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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 2023; 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] [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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Eriksen PRG, Clasen-Linde E, Nully Brown PD, Haunstrup L, Christoffersen M, Asdahl P, Thomsen TM, Harwood CD, Heegaard S, Buchwald CV. Sinonasal B-cell lymphomas: A nationwide cohort study, with an emphasis on the prognosis and the recurrence pattern of primary diffuse large B-cell lymphoma. Hematol Oncol 2022; 40:160-171. [PMID: 35104916 PMCID: PMC9303446 DOI: 10.1002/hon.2968] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 02/06/2023]
Abstract
Lymphomas of the nasal cavity and paranasal sinuses (NPS) are rare. Knowledge on sinonasal B‐cell lymphoma (SNBCL) primarily comes from case series or single‐center studies on small cohorts. We sought to determine the subtype distribution, clinical characteristics, disease behavior, and prognosis on a nationwide scale, with an emphasis on prognostic factors for the most common sinonasal lymphoma, primary sinonasal diffuse large B‐cell lymphoma (PSDLBCL). We collated all data from medical records and national databases on patients registered with SNBCL from 1980 through 2018 in the national pathology registry and collected all tissue samples for validation of diagnosis. We included 205 patients and found 10 different subtypes of lymphoma. Diffuse large B‐cell lymphoma (DLBCL) was the predominant subtype (80%). The incidence of SNBCL was 0.14/100,000 person‐years. The five‐year progression‐free survival (PFS) and overall survival rates for PSDLBCL were 50% and 56%, respectively. For PSDLBCL, Rituximab showed a statistically significant effect (Hazard Ratio 0.22, p < 0.001), whereas consolidative radiotherapy combined with immunochemotherapy was of limited value (PFS, p = 0.93). When treatment failure occurred, DLBCL showed a distinct pattern of recurrence/dissemination to the NPS, skin, breast, central nervous system (CNS), and/or testis. Collectively, DLBCL comprised a clear majority of SNBCLs, although nine other subtypes were represented. Data showed that immunochemotherapy increased survival for PSDLBCL and that the addition of radiotherapy did not benefit patients. Furthermore, treatment failure for sinonasal DLBCL showed a possible common pathogenesis with primary extranodal lymphomas of specific locations (e.g., CNS, skin, breast, and testis).
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Affiliation(s)
- Patrick R G Eriksen
- Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Erik Clasen-Linde
- Hematopathology Section, Department of Pathology, Rigshospitalet, Kobenhavn, Denmark
| | - Peter de Nully Brown
- Department of Hematology, Rigshospitalet, University of Copenhagen, Kobenhavn, Denmark
| | - Laura Haunstrup
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Peter Asdahl
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Cecilie Dupont Harwood
- Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Steffen Heegaard
- Eye Pathology Section, Department of Pathology, Rigshospitalet, University of Copenhagen, Kobenhavn, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, Copenhagen, Denmark
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Tvedten E, Richardson J, Motaparthi K. What Effect Does Epstein-Barr Virus Have on Extranodal Natural Killer/T-Cell Lymphoma Prognosis? A Review of 153 Reported Cases. Cureus 2021; 13:e17987. [PMID: 34540511 PMCID: PMC8445857 DOI: 10.7759/cureus.17987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/09/2022] Open
Abstract
The primary aim of this review is to identify the relationship between Epstein-Barr virus (EBV) and prognosis in extranodal natural killer/T-cell lymphoma (ENKTL). Additionally, a literature review of ENKTL was carried out. The investigators designed and implemented a 21-year literature review using the online databases PubMed and Google Scholar. The total number of cases analyzed was 153 (64 case reports; one comparative study; one systematic review). Information related to ENKTL from July 1999 to February 2021 was included in the study. Study variables included: patient demographics, tumor classification, screening modalities, tumor characteristics, symptomatology, treatment, and prognosis. The average age at diagnosis was 50.9 years (range: 4-90 years). Patients of Asian ethnicity were most commonly affected, and there was a 1.6:1 male to female ratio. ENKTL was most frequently detected in the head and neck region, and 53.1% of cases metastasized. Of all head and neck cases, the nose was the most affected location. Immunohistochemistry positivity included: EBV (32.0%), CD2 (96.6%), CD3ϵ (81.7%), CD43 (91.7%), CD56 (86.4%), Granzyme (97.1%), Perforin (90.9%), TIA-1 (97.8%), p53 (33.3%). The most frequently employed single treatment modality was chemotherapy alone, and 34.2% of patients expired within five years of diagnosis. The average follow-up period was 16.51 months (range: 0.25-66 months). EBV was significantly associated with metastatic ENKTL (χ2 = 4.36; CV = 3.84; p = 0.037). We found no association between EBV and ENKTL prognosis (χ2 = 17.2; CV = 21.0; p = 0.14).
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Affiliation(s)
- Erika Tvedten
- Department of Dermatology, Michigan State University, Detroit, USA
| | | | - Kiran Motaparthi
- Department of Dermatology, University of Florida, Gainesville, USA
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Brown HJ, Varelas EA, Ganti A, Papagiannopoulos P, Mark M, Kuan EC, Tajudeen BA. Prognostic Indicators of Survival in Sinonasal Diffuse Large B-Cell Lymphoma: A National Cancer Database Analysis. Laryngoscope 2021; 132:1515-1522. [PMID: 34542177 DOI: 10.1002/lary.29864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/18/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study offers an update on the epidemiologic and prognostic factors and treatment-specific outcomes in patients diagnosed with sinonasal diffuse large B-cell lymphoma (DLBCL). STUDY DESIGN Retrospective cohort study. METHODS National Cancer Database was queried from 2004 to 2016 for patients with sinonasal DLBCL. Univariate Kaplan-Meier and multivariate Cox-regression analyses were performed to evaluate the association of suspected prognostic factors with overall survival (OS). RESULTS A total of 2,222 patients with sinonasal DLBCL were analyzed. OS was 62% at 5 years and 42% at 10 years. Prognostic factors associated with increased survival included African-American race (HR: 0.48, 95% CI: 0.33-0.70), chemotherapy (HR: 0.30, CI: 0.25-0.35), and radiation (HR: 0.80, CI: 0.69-0.93). Prognostic factors associated with decreased survival included patients with Charlson-Deyo scores of 1 (HR: 1.51, CI: 1.25-1.84), 2 (HR: 2.25, CI: 1.67-3.03), and 3 (HR: 2.36, CI: 1.49-3.74) and patients with Lugano stage III (HR: 1.69, CI: 1.09-2.62) and IV (HR: 1.96, CI: 1.46-2.64) disease. Stage-based split multivariate analysis was performed and revealed chemotherapy was independently associated with increased OS in patients with stage I (HR: 0.24, CI: 0.19-0.30), II (HR: 0.17, CI: 0.11-0.28), and IV (HR: 0.41, CI: 0.26-0.64) disease. Radiotherapy was independently associated with increased OS in patients with stage I disease only (HR: 0.67, CI: 0.55-0.83), while immunotherapy was an independent prognostic factor in patients with stage IV disease only (HR: 0.60, CI: 0.37-0.98). CONCLUSION This study is the largest to date to analyze the association of demographic features and treatment modalities with OS in patients with sinonasal DLBCL. It is the first to investigate the association of immunotherapy with OS in this population. A combination treatment of immunochemotherapy or radioimmunochemotherapy confers increased survival, particularly in patients with advanced disease. LEVEL OF EVIDENCE IV Laryngoscope, 2021.
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Affiliation(s)
- Hannah J Brown
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Eleni A Varelas
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Ashwin Ganti
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Peter Papagiannopoulos
- Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Michelle Mark
- Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Bobby A Tajudeen
- Rush Sinus Program, Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
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5
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Zhang Y, Liu Y, Xia Z, Jin J, Xue K, Wang J, Sun H, Lv F, Liu X, Cao J, Hong X, Guo Y, Ma X, Zhang Q. Phase II study of sequential chemoradiotherapy with L-asparaginase, dexamethasone, ifosfamide, cisplatin, and etoposide (DICE-L) in the early stage of extranodal natural killer (NK)/T-cell lymphoma. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1178. [PMID: 34430619 PMCID: PMC8350702 DOI: 10.21037/atm-21-3525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/22/2021] [Indexed: 11/11/2022]
Abstract
Background To explore a more effective treatment strategy for newly diagnosed stage I and II extranodal natural killer/T-cell lymphoma (ENKTL), nasal type, we conducted a prospective phase II study of sequential chemoradiotherapy with the L-asparaginase, dexamethasone, ifosfamide, cisplatin, and etoposide (DICE-L) regimen. Methods Patients with newly diagnosed stage I and II ENKTL in the upper-aerodigestive tract were enrolled. Treatment was comprised of up to 4 cycles of DICE-L followed by 50 Gy of intensity modulated radiation therapy (IMRT) to the involved field. The primary endpoint was the complete response (CR) rate. The secondary endpoints were the objective response rate (ORR), the 5-year overall survival (OS) rate, the 5-year progression-free survival (PFS) rate, and safety. Results A total of 81 patients were enrolled from June 2009 to May 2012 in Shanghai Cancer Hospital. Among these patients, 68 patients achieved CR and 1 patient achieved partial response (PR). The CR rate was 84%, and the ORR was 85.2%. With a median follow up of 88.1 months, the 5-year OS and 5-year PFS rates were 82.4% and 63.4%, respectively. The most common adverse events were grade 3 to 4 neutropenia (73.5%) and febrile neutropenia (21%). Conclusions Sequential chemoradiotherapy using DICE-L followed by radiotherapy is an effective treatment modality for stage I to IIE ENKTL and is safe with acceptable toxicity.
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Affiliation(s)
- Yao Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yizhen Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zuguang Xia
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jia Jin
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kai Xue
- Department of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiachen Wang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hui Sun
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fangfang Lv
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaojian Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Junning Cao
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaonan Hong
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ye Guo
- Department of Medical Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xuejun Ma
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qunling Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Lehrich BM, Abiri A, Goshtasbi K, Birkenbeuel J, Yasaka TM, Papagiannopoulos P, Tajudeen BA, Brem EA, Kuan EC. Treatment Modalities and Survival Outcomes for Sinonasal Diffuse Large B-Cell Lymphoma. Laryngoscope 2021; 131:E2727-E2735. [PMID: 33899946 DOI: 10.1002/lary.29584] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/25/2021] [Accepted: 04/14/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study utilizes a large population national database to comprehensively analyze prognosticators and overall survival (OS) outcomes of varying treatment modalities in a large cohort of sinonasal diffuse large B-cell lymphoma (SN-DLBCL) patients. STUDY DESIGN Retrospective database study. METHODS The National Cancer Database was queried for all SN-DLBCL cases diagnosed from 2004 to 2015. Kaplan-Meier log-rank test determined differences in OS based on clinical covariates. Cox proportional-hazards analysis was used to determine clinical and sociodemographic covariates predictive of mortality. RESULTS A total of 2,073 SN-DLBCL patients were included, consisting of 48% female with a mean age of 66.0 ± 16.2 years. Overall, 82% of patients were Caucasian, 74% had early-stage disease, and 49% had primary tumors in the paranasal sinuses. Early-stage patients were more likely to receive multi-agent chemoradiotherapy compared to multi-agent chemotherapy alone (P < .001). Multivariable Cox proportional-hazards analysis revealed chemoradiotherapy to confer significantly greater OS improvements than chemotherapy alone (hazard ratio [HR]: 0.61; P < .001). However, subset analysis of late-stage patients demonstrated no significant differences in OS between these treatment modalities (P = .245). On multivariable analysis of chemotherapy patients treated post-2012, immunotherapy (HR = 0.51; P = .024) demonstrated significant OS benefits. However, subset analysis showed no significant advantage in OS with administering immunotherapy for late-stage patients (P = .326). Lastly, for all patients treated post-2012, those receiving immunotherapy had significantly improved OS compared to those not receiving immunotherapy (P < .001). CONCLUSIONS Treatment protocol selection differs between early- and late-stage SN-DLBCL patients. Early-stage patients receiving chemotherapy may benefit from immunotherapy as part of their treatment paradigm. LEVEL OF EVIDENCE III Laryngoscope, 2021.
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Affiliation(s)
- Brandon M Lehrich
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A.,Medical Scientist Training Program, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, Pennsylvania, U.S.A
| | - Arash Abiri
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Jack Birkenbeuel
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Tyler M Yasaka
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
| | - Peter Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Elizabeth A Brem
- Department of Hematology and Oncology, University of California, Irvine, California, U.S.A
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, U.S.A
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Fabre C, Gil H, Righini CA. Resistant rhinosinusitis? Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138:407-408. [PMID: 33642234 DOI: 10.1016/j.anorl.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C Fabre
- Service hospitalo-universitaire d'ORL et chirurgie cervico-faciale, CHU de Grenoble-Alpes (CHUGA), 38043 Grenoble cedex 09, France; Faculté de médecine, Universités des Alpes, 38043 Grenoble cedex 09, France.
| | - H Gil
- Service hospitalo-universitaire d'ORL et chirurgie cervico-faciale, CHU de Grenoble-Alpes (CHUGA), 38043 Grenoble cedex 09, France; Faculté de médecine, Universités des Alpes, 38043 Grenoble cedex 09, France
| | - C-A Righini
- Service hospitalo-universitaire d'ORL et chirurgie cervico-faciale, CHU de Grenoble-Alpes (CHUGA), 38043 Grenoble cedex 09, France; Faculté de médecine, Universités des Alpes, 38043 Grenoble cedex 09, France; UGA/UMR/CNRS 5309/Inserm 1209, Institut Albert-Bonniot, 38043 Grenoble cedex 09, France
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8
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Santambrogio E, Nicolosi M, Vassallo F, Castellino A, Novo M, Chiappella A, Vitolo U. Aggressive Non-Hodgkin lymphomas: risk factors and treatment of central nervous system recurrence. Expert Rev Hematol 2019; 12:787-796. [DOI: 10.1080/17474086.2019.1643232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Elisa Santambrogio
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Maura Nicolosi
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Francesco Vassallo
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Alessia Castellino
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Mattia Novo
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Annalisa Chiappella
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Umberto Vitolo
- Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
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Hao S, Sun Y, Hu C, Zhi Y, Xiao H, Li Y. Primary nasal diffuse large B-cell lymphoma with synchronous pulmonary involvement: A case report. Medicine (Baltimore) 2019; 98:e15439. [PMID: 31027146 PMCID: PMC6831417 DOI: 10.1097/md.0000000000015439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Diffuse large B-cell lymphoma (DLBCL) is the most commonly occurring type of non-Hodgkin's lymphoma, which may be found at various extranodal sites. The nose is not a common site for DLBCL as compared with natural killer/T-cell lymphoma, and synchronous pulmonary involvement is even rarer. We report a case of primary nasal DLBCL who presented with a mass in the left lower lobe, mimicking primary lung carcinoma. PATIENT CONCERNS A 62-year-old Chinese female visited the Ear-Nose-Throat Department of our hospital with nasal congestion and rhinorrhea for 2 months. DIAGNOSIS Computed tomography scan revealed a mass with soft tissue density in the left vestibule and nasal cavity. Histopathological examination revealed a large number of lymphoma cells, and immunohistochemistry confirmed the diagnosis of DLBCL. INTERVENTIONS The patient was treated with 6 cycles of R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisone, and rituximab). OUTCOMES The treatment was well tolerated and led to complete remission for the patient. There was no sign of relapse over the 3-year close follow-up LESSONS:: DLBCL can be present at various extranodal sites and clinicians irrespective of their specialty must be vigilant for the synchronous mode of presentation of such lesions. Immunohistochemical techniques play a vital role in the diagnosis, because clinical characteristics may be misleading.
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Affiliation(s)
- Shuhong Hao
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Yan Sun
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Chunmei Hu
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Yunhui Zhi
- Department of Ultrasound, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Han Xiao
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
| | - Yarong Li
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin
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10
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Varelas AN, Eggerstedt M, Ganti A, Tajudeen BA. Epidemiologic, prognostic, and treatment factors in sinonasal diffuse large B -cell lymphoma. Laryngoscope 2018; 129:1259-1264. [PMID: 30570148 DOI: 10.1002/lary.27639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/16/2018] [Accepted: 09/04/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To further characterize the epidemiology, prognostic disease-specific factors, and treatment outcomes-including newly available chemotherapy data-for patients with sinonasal diffuse large B-cell lymphoma (DLBCL). METHODS The Surveillance, Epidemiology, and End Results registry was queried from 1973 to 2015 for patients with DLBCL of the nasal cavity and paranasal sinuses. Demographic and disease parameters were collected. Prognostic disease-specific survival and overall survival factors were evaluated with univariate Kaplan-Meier analysis. Significant variables were analyzed with multivariate Cox regression analysis. RESULTS A total of 1,273 cases of DLBCL of the sinonasal tract were identified. Significant differences in age of diagnosis between men (65.3) and women (71.1) existed (P < .01). Most common primary sites of DLBCL were maxillary sinus (36.1%) and nasal cavity (34.5%), with nasal cavity more common among Asian/Pacific Islands (43.4%) and maxillary sinus more common for Caucasians (36.3%) and African Americans (42.1%). Overall survival was 70% at 2 years, 54% at 5 years, and 38% at 10 years. Disease-specific survival was 81%, 73%, and 67%, respectively. Chemotherapy (hazard ratio [HR]: 0.551; P < .001) and radiation therapy (HR: 0.818; P = .012) were associated with improved prognosis, whereas higher Ann Arbor stage worsened prognosis (HR: 1.21; P < .001). Surgical intervention did not significantly impact survival. CONCLUSION This is the first study to include chemoradiation therapy in population-based analysis of sinonasal DLBCL. Chemotherapy and radiation therapy use significantly improve survival in these patients, whereas Ann Arbor staging is significantly associated with poorer outcomes. The mainstay of treatment for DLBCL should remain combination chemoradiation. LEVEL OF EVIDENCE NA Laryngoscope, 129:1259-1264, 2019.
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Affiliation(s)
- Antonios N Varelas
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Michael Eggerstedt
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Ashwin Ganti
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
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11
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Kewan T, Awada H, Covut F, Haddad A, Daw H. Late Central Nervous System Relapse in a Patient with Maxillary Sinus Lymphoma. Cureus 2018; 10:e3745. [PMID: 30820366 PMCID: PMC6388875 DOI: 10.7759/cureus.3745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Paranasal sinus lymphoma (PNL) is a rare presentation of extranodal non-Hodgkin lymphoma (NHL) with a natural history different from other types of lymphoma. The maxillary sinus is the most common paranasal sinus involved in NHL. Involvement of the central nervous system (CNS) is a rare complication of PNL. In this case report, we present a case of diffuse large B cell lymphoma (DLBL) that developed in the left maxillary sinus and relapsed as a left frontal brain mass after four years of disease remission.
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Affiliation(s)
- Tariq Kewan
- Internal Medicine, Cleveland Clinic - Fairview Hospital, Cleveland, USA
| | - Hassan Awada
- Internal Medicine, Cleveland Clinic - Fairview Hospital, Cleveland, USA
| | - Fahrettin Covut
- Internal Medicine, Cleveland Clinic - Fairview Hospital, Cleveland, USA
| | - Abdo Haddad
- Hematology and Oncology, Cleveland Clinic - Fairview Hospital, Cleveland, USA
| | - Hamed Daw
- Hematology and Oncology, Cleveland Clinic - Fairview Hospital, Cleveland, USA
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12
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RODRÍGUEZ-PÉREZ MA, SANMARTÍN-CABALLERO A, SALOM-COVEÑAS MC. Linfoma nasal de células T/Natural Killer. Descripción de un caso. REVISTA ORL 2017. [DOI: 10.14201/orl.16861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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13
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Kilic S, Kilic SS, Baredes S, Liu JK, Eloy JA. Survival, Morbidity, and Quality-of-Life Outcomes for Sinonasal and Ventral Skull Base Malignancies. Otolaryngol Clin North Am 2017; 50:467-480. [DOI: 10.1016/j.otc.2016.12.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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14
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[A Third nerve palsy that reveals a diffuse large B cell lymphoma in an octogenarian patient]. Rev Esp Geriatr Gerontol 2017; 52:286-288. [PMID: 28341218 DOI: 10.1016/j.regg.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/19/2017] [Accepted: 02/01/2017] [Indexed: 11/22/2022]
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15
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Tan B, Abdelmalek C, O'Donnell JE, Toltaku T, Chaudhry R, Wang JC, Gotlieb V. A Case Report of Primary Nasal Natural Killer (NK)/T-Cell Lymphoma in an African American Patient Presenting with Hemophagocytic Syndrome. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:160-165. [PMID: 28193996 PMCID: PMC5319307 DOI: 10.12659/ajcr.900995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Patient: Male, 55 Final Diagnosis: Primary NK-T cell lymphoma • nasal type Symptoms: Fever • nasal bleeding • nasal mass • weight loss Medication: — Clinical Procedure: Chemotherapy×2 cycles • radiation therap Specialty: Oncology
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Affiliation(s)
- Bowei Tan
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Cherif Abdelmalek
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - James E O'Donnell
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Thomas Toltaku
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Rashid Chaudhry
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Jen C Wang
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
| | - Vladimir Gotlieb
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA
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16
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Kuan EC, Tajudeen BA, Bhuta SM, Palma Diaz MF, Kedeshian PA, Suh JD. Incidental finding of lymphoma after septoplasty. ALLERGY & RHINOLOGY 2016; 7:90-5. [PMID: 27470206 PMCID: PMC5010439 DOI: 10.2500/ar.2016.7.0153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Septoplasty, or surgical correction of the deviated septum, is an elective, routinely performed rhinologic procedure to address nasal airway obstruction. In many cases, resected septal cartilage and bone fragments are sent for pathologic review, although there is no consensus on this practice. We reported two cases of incidentally diagnosed lymphoma after elective septoplasty and discussed clinical presentation, diagnosis, and management. Methods: Retrospective chart review of two patients who underwent septoplasty at a tertiary academic medical center and found to have incidental lymphoma based on histopathology. Results: Two patients who underwent septoplasty had an incidental diagnosis of lymphoma on pathologic analysis. One patient was noted to have an S-shaped septal deviation that produced bilateral nasal obstruction. She underwent a difficult septoplasty, in which the mucoperichondrial flap was firmly adherent to the underlying septum and bone. Final pathology demonstrated diffuse large B-cell lymphoma. She was treated with chemoradiation and remained free of disease at 59 months. The other patient had a history of nasal trauma, which produced left septal deviation. He underwent an uncomplicated septoplasty, with pathology that demonstrated low-grade B-cell lymphoma. Because there was no evidence of active disease, the decision was made to not treat and to observe the patient clinically. Conclusions: This is the first reported series of septal lymphoma incidentally diagnosed on routine septoplasty. Although histopathologic review of specimens from routine nasal and sinus surgery is not routinely performed, this report highlighted the importance of this process, on a case-by-case basis, in detecting unexpected malignancies that otherwise were clinically silent.
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Affiliation(s)
- Edward C Kuan
- Department of Head and Neck Surgery, University of California, Los Angeles (UCLA), Los Angeles, California, USA
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17
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Abstract
Various hematolymphoid lesions involve the sinonasal tract, including aggressive B, T, and NK-cell neoplasms; myeloid sarcoma; low-grade lymphomas; indolent T-lymphoblastic proliferations; and Rosai-Dorfman disease. Differentiating aggressive lymphomas from non-hematopoietic neoplasms such as poorly differentiated squamous cell carcinoma, olfactory neuroblastoma, or sinonasal undifferentiated carcinoma may pose diagnostic challenges. In addition, the necrosis, vascular damage, and inflammatory infiltrates that are associated with some hematolymphoid disorders can result in misdiagnosis as infectious, autoimmune, or inflammatory conditions. Here, we review hematolymphoid disorders involving the sinonasal tract including their key clinical and histopathologic features.
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Affiliation(s)
- Genevieve M Crane
- Department of Pathology, The Johns Hopkins Medical Institutions, Weinberg 2242, 401 N Broadway, Baltimore, Maryland 21231-2410
| | - Amy S Duffield
- Department of Pathology, The Johns Hopkins Medical Institutions, Weinberg 2242, 401 N Broadway, Baltimore, Maryland 21231-2410.
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18
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An unusual presentation of NK/T-cell lymphoma, nasal-type in the United States. Am J Otolaryngol 2015; 36:80-3. [PMID: 25304998 DOI: 10.1016/j.amjoto.2014.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 07/18/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION NK/T-cell lymphoma (NKCL), nasal-type is rare in the United States, representing only 1.5% of non-Hodgkin lymphomas. Classically, patients initially present with nasal obstruction (70%), caused by invasion of the localized lesion into the sinuses and nasal cavities. Initial presentation with persistent sore throat and odynophagia due to oropharyngeal tumor extension is rare, and thus, is often overlooked as viral or bacterial pharyngitis. By studying a case of NKTCL nasal type, we emphasize the need to apply high clinical suspicion for NKTCL, nasal type for early diagnosis and improved survival. METHODS A case report of a rare presentation of NKTCL, nasal-type is discussed. A literature review is provided to define clinical signs crucial for early diagnosis, appropriate work-up, and expedient treatment of this aggressive, rapidly progressive malignancy. RESULTS In the present case, a 25year-old healthy male presented with a 2-week history of sore throat and odynophagia. On exam, the patient had an ulcerative lesion of the soft palate, an enlarged uvula, and tonsillar exudate with tender submandibular lymphadenopathy. After the patient failed to respond to antibiotic therapy for presumptive pharyngitis, a biopsy of the oropharyngeal tissue was completed, which identified necrotizing sialometaplasia. High clinical suspicion led to repeat deep-tissue biopsy, where a final diagnosis of NKTCL, nasal type was made. The patient then began definitive treatment with chemotherapy and radiation. CONCLUSIONS High clinical suspicion is key to early diagnosis and improved survival of NKTCL, nasal-type. Otolaryngologists who encounter prolonged, complicated cases of pharyngitis or necrotizing sialometaplasia should consider a diagnosis of NKTCL, nasal-type, in order to prevent rapid disease progression.
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Lee GW, Go SI, Kim SH, Hong J, Kim YR, Oh S, Kim SY, Do YR, Lee H, Lee SI, Bae SH, Oh SY, Song MK, Lee WS, Lee B, Kim JS, Kim MK, Kang HJ, Ahn JS, Yhim HY, Kim HJ, Kim SJ, Kim WS, Suh C. Clinical outcome and prognosis of patients with primary sinonasal tract diffuse large B-cell lymphoma treated with rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy: a study by the Consortium for Improving Survival of Lymphoma. Leuk Lymphoma 2014; 56:1020-6. [DOI: 10.3109/10428194.2014.946027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas. Blood 2014; 124:720-8. [DOI: 10.1182/blood-2013-10-535021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Key Points
The results of this retrospective analysis do not support intrathecal prophylaxis or radiotherapy to ECFI patients in complete remission/unconfirmed complete remission.
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21
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22
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Diffuse large B-cell lymphoma of the sinonasal tract: analysis of survival in 852 cases. Am J Otolaryngol 2014; 35:154-8. [PMID: 24209993 DOI: 10.1016/j.amjoto.2013.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 09/20/2013] [Indexed: 11/22/2022]
Abstract
PURPOSE Diffuse large B-cell lymphomas (DLBCLs) are rare tumors of the head and neck that often have non-specific presentations and significant morbidity and mortality. In this analysis we use a large cohort to compare the demographic and disease-specific parameters affecting survival and incidence of DLBCLs. METHODS The United States National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry was utilized to extract data regarding sinonasal diffuse large B-cell lymphoma between 1973 and 2009. A total of 852 cases of sinonasal DLBCLs were found. Presenting symptoms, demographics, disease specific survival, relative survival and survival by treatment modality were described for this rare tumor. RESULTS Overall disease specific survival (DSS) at 1-year was 84.7% and at 5 years was 68.0%. DSS was significantly lower for those not treated with radiation therapy, with 1- and 5-year survival rates of 77.3% and 62.5%, versus those treated with radiation therapy, with 1- and 5-year rates of 89.2% and 71.5% (p<0.05). Prognosis was significantly better for patients treated with radiation therapy (HR 0.6, p<0.05) while it was poorer for patients with involvement of multiple sinuses (HR 1.5, 1.8, p<0.05). CONCLUSIONS DLBCLs of the sinonasal tract are rare tumors of the head and neck. Survival is significantly improved for those treated with radiation therapy while the involvement of multiple sinuses is a negative prognostic indicator.
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23
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Mian M, Capello D, Ventre MB, Grazio D, Svaldi M, Rossi A, Tsang R, Gospodarowicz MK, Oldani E, Federico M, Luminari S, Marcheselli L, Pogliani EM, Rossini F, Cabrera ME, Martelli M, Gutierrez-Garcia G, Busetto M, Visco C, Fiegl M, Rossi D, Gaidano G, Cavalli F, Zucca E, Rambaldi A, Cortelazzo S. Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biological characterization and 18 year follow-up of 488 patients (IELSG 23 study). Ann Hematol 2013; 93:221-231. [PMID: 23959436 DOI: 10.1007/s00277-013-1856-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 07/18/2013] [Indexed: 11/30/2022]
Abstract
It is known that extranodal head and neck diffuse large B cell lymphomas (eHN-DLBCL) can affect various anatomical structures what is not well-known, however, is whether they differ in terms of clinical presentation and outcome. Clinical data of the multi-institutional series, the largest of its kind as yet, has been analysed with the aim of answering these open questions and providing long-term follow-up information. Data from 488 patients affected by stage I/II eHN-DLBCL was collected: 300 of the Waldeyer's Ring (WR), 38 of the parotid and salivary glands (PSG), 48 of the thyroid gland (TG), 53 of the nasal cavity and paranasal sinuses (NPS), 24 of the palate and oral cavity (POC) and 25 with more than one involved site. Different eHN-DLBCL arising have distinct characteristics at presentation. The intermediate high risk-modified IPI was 67 % in TG, 44 % in WR, 38 % in PSG and POC and 20 % in MS. The worst 5-year survival rate had TG-DLBCL (61 %) due to the 61 % of patients with a mIPI >1. The addition of radiotherapy (cRT) to remitters did not translate into a survival advantage (5-year disease-free survival of 67 % in the cRT group vs. 70 % in the other). Three of four central nervous system recurrences occurred in NPS-DLBCL. Survival of HN-DLBCL was inferior to nodal DLBCL. This study showed that eHN-DLBCL remitters have an inferior survival when compared to nodal DLBCL, and that the addition of cRT does not provide a survival advantage. Since the standard of care nowadays is chemo-immunotherapy, survival of these patients might have been improved.
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Affiliation(s)
- M Mian
- Division of Hematology, Azienda Ospedaliera S. Maurizio, Bolzano/Bozen, Italy,
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Peterson JL, Hayostek CJ, Garvey C, Menke DM, Rivera CE. Hodgkin lymphoma of the maxillary sinus: an unusual occurrence. EAR, NOSE & THROAT JOURNAL 2012; 91:E16-9. [PMID: 22278873 DOI: 10.1177/014556131209100118] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The maxillary sinus is a rare anatomic site for Hodgkin lymphoma, as only 1 such case has been previously reported in the literature. Nevertheless, we recommend that lymphoma be considered in the differential diagnosis of a mass that involves the maxillary sinus or any other unusual extranodal site in the head and neck. Lymphoma in a patient who presents with disease in an unusual site and without lymphadenopathy is difficult to diagnose. We report the case of a 60-year-old woman who presented with nasal congestion and obstruction. Examination revealed an abnormal-appearing mucosa involving the maxillary sinus. Subsequent evaluation led to a diagnosis of Hodgkin lymphoma. Because making such a diagnosis is difficult, close attention to radiologic and pathologic findings is important. Our review of the literature revealed that treatment commonly includes chemotherapy and radiotherapy, which yield excellent outcomes. The current standard of care for patients with similar-stage Hodgkin lymphoma at other sites can guide the treatment course for patients with extranodal Hodgkin lymphoma.
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Affiliation(s)
- Jennifer L Peterson
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL 32224, USA.
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25
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Compressive Optic Neuropathy Caused by Orbital Non-Hodgkin's Lymphoma. Case Rep Ophthalmol Med 2012; 2012:894062. [PMID: 22606505 PMCID: PMC3350013 DOI: 10.1155/2012/894062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 01/18/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose. To present a unique case of Non-Hodgkin's-Lymphoma- (NHL) associated compressive optic neuropathy. Method. An 89-year-old male presenting with acute unilateral visual loss and headache. Results. Patient was initially diagnosed with occult giant cell arteritis; however after visual acuity deteriorated despite normal inflammatory markers, an urgent MRI scan revealed an extensive paranasal sinus mass compressing the optic nerve. Conclusion. Paranasal sinus malignancies occasionally present to the ophthalmologist with signs of optic nerve compression and must be included in the differential diagnosis of acute visual loss.
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Lu NN, Li YX, Wang WH, Jin J, Song YW, Zhou LQ, Wang SL, Liu YP, Liu XF, Yu ZH. Clinical behavior and treatment outcome of primary nasal diffuse large B-cell lymphoma. Cancer 2011; 118:1593-8. [PMID: 21837667 DOI: 10.1002/cncr.26452] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 06/21/2011] [Accepted: 06/23/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND Nasal diffuse large B-cell lymphoma (DLBCL) is rare. The objective of this study was to evaluate the clinical features and treatment outcomes of patients with nasal DLBCL. METHODS Twenty-five patients were included in the study. All patients received combination chemotherapy with or without radiotherapy. RESULTS Patients with nasal DLBCL usually were older and were predominantly men with early stage disease, low frequency of B symptoms and elevated lactate dehydrogenase (LDH), good performance status, and a low-risk international prognostic index (IPI) score. The overall response rate after initial treatment was 76%, the 3-year overall survival (OS) rate for the whole group was 44%, and the median OS was 35 months. Performance status and IPI were significant prognostic factors for OS. For patients with IPI scores of 0 or 1, the 3-year OS rate was 54%, and the median OS was 52 months compared with 17% and 11 months, respectively, for patients with IPI scores of 2 or 3 (P = .033). The prognosis for patients who achieved a complete response (CR) was significantly better than that for patients who did not achieve a CR. Extranodal spread was the primary pattern of failure. CONCLUSIONS The current results indicated that primary nasal DLBCL appears to have distinct clinical features; its poor outcome and propensity for extranodal failure illustrate the need for innovative therapies.
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Affiliation(s)
- Ning-Ning Lu
- Department of Radiation Oncology, Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Hayashi T, Watanabe K, Tsuura Y, Tsuji G, Koyama S, Yoshigi J, Hirata N, Yamane S, Iizima Y, Toyota S, Takeuchi S. Sight-threatening optic neuropathy is associated with paranasal lymphoma. Clin Ophthalmol 2010; 4:143-6. [PMID: 20390034 PMCID: PMC2850826 DOI: 10.2147/opth.s8907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Indexed: 11/23/2022] Open
Abstract
Malignant lymphoma around the orbit is very rare. We present a rare case of optic neuropathy caused by lymphoma. A 61-year-old Japanese woman was referred to our hospital for evaluation of idiopathic optic neuropathy affecting her right eye. The patient was treated with steroid pulse therapy (methyl-predonisolone 1 g daily for 3 days) with a presumed diagnosis of idiopathic optic neuritis. After she had been switched to oral steroid therapy, endoscopic sinus surgery had been performed, which revealed diffuse large B cell lymphoma of the ethmoidal sinus. Although R-CHOP therapy was immediately started, prolonged optic nerve compression resulted in irreversible blindness. Accordingly, patients with suspected idiopathic optic neuritis should be carefully assessed when they show a poor response, and imaging of the orbits and brain should always be done for initial diagnosis because they may have compression by a tumor.
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Affiliation(s)
- Takahiko Hayashi
- Department of Ophthalmology, Yokosuka Kyosai Hospital, Kanagawa, Japan.
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Reyes VE, Al-Saleem T, Robu VG, Smith MR. Extranodal NK/T-cell lymphoma nasal type: efficacy of pegaspargase. Report of two patients from the United Sates and review of literature. Leuk Res 2009; 34:e50-4. [PMID: 19786301 DOI: 10.1016/j.leukres.2009.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 08/30/2009] [Accepted: 09/02/2009] [Indexed: 12/11/2022]
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29
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Karantanis D, Subramaniam RM, Peller PJ, Lowe VJ, Durski JM, Collins DA, Georgiou E, Ansell SM, Wiseman GA. The value of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography in extranodal natural killer/T-cell lymphoma. ACTA ACUST UNITED AC 2008; 8:94-9. [PMID: 18501102 DOI: 10.3816/clm.2008.n.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To our knowledge, there are no published data pertinent to the use of [(18F)]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with natural killer (NK)/T-cell lymphoma. The purpose of this study was to assess the value of FDG PET/CT in this aggressive type of non-Hodgkin lymphoma. PATIENTS AND METHODS All patients with NK/T-cell lymphoma referred for FDG PET/CT at our institution from July 2001 to July 2006 were retrospectively studied. PET/CT examinations were blindly reviewed by 2 experienced readers. The results were compared with the status of the disease, which was determined after evaluation of biopsy, laboratory, clinical and conventional imaging examination, and follow-up results. PET/CT results were thereby classified as true-positive, true-negative, false-positive, or false-negative. The degree of FDG uptake in the positive lesions was semiquantified using maximum standard uptake value (SUV(max)). RESULTS Twenty-one PET/CT examinations were performed in 10 patients with NK/T-cell lymphoma. For nasal disease, PET/CT was true-positive in 5 cases, true-negative in 15 cases, and positive but unconfirmed in 1 case. For extranasal disease, PET/CT was true-positive in 3 cases, true-negative in 16 cases, and false-negative in 2 cases. The mean SUV(max) in PET-positive lesions in nasal cavities or paranasal sinuses was 16 gm/mL (range, 5-25 gm/mL; median, 19.3 gm/mL). In extranasal disease, the mean SUV(max) was 10.9 gm/mL (range, 4.6-34.1 gm/mL; median, 5.6 gm/mL). CONCLUSION Viable NK/T-cell lymphoma is intensely FDG hypermetabolic. PET/CT appears to be sensitive for the detection of disease in the nasopharynx and, to a lesser extent, in extranasal sites.
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Affiliation(s)
- Dimitrios Karantanis
- Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
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Nagasaki A, Miyagi T, Taira T, Shinhama A, Kojya S, Suzuki M, Aonahata M, Yoshimi N, Takasu N. Adult T-cell leukemia/lymphoma with multiple integration of HTLV-1 provirus presenting as an isolated paranasal sinus tumor: A case report. Head Neck 2008; 30:815-20. [DOI: 10.1002/hed.20730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Wang B, Lu JJ, Ma X, Guo Y, Lu H, Hong X, Li J. Combined chemotherapy and external beam radiation for stage IE and IIE natural killer T-cell lymphoma of nasal cavity. Leuk Lymphoma 2007; 48:396-402. [PMID: 17325902 DOI: 10.1080/10428190601059795] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To evaluate the outcome of CHOP chemotherapy and radiotherapy in Stage IE and IIE nasal natural killer (NK)/T-cell lymphoma, 53 patients with stage IE and IIE nasal NK/T-cell lymphoma were studied. By the Ann Arbor Lymphoma Staging Classification, 41 patients (77%) had Stage IE disease and 12 patients (23%) had Stage IIE disease. All patients were treated curatively using chemotherapy, followed by radiotherapy. Chemotherapy consisted of up to six cycles of the standard CHOP based regimen. The median radiation dose to the tumor bed was 45 Gy for all patients. The median follow-up for all 39 surviving patients was 30.2 months (range, 6 - 104 months). Twenty-six patients had complete response after chemotherapy, and all patients who completed first line chemotherapy achieved complete response after radiotherapy. The 2-year overall survival and progression-free survival rates were 75.6% and 61.8%, respectively. Multivariate analysis revealed that perforation as a presenting symptom, elevated pretreatment serum lactate dehydrogenase level, and ECOG performance status >or=2 were significant independent prognostic factors for this group of patients. Combined chemotherapy followed by involved field radiation produced suboptimal outcome for patients with early stage nasal NK/T-cell lymphoma. Further investigations, preferably prospective clinical trials, for more efficacious treatment strategies are needed to improve the treatment outcome of this malignancy.
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Affiliation(s)
- Biyun Wang
- Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai, People's Republic of China
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Guo Y, Lu JJ, Ma X, Wang B, Hong X, Li X, Li J. Combined chemoradiation for the management of nasal natural killer (NK)/T-cell lymphoma: elucidating the significance of systemic chemotherapy. Oral Oncol 2007; 44:23-30. [PMID: 17306611 DOI: 10.1016/j.oraloncology.2006.11.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Revised: 11/25/2006] [Accepted: 11/27/2006] [Indexed: 11/29/2022]
Abstract
The objective of this analysis was to evaluate the efficacy and treatment outcome of CHOP and CHOP combined with nitrosourea chemotherapy in natural killer (NK)/T-cell lymphoma of the nasal cavity. Sixty-three patients with NK/T-cell lymphoma of the nasal cavity were treated with CHOP or CHOP combined with oral nitrosourea chemotherapy between January 1997 and June 2005. By the Ann Arbor Lymphoma Staging Classification, 57 patients (90%) had Stage IE or IIE disease and six patients (10%) had Stage III or IV disease. All patients with Stage IE or IIE disease were intended to be treated curatively with combined chemoradiation; and patients who had Stage III or IV disease were treated with chemotherapy alone with curative intention. Chemotherapy consisted of: (1) up to six cycles of the standard CHOP based regimen, or (2) up to six cycles of the standard CHOP based regimen with oral Semustine dosed at 120 mg (or Lomustine dosed at 100mg) on day 1 of each chemotherapy cycle. External beam radiation therapy was delivered by daily conventional fractionation by Co-60 or 6MVx linear accelerator for patients with Stage IE or IIE disease. The radiation dose to the tumor bed was between 36 and 50 Gy with a median dose of 45 Gy. Fifty-three patients received chemotherapy prior to radiation, and four patients were treated with involved field radiation before chemotherapy. The median follow up for all 44 surviving patients was 31 months (range: 6-104 months). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 60% and 70%, respectively. The PFS and OS of patients who were treated with or without oral nitrosourea in addition to CHOP were 73% vs. 44% (P=0.035) and 75% vs. 64% (P=0.276), respectively. Nine patients with Stage IE or IIE diseases developed disease progression during their planned treatment and died within 10 months after the initiation of treatment; Six patients who achieved complete response (CR) after planned chemoradiation developed systemic recurrence and died at 13-48 months despite salvage treatment; one patient died of Hemophagocytic Syndrome during radiotherapy after achieving CR from chemotherapy. Three patients with Stage III or IV disease died during chemotherapy or during salvage treatment at 2, 4, and 19 months, respectively. Among the 59 patients who received chemotherapy as their initial treatment, 29, 6, 12, and 12 patients had complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) respectively after chemotherapy. The 2-year overall survival rates for these four groups of patients were 100%, 75%, 60%, and 17%, respectively (P<0.0001). Multivariate analysis revealed that International Prognostic Index (IPI) for Lymphoma, perforation of nasal septum as a presenting symptom, "B" symptoms, ECOG performance, as well as response after chemotherapy, were significant independent prognostic factors for this group of patients. The extent of response after induction chemotherapy is significantly related to the treatment outcome of patients with nasal NK/T-cell lymphoma. CHOP based chemotherapy combined with oral nitrosourea followed by involved field radiotherapy may provide improved treatment results compared to conventional CHOP chemotherapy and radiation. This strategy needs to be optimized and tested in a prospective trial for its efficacy.
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Affiliation(s)
- Ye Guo
- Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai, China
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Bossard C, Belhadj K, Reyes F, Martin-Garcia N, Berger F, Kummer JA, Brière J, Baglin AC, Cheze S, Bosq J, Ribrag V, Gisselbrecht C, Mounier N, Gaulard P. Expression of the granzyme B inhibitor PI9 predicts outcome in nasal NK/T-cell lymphoma: results of a Western series of 48 patients treated with first-line polychemotherapy within the Groupe d'Etude des Lymphomes de l'Adulte (GELA) trials. Blood 2006; 109:2183-9. [PMID: 17077322 DOI: 10.1182/blood-2006-07-033142] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AbstractNasal NK/T-cell lymphoma is a rare disease entity with a poor outcome. Expression of antiapoptotic proteins has not been extensively investigated in this entity. Forty-eight patients with nasal T/NK-cell lymphoma who received first-line polychemotherapy (n = 44) or chemoradiotherapy (n = 4) were analyzed for expression of active caspase-3 (aC3), granzyme B protease inhibitor 9 (PI9), and Bcl-2 proteins. Lymphomas were CD3+/CD5−/granzyme B+ and EBV-associated. Median age was 46 years. Stage I/II disease was present in 75% of the cases and an International Prognostic Index (IPI) score less than 1 in 65%. With a median follow-up of 6.3 years, 5-year event-free survival (EFS) and overall survival (OS) rates were 39% and 49%, respectively. Apoptotic index was scored as high in 32% of cases and PI9 expression as positive in 68%, whereas 35% disclosed a high number of aC3+ tumor cells. Univariate analysis showed that absence of PI9 and low apoptotic index were associated with poor outcome, but not aC3 expression nor IPI score. By multivariate analysis, both parameters affected independently EFS (P = .02 and .08, respectively) and OS (P = .009 and .04). In view of its constitutive expression by normal NK cells, it is suggested that loss of PI9 expression in tumor cells may reflect some mechanism associated with progression.
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Affiliation(s)
- Céline Bossard
- Département de Pathologie and Institut National de la Santé et de la Recherche Médicale (Inserm) Unité (U) 617, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
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Abstract
Paranasal sinus lymphoma is an uncommon malignancy and is often difficult to diagnose. Early diagnosis is essential for effective treatment. The tumour generally has poor prognosis. Ophthalmological symptoms and signs occur early in the disease process due to the close proximity of the orbit to the paranasal sinuses. Common presenting features include eye pain, proptosis, visual loss and diplopia. We report a case of frontal sinus lymphoma that presented as a superior-nasal orbital mass in an 84 year old man. CT scan demonstrated a mass occupying the frontal sinuses, with destruction of the anterior bony wall of the frontal sinus and extending to the right orbit. Histology revealed diffuse large B cell non Hodgkin's lymphoma. The tumor was treated with radiotherapy and showed regression; however the patient died 9 months later. Sinus tumours are encountered by ophthalmologists and should be considered in patients presenting with an orbital mass.
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Affiliation(s)
- Arie Y Nemet
- Department of Ophthalmology, Sydney Hospital, Sydney, NSW, Australia.
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Sjö LD, Ralfkiaer E, Juhl BR, Prause JU, Kivelä T, Auw-Haedrich C, Bacin F, Carrera M, Coupland SE, Delbosc B, Ducrey N, Kantelip B, Kemeny JL, Meyer P, Sjö NC, Heegaard S. Primary lymphoma of the lacrimal sac: an EORTC ophthalmic oncology task force study. Br J Ophthalmol 2006; 90:1004-9. [PMID: 16672329 PMCID: PMC1857190 DOI: 10.1136/bjo.2006.090589] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To define the clinical and histopathological characteristics of primary lacrimal sac lymphoma in a predominantly white population. METHODS Specimens of lacrimal sac lymphoma and follow up data were solicited from members of the Ophthalmic Oncology Task Force of the European Organization for Research and Treatment of Cancer (EORTC) and the European Ophthalmic Pathology Society (EOPS). Specimens were stained with haematoxylin and eosin and an immunohistochemical panel against leucocyte antigens was applied. Diagnosis was reached by consensus of five experienced pathologists according to the World Health Organization classification system. The histopathological findings were correlated with the clinical data. RESULTS Of 15 primary lacrimal sac lymphomas, five (33%) were diffuse large B cell lymphoma (DLBCL), five (33%) were extranodal marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT lymphoma), three were classified as "transitional MALT lymphoma," being in transition from MALT lymphoma to DLBCL, and two were unclassified B cell lymphomas. Nine of the patients were female, and the median age at the time of diagnosis was 71 years (range 45-95 years). The most frequent presenting symptoms were epiphora (85%), swelling in the region of the lacrimal sac (79%), and dacryocystitis (21%). All but one patient presented in stage I. Systemic spread occurred in three of nine patients (33%). The 5 year overall survival was 65%. CONCLUSIONS DLBCL and MALT lymphoma are equally common in the lacrimal sac in contrast with the remaining periorbital and/or orbital region where MALT lymphoma predominates.
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MESH Headings
- Aged
- Aged, 80 and over
- Antigens, CD/metabolism
- Antigens, Neoplasm/metabolism
- Female
- Humans
- Lacrimal Apparatus Diseases/diagnosis
- Lacrimal Apparatus Diseases/pathology
- Lacrimal Apparatus Diseases/therapy
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Male
- Middle Aged
- Retrospective Studies
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Affiliation(s)
- L D Sjö
- Eye Pathology Institute, University of Copenhagen, Denmark
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Baier G, Völter C, Steigerwald I, Müller J, Schwager K. [Malignant paranasal sinus tumors. Diagnosis, therapy and results]. HNO 2006; 53:957-65. [PMID: 15883842 DOI: 10.1007/s00106-005-1251-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Malignant neoplasmas of the paranasal sinuses are rare and present usually in advanced tumor stage due to the lack of early clinical symptoms. PATIENTS AND METHODS In the last 10 years, 63 patients with paranasal malignancies were treated at the Department of Otolaryngology, Head and Neck Surgery of the University of Würzburg. 33% of the patients showed an occupational exposition (wood-processing or metal industry). At the time of the first visit to our institution 95% of the patients presented with an extensive disease, staged T3 and T4. Adenocarcinoma (24%), squamous cell carcinoma (22%) and malignant melanoma (19%) were the most common histologies. Surgery combined with radiotherapy was the treatment strategy in 55 patients (87%). RESULTS Patients with a complete surgical resection showed a higher 5-year-survival rate (77%) than patients with an incomplete resection (56%). In 38% (n=21) of the patients treated with surgery and radiotherapy, a local recurrence of the tumor was observed. This recurrence localised in the skull base and/or the orbita/periorbita occurred most frequently in the first (46%) or the second year (31%). CONCLUSION The prognosis of malignant paranasal tumors depends mainly on the control of the local tumor growth. Modern strategies of surgical treatment in combination with radiotherapy need to be implemented in an effort to achieve a continuous remission.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/mortality
- Adenocarcinoma/pathology
- Adenocarcinoma/surgery
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Child
- Combined Modality Therapy
- Cross-Sectional Studies
- Disease-Free Survival
- Female
- Humans
- Male
- Melanoma/diagnosis
- Melanoma/mortality
- Melanoma/pathology
- Melanoma/surgery
- Middle Aged
- Neoplasm Invasiveness/pathology
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasm Staging
- Occupational Diseases/diagnosis
- Occupational Diseases/mortality
- Occupational Diseases/pathology
- Occupational Diseases/surgery
- Paranasal Sinus Neoplasms/diagnosis
- Paranasal Sinus Neoplasms/mortality
- Paranasal Sinus Neoplasms/pathology
- Paranasal Sinus Neoplasms/surgery
- Prognosis
- Radiotherapy, Adjuvant
- Retrospective Studies
- Survival Rate
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Affiliation(s)
- G Baier
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Kopf- und Halschirurgie, Bayerische Julius-Maximilians-Universität Würzburg.
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Narula S, Cherian S, Schuster S, Chalian AA, Apter AJ. A 65-year-old woman with intractable nasal congestion. Ann Allergy Asthma Immunol 2006; 96:281-5. [PMID: 16498848 DOI: 10.1016/s1081-1206(10)61236-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
MESH Headings
- Aged
- Diagnosis, Differential
- Female
- Humans
- Lymphoma, B-Cell/complications
- Lymphoma, B-Cell/diagnosis
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Nasopharyngeal Neoplasms/complications
- Nasopharyngeal Neoplasms/diagnosis
- Neoplasms, Second Primary/complications
- Neoplasms, Second Primary/diagnosis
- New England
- Otitis Externa/complications
- Otitis Externa/therapy
- Physical Examination
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/drug therapy
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Affiliation(s)
- Shilpi Narula
- Division of Pulmonary, Allergy, and Critical Care Medicine, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Li YX, Yao B, Jin J, Wang WH, Liu YP, Song YW, Wang SL, Liu XF, Zhou LQ, He XH, Lu N, Yu ZH. Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T-cell lymphoma. J Clin Oncol 2006; 24:181-9. [PMID: 16382127 DOI: 10.1200/jco.2005.03.2573] [Citation(s) in RCA: 281] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
UNLABELLED PURPOSE The optimal therapy remains unclear for nasal natural killer (NK)/T-cell lymphoma. The purpose of this study is to analyze the outcome of radiotherapy as the primary treatment for localized stage IE and IIE diseases. PATIENTS AND METHODS One hundred five patient cases were reviewed. There were 83 stage IE and 22 stage IIE patients. All except three patients received radiotherapy (RT) alone or RT combined with chemotherapy (CT; combined-modality therapy [CMT]). Overall, 31 patients were treated with RT alone, 34 with RT followed by CT, 37 with CT followed by RT, and three with CT alone. RESULTS Five-year overall survival (OS) and progression-free survival (PFS) for all patients were 71% and 59%, respectively. The 5-year OS and PFS were 78% and 63% for stage IE, and 46% and 40% for stage IIE, respectively. Complete response (CR) was achieved in 91 patients (87%) after RT and/or CT. Initial RT resulted in a superior CR as compared with initial CT, with 54 (83%) of 65 patients achieving CR with initial RT, versus only eight (20%) of 40 after initial CT. For 102 patients who received RT with or without CT, the outcome of primary treatment with RT alone was compared with that of CMT. Five-year OS and PFS was 66% and 61% for RT alone, and 76% and 61%% for CMT, respectively (OS, P = .6433; PFS, P = .8391). CONCLUSION RT as primary therapy resulted in good outcome in early-stage disease, and the addition of CT to RT was not accompanied by an improvement in survival.
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Affiliation(s)
- Ye-Xiong Li
- Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China.
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Oprea C, Cainap C, Azoulay R, Assaf E, Jabbour E, Koscielny S, Lapusan S, Vanel D, Bosq J, Ribrag V. Primary diffuse large B-cell non-Hodgkin lymphoma of the paranasal sinuses: a report of 14 cases. Br J Haematol 2005; 131:468-71. [PMID: 16281936 DOI: 10.1111/j.1365-2141.2005.05787.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Sinonasal lymphoma (SL) is a rare form of extranodal lymphoma. Of 33 SL cases, 14 consecutive diffuse large B-cell lymphomas were treated with CHOP (adriamycin, cyclophosphamide, vincristine and prednisone) or CHOP-like chemotherapy regimen. Ten achieved complete remission (CR) and three achieved a partial remission. With a median follow-up period of 80 months, seven patients relapsed or progressed [one case including central nervous system (CNS) progression]. Four of the relapses involved the CNS. Eight patients were alive, including seven in CR and six patients had died of their lymphoma. This observation strongly suggests that CNS prophylaxis should be used in SL.
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Affiliation(s)
- C Oprea
- Department of Medicine, Institut Gustave Roussy, Villejuif, France
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Abstract
Lymphoid neoplasms that are derived from natural killer (NK) cells are uncommon but distinct clinicopathologic disease entities. Three types have been recognized and categorized in the latest World Health Organization classification: extranodal NK cell lymphoma, nasal-type; aggressive NK cell leukemia; and blastic NK cell lymphoma. All NK tumor cells express the NK cell marker CD56, but they lack the expression of surface CD3 and the rearrangement of T-cell receptor genes, which distinguish them from T-lymphoid neoplasms. There is also a strong association with the Epstein-Barr virus, except in blastic NK cell lymphoma. Extranodal involvement by the NK cell tumor is common, especially in the nasal cavity, the skin, and the gastrointestinal tract. All 3 NK cell neoplasms are characterized by aggressive clinical course and poor response to treatment. Although the optimal treatment modality remains to be determined, good initial response to combined radiation therapy and chemotherapy has been observed in localized disease. Further studies in the basic biology of the NK cell and the pathology of NK cell neoplasms may shed light on the development of newer and more effective therapy.
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Affiliation(s)
- Eric Tse
- University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
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Götte K, Hörmann K. Sinonasal malignancy: what's new? ORL J Otorhinolaryngol Relat Spec 2004; 66:85-97. [PMID: 15162007 DOI: 10.1159/000077801] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2003] [Accepted: 01/09/2004] [Indexed: 11/19/2022]
Abstract
Tumors of the nasal cavity are located at a complex anatomic site and show a huge histological diversity. Although dealing with a rare malignancy, the last decade has brought--besides new histological and clinical classifications--a variety of new insights into etiological agents, tumor biology and therapeutic concepts as well as valuable overviews of rare histological subtypes. This review tries to disentangle the different medical and scientific aspects of the most frequently encountered histological types of tumors in the nasal cavity and the paranasal sinuses. We concentrate on epidemiology, classification, etiology, cytogenetics and molecular genetics, outcome and prognosis as well as treatment modalities, as far as the past few years have brought considerable new insights. Our principal aim is to provide the clinician with important data from publications of the last decade.
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Affiliation(s)
- Karl Götte
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.
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You JY, Chi KH, Yang MH, Chen CC, Ho CH, Chau WK, Hsu HC, Gau JP, Tzeng CH, Liu JH, Chen PM, Chiou TJ. Radiation therapy versus chemotherapy as initial treatment for localized nasal natural killer (NK)/T-cell lymphoma: a single institute survey in Taiwan. Ann Oncol 2004; 15:618-25. [PMID: 15033670 DOI: 10.1093/annonc/mdh143] [Citation(s) in RCA: 158] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To clarify the role of intention to treat for patients with localized nasal natural killer (NK)/T-cell lymphoma, and to determine the prognostic factors for these patients. PATIENTS AND METHODS We conducted a retrospective review of 46 patients with localized nasal NK/T-cell lymphomas treated at a single institute between January 1988 and July 2002. RESULTS The type of intended treatment was a significant factor for overall survival (OS) (5-year OS: RT versus CT = 83.3% versus 28.6%, P = 0.0269) or failure-free survival (FFS) (5-year FFS: RT versus CT = 83.3% versus 27.1%, P = 0.0247). In the intended chemotherapy group, salvage with radiotherapy was superior to chemotherapy alone for OS (5-year OS: 42.2% versus 20.0%, P = 0.0252) or FFS (5-year FFS: 41.0% versus 20.0%, P = 0.0352). On multivariate analysis, both N stage and serum lactate dehydrogenase level were independent factors for OS and FFS. No radiotherapy was an independent adverse factor for OS; advanced T stage and more than one extranodal involvement were independent adverse factors for FFS. CONCLUSIONS Patients with localized nasal NK/T-cell lymphomas were better managed with radiotherapy as front-line therapy. The advantage of radiotherapy persisted even as palliative therapy after chemotherapy.
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Affiliation(s)
- J-Y You
- Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
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