebacz B, Lisowska G, Ścierski W. Head and neck lymphomas - a retrospective ten-year observation. Contemp Oncol (Pozn) 2017; 21:66-69. [PMID: 28435401 PMCID: PMC5385481 DOI: 10.5114/wo.2017.66659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/27/2017] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY Lymphomas are a heterogeneous group of tumours of lymphoid tissue in which there is an abnormal proliferation of cells of the lymphatic system. The literature notes a gradual increase in the incidence of this type of cancer in the whole population. The aim of the study was to evaluate whether the above tendency occurs in the head and neck area. MATERIAL AND METHODS In the years 2005-2014, at the Otolaryngology and Laryngological Oncology Department of the Upper Silesian Medical Centre in Katowice, 77 cases of lymphoma were recorded, 58 of which were analysed in terms of location, histological type, age and sex of the patient, and the presence of risk factors. RESULTS The vast majority of them were non-Hodgkin's lymphomas (NHL) - 67.53%. Hodgkin's lymphomas (HL) accounted for only a small fraction of diagnoses (7.79%). In terms of histopathological types, in most cases of NHL, there occurred diffuse large B-cell lymphomas (DLBCL) - 51.92%. The most common location was the lymph nodes, representing the location of the primary lesion in more than half of the cases. As regards the extranodal location, the Waldeyer ring dominated (54.54%) along with the palatal tonsil (40.90%). There has been a significant upward trend, especially in the incidence of NHL.
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Affiliation(s)
- Marcelina Niemiec
- Department of Laryngology and Laryngological Oncology, Silesian Medical University in Katowice, Poland
| | - Grażyna Stryjewska-Makuch
- Department of Laryngology and Laryngological Oncology, Silesian Medical University in Katowice, Poland
| | - Małgorzata Janik
- Department of Biomedical Computer System, Institute of Informatics, University of Silesia, Katowice, Poland
| | - Bogdan Kolebacz
- Department of Laryngology and Laryngological Oncology, Silesian Medical University in Katowice, Poland
| | - Grażyna Lisowska
- Department of Otorhinolaryngology and Oncology in Zabrze, Silesian Medical University in Katowice, Poland
| | - Wojciech Ścierski
- Department of Otorhinolaryngology and Oncology in Zabrze, Silesian Medical University in Katowice, Poland
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Sibaud V, Vigarios E, Tavitian S, Cougoul P, de Bataille C, Campana F, Fricain JC. [Gingival enlargement: Practical management]. Ann Dermatol Venereol 2016; 143:467-81. [PMID: 27259395 DOI: 10.1016/j.annder.2016.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 03/20/2016] [Accepted: 04/01/2016] [Indexed: 12/27/2022]
Affiliation(s)
- V Sibaud
- Oncodermatologie, consultation pluridisciplinaire de pathologies de la muqueuse buccale, institut Claudius-Regaud, institut universitaire du cancer, Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
| | - E Vigarios
- Médecine bucco-dentaire, consultation pluridisciplinaire de pathologies de la muqueuse buccale, institut Claudius-Regaud, institut universitaire du cancer, Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; UFR d'odontologie, 3, rue des Maraîchers, 31062 Toulouse, France
| | - S Tavitian
- Hématologie, institut universitaire du cancer, Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - P Cougoul
- Médecine interne, institut universitaire du cancer, Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - C de Bataille
- Médecine bucco-dentaire, consultation pluridisciplinaire de pathologies de la muqueuse buccale, institut Claudius-Regaud, institut universitaire du cancer, Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; UFR d'odontologie, 3, rue des Maraîchers, 31062 Toulouse, France
| | - F Campana
- Chirurgie orale, centre Massilien de la face, 24, avenue du Prado, 13006 Marseille, France
| | - J-C Fricain
- Chirurgie orale, consultation pluridisciplinaire de pathologies de la muqueuse buccale, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; UFR d'odontologie, 16-20, cours de la Marne, 33082 Bordeaux cedex, France
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Extranodal lymphoma of the posterior auricle. Am J Otolaryngol 2015; 36:587-9. [PMID: 25913779 DOI: 10.1016/j.amjoto.2015.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/31/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Malignant lymphoma of the head and neck represents the most common non-epithelial head and neck cancer. Approximately one third of these occur outside of lymph nodes and have been described in most sub-sites of the head and neck. CASE We describe a case of an elderly woman who presented with a non-healing ulcer on the posterior aspect of her right pinna. Biopsy was performed and found to be a diffuse large B-cell lymphoma. This patient was treated with chemotherapy and local radiation therapy. CONCLUSIONS This is the first reported case of an extranodal lymphoma affecting the auricle. We review lymphoma of the head and neck and the role of the otolaryngologist.
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Takano S, Matsushita N, Oishi M, Okamoto S, Teranishi Y, Yokota C, Iguchi H. Site-specific analysis of B-cell non-Hodgkin's lymphomas of the head and neck: A retrospective 10-year observation. Acta Otolaryngol 2015; 135:1168-71. [PMID: 26113048 DOI: 10.3109/00016489.2015.1061700] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION B-cell non-Hodgkin's lymphoma (B-NHL) in the head and neck most commonly affected the oropharynx and the cervical lymph node in sexagenarian patients, with more than 70% of these cases being diffuse large B-cell lymphoma (DLBCL). Accordingly, B-NHL should be considered one of the most important differential diagnoses of head and neck malignancies. OBJECTIVES It has previously been reported that the majority of head and neck malignant lymphomas are B-NHLs. This analysis aimed to assess the site-specific profiles of B-NHL of the head and neck. METHODS The medical records of patients with B-NHL of the head and neck diagnosed between January 2004 and December 2013 were retrospectively reviewed. The clinical parameters of these patients, including age, sex, site distribution, and histopathologic sub-type, were analyzed. RESULTS A total of 153 cases (95 males; 58 females) were included in this analysis (male-to-female ratio = 1.64:1). The patient age at the time of diagnosis ranged from 30-92 years (median = 68 years). The oropharynx was the most commonly affected site (40.5%), followed by the cervical lymph nodes (33.3%). The most common histopathologic sub-type was DLBCL (71.9%), followed by follicular lymphoma (11.1%), and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (9.2%).
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Affiliation(s)
- Sakurako Takano
- a Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine , Osaka, Japan
| | - Naoki Matsushita
- a Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine , Osaka, Japan
| | - Masahiro Oishi
- a Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine , Osaka, Japan
| | - Sachimi Okamoto
- a Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine , Osaka, Japan
| | - Yuichi Teranishi
- a Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine , Osaka, Japan
| | - Chieko Yokota
- a Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine , Osaka, Japan
| | - Hiroyoshi Iguchi
- a Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine , Osaka, Japan
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