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Zheng YH, Tian B, Qin WW, Zhu QW, Feng J, Hu WY, Chen RA, Liu L. Distribution and survival outcomes of primary head and neck hematolymphoid neoplasms in older people: a population-based study. Clin Exp Med 2023; 23:3957-3967. [PMID: 37093452 DOI: 10.1007/s10238-023-01069-2] [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: 02/08/2023] [Accepted: 04/05/2023] [Indexed: 04/25/2023]
Abstract
Primary head and neck hematolymphoid neoplasms (PHNHLN) are defined as a series of hematolymphoid system-derived neoplasms which primarily emanate in head and neck region. Due to the rarity and absence of symptomatic specificity, PHNHLN is easily neglected. The objective of this study is to investigate demographics, pathological subtype distribution, anatomical location, survival outcomes and prognostic factors of PHNHLN among older patients aged ≥ 60. The individual patient information in our study was derived from Surveillance, Epidemiology and End Results database. Descriptive epidemiological methods were used to analyze the distribution of histologic subtypes and primary anatomical sites. Kaplan-Meier survival curves and log-rank test were conducted to evaluate the effect of variables on the prognosis. Cox hazard regression was conducted to identify the independent prognostic factors. The male-to-female ratio in most pathological subtypes was close to 1:1. The most common pathological subtype was diffuse large B-cell lymphoma. The most commonly involved sites outside the lymph nodes were salivary glands, especially parotid gland, followed by tonsil, thyroid gland and tongue. The prognosis of mature T- and NK-cell non-Hodgkin lymphoma (NHL) was bleaker than Hodgkin lymphoma, mature B-cell NHL and plasma cell neoplasm. Age at diagnosis, presence of second primary malignancy (SPM), pathological subtype, Ann-Arbor stage, chemotherapy and radiation were independent prognostic factors of overall survival. Our study comprehensively reported the subtype distribution, anatomical sites and survival outcomes of PHNHLN among older patients, improving understanding of this rare group of cancer entities.
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Affiliation(s)
- Yan-Hua Zheng
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), No.1 Xin'si Road, Xi'an, 710038, Shaanxi, China
- National Clinical Research Center for Hematological Diseases of China, Shaanxi Branch Center, Clinical Research Center for Hematologic Disease of Shaanxi Province, Xi'an, Shaanxi, China
| | - Biao Tian
- Department of Hematology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, Shaanxi, China
| | - Wei-Wei Qin
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), No.1 Xin'si Road, Xi'an, 710038, Shaanxi, China
- National Clinical Research Center for Hematological Diseases of China, Shaanxi Branch Center, Clinical Research Center for Hematologic Disease of Shaanxi Province, Xi'an, Shaanxi, China
| | - Qing-Wen Zhu
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, Shaanxi, China
| | - Juan Feng
- Department of Hematology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, Shaanxi, China
| | - Wu-Yue Hu
- Department of Hematology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, Shaanxi, China
| | - Ren-An Chen
- Department of Internal Medicine II, Tumour Hospital of Shaanxi Province, No.309 Yan'ta West Road, Xi'an, Shaanxi, China.
| | - Li Liu
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), No.1 Xin'si Road, Xi'an, 710038, Shaanxi, China.
- National Clinical Research Center for Hematological Diseases of China, Shaanxi Branch Center, Clinical Research Center for Hematologic Disease of Shaanxi Province, Xi'an, Shaanxi, China.
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2
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Pant S, Kang SR, Lee M, Phuc PS, Yang HJ, Yang DH. Survival Prediction Using Transformer-Based Categorical Feature Representation in the Treatment of Diffuse Large B-Cell Lymphoma. Healthcare (Basel) 2023; 11:healthcare11081171. [PMID: 37108006 PMCID: PMC10137756 DOI: 10.3390/healthcare11081171] [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: 02/07/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a common and aggressive subtype of lymphoma, and accurate survival prediction is crucial for treatment decisions. This study aims to develop a robust survival prediction strategy to integrate various risk factors effectively, including clinical risk factors and Deauville scores in positron-emission tomography/computed tomography at different treatment stages using a deep-learning-based approach. We conduct a multi-institutional study on 604 DLBCL patients' clinical data and validate the model on 220 patients from an independent institution. We propose a survival prediction model using transformer architecture and a categorical-feature-embedding technique that can handle high-dimensional and categorical data. Comparison with deep-learning survival models such as DeepSurv, CoxTime, and CoxCC based on the concordance index (C-index) and the mean absolute error (MAE) demonstrates that the categorical features obtained using transformers improved the MAE and the C-index. The proposed model outperforms the best-performing existing method by approximately 185 days in terms of the MAE for survival time estimation on the testing set. Using the Deauville score obtained during treatment resulted in a 0.02 improvement in the C-index and a 53.71-day improvement in the MAE, highlighting its prognostic importance. Our deep-learning model could improve survival prediction accuracy and treatment personalization for DLBCL patients.
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Affiliation(s)
- Sudarshan Pant
- Department of Artificial Intelligence Convergence, Chonnam National University, Buk-gu, Gwangju 61186, Republic of Korea
| | - Sae-Ryung Kang
- Department of Nuclear Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun 58128, Republic of Korea
| | - Minhee Lee
- Department of Nuclear Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun 58128, Republic of Korea
| | - Pham-Sy Phuc
- Department of Artificial Intelligence Convergence, Chonnam National University, Buk-gu, Gwangju 61186, Republic of Korea
| | - Hyung-Jeong Yang
- Department of Artificial Intelligence Convergence, Chonnam National University, Buk-gu, Gwangju 61186, Republic of Korea
| | - Deok-Hwan Yang
- Department of Hematology-Oncology, Chonnam National University Medical School and Hwasun Hospital, Hwasun 58128, Republic of Korea
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Mahmoud EM, Howard E, Ahsan H, Cousins JP, Nada A. Cross-sectional imaging evaluation of atypical and uncommon extra-nodal head and neck Non-Hodgkin lymphoma: Case series. J Clin Imaging Sci 2023; 13:6. [PMID: 36751565 PMCID: PMC9899482 DOI: 10.25259/jcis_134_2022] [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] [Received: 11/29/2022] [Accepted: 01/14/2023] [Indexed: 01/26/2023] Open
Abstract
Extra-nodal Non-Hodgkin lymphoma (ENHL) of the head and neck is not uncommon and has variable clinical and imaging presentations. It represents about 25% of extra-nodal lymphomas. In addition, lymphoma is the third most common malignancy of the head and neck just after squamous cell carcinoma (SCC) and salivary gland neoplasms. Unlike SCC, ENHL usually presents as a well-defined mass in the oral cavity, along the pharyngeal mucosa, sinonasal cavity, orbit, and other different neck spaces. One of the common presentations of ENHL is the glandular type which can arise within the salivary or thyroid glands as marginal zone non-Hodgkin lymphoma. ENHL can infiltrate the bone resembling high grade osseous malignancies. Rarely, ENHL can present as perineural spread without definitive mass and manifest clinically with several neuropathies. In this case series, we presented different imaging features and presentation of ENHL of the head and neck. The knowledge of various presentations of ENHL of the head and neck can help early diagnosis and prompt management of these patients' population.
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Affiliation(s)
- Esmat M. Mahmoud
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo, Egypt
| | - Emily Howard
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Humera Ahsan
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Joseph P. Cousins
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Ayman Nada
- Department of Radiology, University of Missouri, Columbia, Missouri, United States.,Corresponding author: Ayman Nada, Department of Radiology, University of Missouri, Columbia, Missouri, United States.
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4
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Faisal M, Mariyam R, Krishna J, Basheer B. A rare case of high-grade non-Hodgkin's lymphoma with oral and multiple extranodal manifestations. Natl J Maxillofac Surg 2023; 14:147-151. [PMID: 37273429 PMCID: PMC10235732 DOI: 10.4103/njms.njms_497_21] [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] [Received: 11/19/2021] [Revised: 01/25/2022] [Accepted: 04/25/2022] [Indexed: 06/06/2023] Open
Abstract
Lymphomas are a group of malignant diseases affecting the lymphoreticular system. Lymphoma is the second most common neoplasm of the head and neck after squamous cell carcinoma, but the incidence of lymphomas in the oral cavity and orbit is rare. Non-Hodgkin's lymphoma (NHL) is less predictable than Hodgkin's but has a greater predilection to extranodal tissues. Non-Hodgkin's incidence in extranodal sites accounts for about 20% to 30%, but in the oral cavity, its around 0.1% to 5%. The rarity of incidence in the oral cavity and atypical radiographic features diagnosing a lymphoma is quite a challenge for clinicians. Here we describe a case of 31-year-old male patient with high-grade non-Hodgkin's lymphoma involving oral cavity with metastasis to orbit, skeletal structures, testes, liver, pancreas and nasopharynx, which is quite rare.
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Affiliation(s)
- Mohammed Faisal
- Maxillofacial Surgeon, Mother Care Hospital, Mannarkad, Kerala, India
| | | | | | - Binshad Basheer
- Department of Oral Maxillofacial Surgery, KMCT Dental College, Mukkam, Calicut, Kerala, India
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Ashoub M, Wali M, Noureldin N, Keraa K, El Desouky E, Mokbel ElShafei M. Oral and para-oral lymphomas: a 10-year multi-center retrospective study in Egypt with time series analysis and forecasting to 2030. BMC Oral Health 2022; 22:556. [PMID: 36457022 PMCID: PMC9714137 DOI: 10.1186/s12903-022-02582-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Little is known about the epidemiology of lymphomas occurring in oral and para-oral sites, especially in developing countries such as Egypt. Hence, the aim of this study was to describe the frequency and time trends of oral and para-oral lymphomas in Cairo governorate from 2010 to 2019, with forecasting to 2030, and to examine relations between age, gender, site and type of lymphoma. METHODS Histopathological reports of patients diagnosed with oral and para-oral lymphomas from 2010 to 2019 were retrospectively retrieved from archives of six different centers in Cairo governorate. Data regarding age, gender and site was collected and associations between types of lymphoma and these variables were detected using appropriate statistical methods. The significance level was set at p ≤ 0.05. Time series analysis was used to determine the trend of lymphoma frequency within 10 years of the study and to predict frequency until 2030. RESULTS Lymphomas constituted 2.86% of oral and para-oral lesions. Non-Hodgkin lymphoma was more common than Hodgkin lymphoma. Patients with non-Hodgkin lymphoma showed a higher median age than patients with Hodgkin lymphoma (p = 0.001). Non-Hodgkin lymphoma was more prone to occur intra-orally (p = 0.014). No statistical significance was observed in gender distribution between Hodgkin and non-Hodgkin lymphoma. Even though no specific time trend was observed from 2010 to 2019, forecasting for frequency of lymphomas through 10 years (2020 to 2030) showed a predicted increase. CONCLUSIONS The findings of this study were consistent with majority of other studies held in various geographic regions. The study revealed that frequency of oral and para-oral lymphomas in Cairo governorate is expected to rise; hence, oral pathologists should be more clinically suspicious and expect to encounter these lesions more in their practice within the upcoming years.
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Affiliation(s)
- Madiha Ashoub
- grid.411810.d0000 0004 0621 7673Oral Pathology Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Mona Wali
- grid.7776.10000 0004 0639 9286Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nada Noureldin
- grid.7776.10000 0004 0639 9286Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Khaled Keraa
- grid.411810.d0000 0004 0621 7673Biostatistician, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Eman El Desouky
- grid.7776.10000 0004 0639 9286Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Marwa Mokbel ElShafei
- grid.411810.d0000 0004 0621 7673Oral Pathology Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
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Sgro JM, Campisi ES, Selvam S, Greer MLC, Alexander S, Ngan B, Campisi P. Cervical lymph node biopsies in the evaluation of children with suspected lymphoproliferative disorders: Experience in a tertiary pediatric setting. J Pediatr Surg 2022; 57:1525-1531. [PMID: 34563360 DOI: 10.1016/j.jpedsurg.2021.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/19/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND/PURPOSE The objectives of this study were: (1) to determine the incidence of lymphoproliferative disorders in a cohort of patients requiring a biopsy at a tertiary pediatric center; and (2) to elucidate the demographic, clinical, laboratory and diagnostic imaging characteristics associated with a malignant diagnosis. METHODS A retrospective review of pediatric cervical lymph node biopsies performed between 2012 and 2019 at a tertiary center was undertaken. Demographic data, clinical presentations, laboratory results, diagnostic imaging findings, and pathology results were compiled and analyzed to identify characteristics associated with a malignant diagnosis. RESULTS Malignancy was identified in 49.5% of patients (55/111) subjected to a cervical lymph node biopsy. The median age of patients with a benign diagnosis was lower than malignant diagnosis (11.0 vs. 14.0 years, p < 0.01). Mediastinal lymphadenopathy based on chest radiography and/or computed tomography scan was identified in 37/49 malignant cases (75.5%) CONCLUSION: In this retrospective study, 49.5% of biopsies performed at a tertiary pediatric setting yielded a malignant diagnosis. Traditional clinical characteristics such as weight loss, night sweats and nodal texture were not informative when derived retrospectively. The most valuable features identified were increased age, increased long and short axis measurements of the involved node(s), and the presence of mediastinal lymphadenopathy. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Jonathan M Sgro
- Department of Otolaryngology - Head and Neck Surgery, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1 × 8, Canada
| | - Emma S Campisi
- Department of Otolaryngology - Head and Neck Surgery, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1 × 8, Canada
| | - Swathi Selvam
- Department of Diagnostic Imaging, Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G 1 × 8, Canada
| | - Mary-Louise C Greer
- Department of Diagnostic Imaging, Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G 1 × 8, Canada
| | - Sarah Alexander
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, M5G 1 × 8, Toronto, Ontario, Canada
| | - Bo Ngan
- Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario M5G 1 × 8, Canada
| | - Paolo Campisi
- Department of Otolaryngology - Head and Neck Surgery, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1 × 8, Canada.
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7
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Kamiya N, Ishikawa Y, Kotani K, Hatakeyama S, Matsumura M. Monocyte-to-Lymphocyte Ratio in the Diagnosis of Lymphoma in Adult Patients. Int J Gen Med 2022; 15:4221-4226. [PMID: 35480988 PMCID: PMC9035440 DOI: 10.2147/ijgm.s357468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 12/22/2022] Open
Abstract
Background Lymphomas, including Hodgkin lymphoma and non-Hodgkin lymphoma, are one of the differentials for peripheral lymphadenopathy and are difficult to diagnose clinically. Biopsy is essential for diagnosing lymphoma, although it is invasive. Non-invasive methods are required to identify patients with suspected lymphoma who should undergo a biopsy. The relevance of the monocyte-to-lymphocyte ratio has recently been reported to be a useful diagnostic marker in children with lymphoma and a prognostic marker of various other diseases. This study aimed to determine the relevance of the monocyte-to-lymphocyte ratio in the diagnosis of lymphoma in adults. Methods The study included 246 adult outpatients (median age of 49.0 years) presenting with peripheral lymphadenopathy. The final diagnosis was determined by reviewing the medical records. We categorized all patients into either the lymphoma group or the non-lymphoma group. The lymphoma group included patients who underwent biopsy and were diagnosed with lymphoma by histopathology, while the non-lymphoma group included those diagnosed with disease excluding lymphoma. The monocyte-to-lymphocyte ratios were compared between the two groups. Results Of the participants, 33 (13.4%) were assigned to the lymphoma group. The median age of the lymphoma and non-lymphoma groups were 67.0 years (interquartile range [IQR] 55.5–75.5 years) and 46.0 years (IQR 36.0–61.0 years), respectively. The lymphocyte and monocyte levels showed no significant differences between the two groups individually. Nonetheless, the monocyte-to-lymphocyte ratio was significantly higher in the lymphoma group (median, 0.36; IQR, 0.24–0.73) than in the non-lymphoma group (median, 0.29; IQR, 0.21–0.43; P = 0.022), independent of lymph node diameter ≥ 1 cm and C-reactive protein levels. Conclusion This study suggests that the monocyte-to-lymphocyte ratio can be a helpful diagnostic marker for lymphoma in adults with peripheral lymphadenopathy when the etiology is unclear even after a medical interview and physical examination.
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Affiliation(s)
- Naoko Kamiya
- Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke-shi, Tochigi, Japan
- Correspondence: Naoko Kamiya, Division of General Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan, Tel +81-285-58-7498, Fax +81-285-40-5160, Email
| | - Yukiko Ishikawa
- Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke-shi, Tochigi, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan
| | - Shuji Hatakeyama
- Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke-shi, Tochigi, Japan
- Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke-shi, Tochigi, Japan
| | - Masami Matsumura
- Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke-shi, Tochigi, Japan
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Abstract
OBJECTIVE To identify the factors associated with the survival of malignant Hodgkin and non-Hodgkin lymphomas in oral and nasal cavities.Study design. Retrospective cohort survival analysis. METHODS The Surveillance, Epidemiology and End Results 18 database was used to analyse the factors associated with the 5-year survival rate of malignant lymphomas diagnosed in the oral cavity and pharynx (OCP) and nasal cavity and sinus (NCS) regions from 1988 to 2011 for all patients in the USA. Multivariable Cox regression models were used to calculate the HR of malignant lymphoma death overall and by the site of cancer diagnosis. RESULTS Among the 8785 patients included in the analysis, 4103 (46.7%) were women, 6096 (69.4%) were non-Hispanic (NH) white, 635 (7.2%) were NH black and 1209 (13.8%) were Hispanic patients of all races. We found that a higher 5-year survival rate of malignant lymphoma is associated with: female gender; younger age at diagnosis; NH white race/ethnicity; diagnosis in the oral cavity; receiving surgery/radiation and surgery/radiation, surgery and chemotherapy as the treatment; diagnosis at a localised stage and diagnosis in later calendar years. No association with lymphoma subtype was observed. CONCLUSION We have identified several demographics and prognosis factors associated with the 5-year survival rate of malignant lymphomas in the OCP and NCS regions. These findings warrant greater public health attention on the prognosis of malignant lymphomas in the OCP and NCS regions among the most vulnerable populations.
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Affiliation(s)
- Feifei Jiang
- Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, China
| | - Ai-Hui Yan
- Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, China
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BAKKAL FK, GÜLHAN N, ERAVCI FC, KIZIL Y, AYDİL U. Head and neck lymphomas from otolaryngology perspective. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.948863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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10
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Fadda GL, Manca A, Testi F, Itri F, Nicoli P, Moratti G, Cavallo G, Guerrasio A. A Rare Case of Hodgkin Lymphoma of the Maxillary Sinus. EAR, NOSE & THROAT JOURNAL 2021; 102:NP232-NP236. [PMID: 33734885 DOI: 10.1177/0145561321993599] [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: 11/16/2022] Open
Abstract
Hodgkin lymphoma (HL) is an uncommon B-cell malignant disease. It usually presents with mediastinal and/or laterocervical lymph node localization, while primary extranodal HL is a rare entity giving rise to diagnostic and therapeutic challenges. It rarely presents as just extranodal localization, so its presence within the maxillary sinus without any lymphadenopathy is exceptional. Given the rarity of this localization, there is no standard treatment for maxillary sinus HL. We present a case of a patient with extranodal HL of the right maxillary sinus treated with primary surgery followed by adjuvant sequential chemoradiation therapy.
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Affiliation(s)
- Gian Luca Fadda
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Andrea Manca
- FPO IRCCS, Head & Neck Oncology Unit, Candiolo Cancer Institute, Turin, Italy
| | - Francesca Testi
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Federico Itri
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Paolo Nicoli
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Giuseppe Moratti
- Department of Otorhinolaryngology, Galliera Hospital, Genova, Italy
| | - Giovanni Cavallo
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Angelo Guerrasio
- Departement of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
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Saadoun R, Risse EM, Obermueller T, Bittar R, Aderhold C. The Secondary Manifestation of a Marginal Zone Lymphoma in the Larynx: Lessons From a Misdiagnosis. Cureus 2021; 13:e13410. [PMID: 33758705 PMCID: PMC7980312 DOI: 10.7759/cureus.13410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The secondary manifestation of a marginal zone lymphoma (MZL), which is a less common type of B-cell non-Hodgkin’s Lymphoma (NHL), in the larynx is a rarity. We report a case of the secondary involvement of the larynx following MZL in a 72-year-old woman who presented with the sensation of a foreign body in the throat and history of MZL. A fiberoptic laryngoscopy confirmed the presence of a mass in the supraglottic area. The initial clinical evaluation indicated that the mass was benign. Hence, it was removed surgically. However, the histopathological analysis confirmed the diagnosis of MZL. After a systemic evaluation, the patient was classified as stage IV A according to the Ann Arbor staging system for lymphomas. Treatment was initiated with Ibrutinib 520mg/d and Rituximab 375 mg/m2 every 28 days. When it comes to tumors of the head and neck, including NHL, the larynx should also be considered as a site for a possible secondary as well as primary involvement.
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Affiliation(s)
- Rakan Saadoun
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Mannheim, DEU.,Faculty of Medicine Mannheim, Ruprecht Karls University Heidelberg, Mannheim, DEU
| | - Eva-Maria Risse
- Department of Hand, Plastic and Reconstructive Surgery, Berufsgenossenschaftliche (BG) Trauma Center Ludwigshafen, Ludwigshafen, DEU.,Faculty of Medicine Heidelberg, Ruprecht Karls University Heidelberg, Heidelberg, DEU
| | - Theresa Obermueller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Mannheim, DEU.,Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institutes of Health, Berlin, DEU
| | - Ranim Bittar
- Department of Cardiology, Heart Center of Riverside, Riverside, USA
| | - Christoph Aderhold
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Mannheim, DEU
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Ali SA, Niaz S, Aguilar-Marcelino L, Ali W, Ali M, Khan A, Amir S, Nasreen, Alanazi AD, Cossio-Bayugar R, Amaro-Estrada I. Prevalence of Ascaris lumbricoides in contaminated faecal samples of children residing in urban areas of Lahore, Pakistan. Sci Rep 2020; 10:21815. [PMID: 33311542 PMCID: PMC7733436 DOI: 10.1038/s41598-020-78743-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/27/2020] [Indexed: 12/31/2022] Open
Abstract
Ascariasis is a common public health problem of preschool and primary school children in developing countries like Pakistan. The aim of the present study was to determine the prevalence and pattern of Ascaris lumbericoides (A. lumbricoides) infection among children residing in urban areas of Lahore, to provide information on ascariasis to promote awareness and prevention programs between the participants specially on the months or season of higher prevalence. To investigate the prevalence of Ascaris Lumbricoides in the contaminated faecal samples of children residing in urban areas of Lahore, a study was conducted from November 2010 to October 2012 and we collected 3600 stratified faecal samples from six urban study areas. Overall 32/3600 (0.88%) prevalence of fecal samples was found positive for eggs of Ascaris lumbricoides. Area wise highest presence positivity 1.67% was observed in Allama Iqbal Town followed by 1.17% in Samanabad, 1.00% in Wapda Town, 1.00% in Gulberg, 0.50% in Cantt, and the lowest 0.00% in Valencia Town respectively (p < 0.001) The highest month wise positivity prevalence 3/300 (3.33%) (p < 0.001) was observed in the month of September that gradually declined up to 0/300 (0.00%) in the month of March. The results reveal that urban areas of Lahore are susceptible to Ascaris Lubricoides infection and the highest prevalence were observed autumn on the month of September.
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Affiliation(s)
- Shahida Azhar Ali
- Department of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, Pakistan
| | - Sadaf Niaz
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Liliana Aguilar-Marcelino
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, INIFAP, Km 11 Carretera Federal Cuernavaca-Cuautla, No. 8534, Col. Progreso, CP 62550, Jiutepec, Morelos, Mexico
| | - Wajid Ali
- Center for Integrated Mountain Research, University of the Punjab, Lahore, Pakistan
| | - Majid Ali
- Center for Integrated Mountain Research, University of the Punjab, Lahore, Pakistan
| | - Adil Khan
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan.
| | - Sohail Amir
- Hayat Abad Medical Complex, Peshawar, Pakistan
| | - Nasreen
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Abdullah D Alanazi
- Department of Biological Sciences, Faculty of Science and Humanities, Shaqra University, P.O. Box 1040, Ad-Dawadimi, 11911, Saudi Arabia
| | - Raquel Cossio-Bayugar
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, INIFAP, Km 11 Carretera Federal Cuernavaca-Cuautla, No. 8534, Col. Progreso, CP 62550, Jiutepec, Morelos, Mexico
| | - Itzel Amaro-Estrada
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, INIFAP, Km 11 Carretera Federal Cuernavaca-Cuautla, No. 8534, Col. Progreso, CP 62550, Jiutepec, Morelos, Mexico
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13
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Zahedi M, Hizomi Arani R, Tohidi M, Haghighi S, Mehrpour M, Hadaegh F. Nasopharyngeal B-cell lymphoma with pan-hypopituitarism and oculomotor nerve palsy: a case report and review of the literature. BMC Endocr Disord 2020; 20:163. [PMID: 33143716 PMCID: PMC7607655 DOI: 10.1186/s12902-020-00644-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/23/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Primary nasopharyngeal lymphoma (NPL) is a very rare tumor of Waldeyer ring (WR) lymphoid tissue. It is challenging to differentiate lymphoma infiltration of pituitary from a pituitary adenoma, meningioma infiltration, and other sellar lesions to plan a suitable treatment strategy. We presented for the first time a unique case of NPL with an unusual presentation of oculomotor nerve palsy associated with pan-pituitary involvement in a diabetic patient. CASE PRESENTATION A 64-year old diabetic woman with no previous history of malignancy presented with intermittent diplopia for about the last nine months. Severe headache, left eye ptosis and hypoglycemic episodes were added to her symptoms after a while. Further complaints include generalized weakness, loss of appetite, generalized musculoskeletal pain, and 6-7 kg weight loss within six months. Her family history was unremarkable. Physical examinations of eyes indicated left eye 3rd, 4th, and 6th nerve palsy. But, she was not anisocoric, and the pupillary reflexes were normal on both eyes. No lymphadenopathy, organomegaly and other abnormalities were found. Magnetic resonance imaging (MRI) showed a heterogeneous enhancement in the seller and suprasellar regions, enlargement of the stalk, parasellar dural enhancement and thickening of the sphenoid sinus without bone erosion. Also, both cavernous sinuses were infiltrated and both internal carotid arteries were encased by the neoplastic lesion. It suggested an infiltrative neoplastic lesion which compressed the cranial nerves. Pituitary hormone levels assessment indicated a pan-hypopituitarism. Following nasopharyngeal mucosal biopsy, the immunohistochemistry (IHC) findings revealed a low-grade non-Hodgkin's B-cell lymphoma. Systemic workup, including cerebrospinal fluid (CSF) studies, bone marrow aspiration, chest and abdominopelvic high-resolution computed tomography (HRCT) indicated no other involvement by the lymphoma. After chemotherapy courses, central adrenal insufficiency, partial central diabetes incipidious (CDI) and central hypothyroidism have been resolved. To our best knowledge, we found 17 cases of NPL with cranial nerve palsy, 1 case of NPL with pan-hypopituitarism and no NPL case with both cranial nerve palsy and pituitary dysfunction. CONCLUSIONS The incidence of cranial neuropathy in patients with diabetes should not merely be attributed to diabetic neuropathy without further evaluation.
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Affiliation(s)
- Maryam Zahedi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, P.O. Box: 19395-4763, Tehran, Velenjak, Iran
| | - Reyhane Hizomi Arani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, P.O. Box: 19395-4763, Tehran, Velenjak, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, P.O. Box: 19395-4763, Tehran, Velenjak, Iran
| | - Shirin Haghighi
- Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mehrpour
- Stroke center, Firoozgar General Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, P.O. Box: 19395-4763, Tehran, Velenjak, Iran.
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14
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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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15
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Oral manifestations and clinical progression of a rare double-hit B-cell lymphoma: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:e38-e43. [DOI: 10.1016/j.oooo.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/28/2019] [Accepted: 12/08/2019] [Indexed: 12/22/2022]
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16
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The diagnostic performance of ultrasound-guided core biopsy in the diagnosis of head and neck lymphoma: results in 226 patients. Int J Oral Maxillofac Surg 2020; 50:431-436. [PMID: 32739250 DOI: 10.1016/j.ijom.2020.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/30/2020] [Accepted: 07/02/2020] [Indexed: 01/21/2023]
Abstract
Many clinical guidelines for investigating lymphomas advise that surgical excision biopsy (SEB) should be performed for a confident diagnosis. It is increasingly recognized in clinical practice that ultrasound-guided core needle biopsy (USCNB) is a reliable diagnostic technique. We aimed to investigate the diagnostic efficacy of USCNB in head and neck lymphoma. A retrospective analysis of all diagnosed head and neck lymphomas between 2013 and 2018 was performed. Patient records, radiology and histopathology reports along with the biopsy technique: fine needle aspiration cytology (FNAC), USCNB, and SEB used were reviewed. The technique providing diagnosis and leading to initiation of treatment was identified. Two-hundred and thirty patients and 267 biopsy samples were included. A total of 226 patients underwent USCN. In 215 of 226 (95.1%) USCNB patients were fully diagnostic allowing for initiation of oncological treatment; 11 patients required a subsequent SEB to provide diagnosis. In four patients, SEB was the only investigation performed. Of the USCNB total number of procedures (number of patients n=230 is the same coincidentally as the number of USCNB procedures), 215 of 230 (93.5%) were fully diagnostic samples. In the majority of cases, USCNB provided a definitive diagnosis allowing initiation of oncological treatment, avoiding the need for SEB. USCNB should be considered the first-line diagnostic modality in appropriate cases, as it reduces time to initiate treatment, costs and avoids patients having to undergo unnecessary surgery and possible complications.
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17
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Reginelli A, Urraro F, Sangiovanni A, Russo GM, Russo C, Grassi R, Agostini A, Belfiore MP, Cellina M, Floridi C, Giovagnoni A, Sica A, Cappabianca S. Extranodal Lymphomas: a pictorial review for CT and MRI classification. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:34-42. [PMID: 32945277 PMCID: PMC7944666 DOI: 10.23750/abm.v91i8-s.9971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
Extranodal lymphomas represent an extranodal location of both non-Hodgkin and Hodgkin lymphomas. This study aims to evaluate the role of CT and MRI in the assessment of relationships of extranodal lymphomas with surrounding tissues and in the characterization of the lesion. We selected and reviewed ten recent studies among the most recent ones present in literature exclusively about CT and MRI imaging of extranodal lymphomas. Contrast-enhanced computed tomography (CT) is usually the first-line imaging modality in the evaluation of extranodal lymphomas, according to Lugano classification. However, MRI has a crucial role thanks to the superior soft-tissue contrast resolution, particularly in the anatomical region as head and neck. (www.actabiomedica.it)
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Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Fabrizio Urraro
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Gaetano Maria Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Carolina Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Andrea Agostini
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Maria Paola Belfiore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Michaela Cellina
- Department of Radiology, Ospedale Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Chiara Floridi
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Andrea Giovagnoni
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Antonello Sica
- Oncology and Hematology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
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18
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Herpesviruses in Head and Neck Cancers. Viruses 2020; 12:v12020172. [PMID: 32028641 PMCID: PMC7077226 DOI: 10.3390/v12020172] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/31/2020] [Accepted: 02/01/2020] [Indexed: 12/16/2022] Open
Abstract
Head and neck cancers arise in the mucosa lining the oral cavity, oropharynx, hypopharynx, larynx, sinonasal tract, and nasopharynx. The etiology of head and neck cancers is complex and involves many factors, including the presence of oncogenic viruses. These types of cancers are among the most common cancers in the world. Thorough knowledge of the pathogenesis of viral infections is needed to fully understand their impact on cancer development.
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19
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Nasopharyngeal Lymphoma: A 22-Year Review of 35 Cases. J Clin Med 2019; 8:jcm8101604. [PMID: 31623372 PMCID: PMC6833098 DOI: 10.3390/jcm8101604] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 09/29/2019] [Accepted: 09/30/2019] [Indexed: 02/07/2023] Open
Abstract
Nasopharyngeal (NP) lymphoma is a rare primary malignancy of the head and neck and represents a minority of malignancies originating from the nasopharynx. For this reason, there are limited data regarding epidemiologic and treatment outcomes. This is a retrospective review of patients diagnosed with NP lymphoma from 1995 to 2017 at a tertiary medical center. The patients’ demographic data, clinical presentations, treatment modalities, Epstein–Barr virus (EBV)-encoded small RNA (EBER) staining, and outcomes were investigated. We considered a total of 35 patients, including 20 males and 15 females, diagnosed with NP lymphoma. The age ranged from 17 to 88 years (mean = 59.6). The common presentations were nasal obstruction, epistaxis, and neck mass. In our study, the most common pathological diagnosis of NP lymphoma was diffuse large B cell lymphoma (DLBCL) (n = 17), followed by NK/T cell lymphoma (NKTCL) (n = 9). Other pathologic diagnoses included extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALToma), small lymphocytic lymphoma, mantle cell lymphoma. There were 13 cases showing EBER positivity, including 7 cases of NKTCL, 5 cases of DLBCL, and 1 case of post-transplant lymphoproliferative disorder (PTLD). Most patients received chemotherapy alone, while some patients received both chemotherapy and radiotherapy. Seven patients had local recurrence, and fewer than half of the patients (n = 16) were alive at the time of the study (mean follow-up duration: 54.4 months). The five-year overall survival was 50.4%. NP lymphoma is very rare, and the most common pathologic type is DLBCL. EBER positivity is found in both NKTCL and DLBCL. Identifying more effective therapeutic agents is extremely important to improve patients’ survival.
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20
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Çolak M, Eravcı FC, Karakurt SE, Karakuş MF, İkincioğulları A, Özcan KM. The Predictive Value of Neutrophil-to-Lymphocyte Ratio for Hodgkin's Lymphoma Diagnosis in Patients with Asymptomatic Cervical Lymphadenopathy. Indian J Otolaryngol Head Neck Surg 2019; 71:986-991. [PMID: 31742107 DOI: 10.1007/s12070-019-01676-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/27/2019] [Indexed: 12/31/2022] Open
Abstract
In patients with asymptomatic cervical lymphadenopathy, the physician often has to choose between evaluation via follow-up or open biopsy. Follow-up evaluation may lead to a delayed diagnosis of lymphoma, while an open biopsy is associated with surgical risks and costs. This dilemma can be avoided using predictive parameters. In the present study, we aimed to investigate whether neutrophil-to-lymphocyte ratio (NLR), a parameter which can be assessed quickly with ease and at low cost, has predictive value for Hodgkin's lymphoma diagnosis in patients with asymptomatic cervical lymphadenopathy. A total of 46 patients with asymptomatic cervical lymphadenopathy who underwent open biopsy were included in the study. Based on the biopsy results, the patients were divided into two groups, Hodgkin lymphoma (26 patients) and reactive lymphadenopathy (20 patients). The mean NLR in the groups was calculated and compared based on the results of complete blood count performed before biopsy. We found that mean NLR (P = 0.022) and mean neutrophil count (P = 0.046) were higher and mean lymphocyte count was lower (P = 0.054) in patients with Hodgkin's lymphoma compared to those in patients with reactive lymphadenopathy. Our results indicate that a high NLR may have predictive value for Hodgkin's lymphoma diagnosis in patients with asymptomatic cervical lymphadenopathy.
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Affiliation(s)
- Mustafa Çolak
- Department of Otorhinolaryngology, Health Sciences University, Ankara Numune Training and Research Hospital, Talatpaşa Blv. No: 44, 06230 Ankara, Turkey
| | - Fakih Cihat Eravcı
- Department of Otorhinolaryngology, Health Sciences University, Ankara Numune Training and Research Hospital, Talatpaşa Blv. No: 44, 06230 Ankara, Turkey
| | - Süleyman Emre Karakurt
- Department of Otorhinolaryngology, Health Sciences University, Ankara Numune Training and Research Hospital, Talatpaşa Blv. No: 44, 06230 Ankara, Turkey
| | - Mehmet Fatih Karakuş
- Department of Otorhinolaryngology, Health Sciences University, Ankara Numune Training and Research Hospital, Talatpaşa Blv. No: 44, 06230 Ankara, Turkey
| | - Aykut İkincioğulları
- Department of Otorhinolaryngology, Health Sciences University, Ankara Numune Training and Research Hospital, Talatpaşa Blv. No: 44, 06230 Ankara, Turkey
| | - Kürşat Murat Özcan
- Department of Otorhinolaryngology, Health Sciences University, Ankara Numune Training and Research Hospital, Talatpaşa Blv. No: 44, 06230 Ankara, Turkey
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21
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Choy B, Venkataraman G, Biernacka A, Lastra RR, Mueller J, Setia N, Reeves W, Antic T. Correlation of cytopathology with flow cytometry and histopathology for the diagnosis of hematologic malignancies in young adults presenting with cervical lymphadenopathy. Diagn Cytopathol 2019; 47:579-583. [PMID: 30794347 DOI: 10.1002/dc.24157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/19/2018] [Accepted: 01/31/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Fine-needle aspiration (FNA) is frequently utilized in the diagnostic workup of lymphadenopathy. We evaluated the correlation of cytopathology with flow cytometry and tissue biopsy results and assessed the prevalence of specific malignancies in young adults presenting with cervical lymphadenopathy. METHODS Database was searched for cervical lymph node FNA performed by a cytopathologist in patients aged 18-30 years from 2005 to 2017. RESULTS Cervical lymph node FNA was performed on 48 patients without prior history of malignancy. Nineteen patients had cytology results only, of which all were interpreted as benign reactive lymph node. None developed subsequent malignancies. The remaining 29 patients had cytology with flow cytometry and/or tissue biopsy results. A benign reactive cytology diagnosis was rendered in 18 (62%) cases, of which 11 had concordant diagnosis on flow cytometry, 2 had tissue biopsy, and 3 had both. Eleven (38%) patients had cytology results concerning for a hematologic malignancy, of which 7 were confirmed by flow cytometry and 3 by both flow cytometry and tissue biopsy. Cervical lymph node FNA has 94.1% sensitivity, 83.3% specificity, 88.9% positive predictive value, and 90.9% negative predictive value. The most common hematologic malignancy in our young adult population presenting with cervical lymphadenopathy was Hodgkin lymphoma. CONCLUSION FNA is a useful first-line diagnostic procedure for assessing cervical lymphadenopathy in young adults to allow for better triage of specimens for flow cytometry and/or tissue biopsy concerning for a hematologic malignancy and potentially avoid invasive excisional biopsy in a proportion of cases.
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Affiliation(s)
- Bonnie Choy
- Department of Pathology, University of Chicago, Chicago, Illinois.,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Anna Biernacka
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Ricardo R Lastra
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Jeffery Mueller
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Namrata Setia
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Ward Reeves
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Tatjana Antic
- Department of Pathology, University of Chicago, Chicago, Illinois
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22
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宿 骞, 彭 歆, 周 传, 俞 光. [Clinicopathological features and possible prognostic factors in parotid lymphomas]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:35-42. [PMID: 30773541 PMCID: PMC7433569 DOI: 10.19723/j.issn.1671-167x.2019.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the clinicopathological features and prognostic factors in lymphoma of parotid origin. METHODS Clinicopathological data of the patients with parotid lymphoma who were initially diagnosed in Peking University Hospital of Stomatology from 2006 to 2016 were collected and analyzed retrospectively. The patients were followed-up for 5 to 149 months with a median period of 45 months, and the factors influencing the prognosis were evaluated. RESULTS A total of 41 patients with primary parotid lymphoma were included in this retrospective study. The rate of male to female was 1:2.15. The median age was 57 years (ranging from 8 months to 91 years). According to WHO classification, 40 cases (97.1%) were diagnosed as non-Hodgkin lymphoma (NHL), including 15 cases of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), 14 cases of diffuse large B cell lymphoma (DLBCL) as well as 4 cases of follicular lymphoma, while other subtypes of NHL were rare. Only one case was diagnosed as Hodgkin lymphoma. Regarding the clinical staging at the initial diagnosis, 37 patients (90.2%) were diagnosed as stage IE or IIE of the disease, while 4 patients (9.8%) as stage IIIE or stage IVE. Seven patients (17.1%) had a history of Sjögren syndrome (SS), all of whom were MALT lymphoma. The mean ill duration of the 41 patients were 20.7 months. Thirty-two patients (78%) presented a slowly growing painless mass in the parotid gland. Treatment options included localized therapy and systemic therapy, all of whom had good curative effect. Nine patients (21.9%) died during the follow-up period. The overall survival rates of 2-year and 5-year were 84.5% and 81.3% respectively. The univariate analysis demonstrated statistically significant differences for accelerated growth of tumor (P=0.005), and presence of tumor capsule (P=0.011). The multi-univariate analysis demonstrated statistically significant differences for presence of tumor capsule (P=0.041). CONCLUSION A large majority of primary parotid lymphoma were NHL, among which MALT lymphoma and DLBCL were common subtypes. Most patients presented an indolent mass in parotid gland, which should be distinguished from the parotid benign tumors. SS is closely related to the pathogenesis of MALT lymphoma. The prognosis is better than that of other malignant parotid tumors. Absence of tumor capsule may predict a poor prognosis in patients with parotid lymphoma.
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Affiliation(s)
- 骞 宿
- 北京大学口腔医学院·口腔医院,口腔颌面外科,北京 100081 Department of Oral and Maxillofacial Surgery, Beijing 100081, China
| | - 歆 彭
- 北京大学口腔医学院·口腔医院,口腔颌面外科,北京 100081 Department of Oral and Maxillofacial Surgery, Beijing 100081, China
| | - 传香 周
- 北京大学口腔医学院·口腔医院, 病理科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 光岩 俞
- 北京大学口腔医学院·口腔医院,口腔颌面外科,北京 100081 Department of Oral and Maxillofacial Surgery, Beijing 100081, China
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23
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Storck K, Brandstetter M, Keller U, Knopf A. Clinical presentation and characteristics of lymphoma in the head and neck region. Head Face Med 2019; 15:1. [PMID: 30606206 PMCID: PMC6317257 DOI: 10.1186/s13005-018-0186-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 12/12/2018] [Indexed: 12/15/2022] Open
Abstract
Background The study analyses clinical characteristics of histologically defined head and neck (H&N) lymphoma to raise the awareness of ENT specialists to the leading symptoms. Method From 2003 to 2011, all patients with histologically defined H&N lymphoma from our clinic were evaluated. Results This study identified 221 patients with H&N lymphoma comprising 193 non-Hodgkin lymphomas (NHL) and 28 Hodgkin lymphomas (HL). Among NHL there were 77 indolent (iNHL), 110 aggressive (aNHL), six highly aggressive NHL and further 28 HL. Patients with highly aggressive NHL and HL were significantly younger (p < 0.0001). Corresponding to the leading symptoms, we found nodal and extranodal involvement. NHL demonstrated manifestation in neck lymph nodes, tonsils, major salivary glands, sinonasal-system and hypopharynx/larynx. HL showed exclusive manifestation in lymph nodes of the neck and the tonsils (p < 0.0001). The mean time from first symptoms to diagnosis ranged from 1.5 ± 0.7 months in highly aggressive lymphoma to 7.5 ± 11.5 months in iNHL. Conclusions The variable clinical presentation of lymphoma is a challenge for the ENT specialist. Fast diagnosis is crucial for rapid treatment, especially in highly aggressive NHL like the Burkitt-lymphoma and HL. A standardized medical history, clinical examination and imaging evaluations paired with patient’s signs, symptoms and demographic knowledge might indicate lymphoma. Biopsies in the H&N region should always be immediately performed in suspicious findings.
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Affiliation(s)
- Katharina Storck
- Department of ENT, Head and Neck Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
| | - Markus Brandstetter
- Department of ENT, Head and Neck Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Ulrich Keller
- Third Department of Internal Medicine, Haematology and Oncology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Andreas Knopf
- Department of ENT, Head and Neck Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
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24
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Xu YH, Liu SH, Hao FR, Zhang YH. Recombinant adenovirus p53 combined with radiotherapy improves efficacy and safety in the treatment of head and neck lymphoma. Cancer Biomark 2018; 23:213-220. [PMID: 30198865 DOI: 10.3233/cbm-181286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Lymphoma is considered to be a kind of malignant tumour. Gene therapy and radiotherapy have been reported as treatment methods for head and neck lymphoma. This study aims to evaluate the efficacy and safety for the treatment of head and neck lymphoma by a combination of recombinant adenovirus p53 (rAd-p53) and radiotherapy. METHODS A total of 156 patients with head and neck lymphoma were selected. All patients received an intratumor injection of rAd-p53 of four different doses, namely, 0, 1 × 1010 VP, 1 × 1011 VP and 1 × 1012 VP, once a week for 8 weeks, and radiotherapy was administered 3 days after the rAd-p53 injection using the same dosage and method. Four, eight and twelve weeks after treatment, tumor reduction and complete response (CR) rates, special laboratory examination and adverse reaction assessment were detected to evaluate the efficacy and safety of combined treatment with rAd-p53 injection and radiotherapy for head and neck lymphoma. RESULTS At week 4, 8 and 12 of treatment with rAd-p53 at the 1 × 1010 VP, 1 × 1011 VP and 1 × 1012 VP doses, the average tumour reduction and CR rates were evidently elevated, the anti rAd-p53 antibody in the serum of patients was expressed positively, and the T cell subsets (CD3/CD4/CD8) increased and interleukin 2 receptor (IL-2R) level decreased markedly. Additionally, rAd-p53 was proven to be clinically safe in the treatment. CONCLUSION Altogether, we conclude that rAd-p53 combined with radiotherapy improves the efficacy and safety in treating head and neck lymphoma, which has a broad scope in future clinical application.
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Affiliation(s)
- Yong-Hua Xu
- Department of Radiotherapy, Weifang People's Hospital, Weifang 261000, Shandong, China
| | - Shuo-Hui Liu
- Department of Outpatient, Weifang People's Hospital, Weifang 261000, Shandong, China
| | - Fu-Rong Hao
- Department of Radiotherapy, Weifang People's Hospital, Weifang 261000, Shandong, China
| | - Yin-Huan Zhang
- The 2nd Department of Cardiology, Weifang People's Hospital, Weifang 261000, Shandong, China
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Agarwal M, Nabavizadeh SA, Mohan S. Chapter 6 Non-Squamous Cell Causes of Cervical Lymphadenopathy. Semin Ultrasound CT MR 2017; 38:516-530. [PMID: 29031368 DOI: 10.1053/j.sult.2017.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cervical lymphadenopathy is a common indication for imaging evaluation of the neck. Besides metastatic squamous cell carcinoma of the head and neck, cervical lymphadenopathy can be due to many causes, with simple reactive lymphadenopathy on one end of the spectrum and malignant lymphadenopathy due to a distant infraclavicular primary, on the other end. A systematic approach to the cause of cervical lymphadenopathy, which includes pattern of lymph node enlargement, lymph node characteristics, systemic symptoms, and extranodal abnormalities, can be very useful in arriving at the correct diagnosis. In this article, various patterns of cervical lymphadenopathy due to non-squamous cell causes are discussed.
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Affiliation(s)
- Mohit Agarwal
- Department of Radiology, Section of Neuroradiology, Medical College of Wisconsin, Milwaukee, WI
| | - Seyed Ali Nabavizadeh
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Suyash Mohan
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
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Dolan JM, DeGraft-Johnson A, McDonald N, Ward BB, Phillips TJ, Munz SM. Maxillary and Mandibular Non-Hodgkin Lymphoma with Concurrent Periapical Endodontic Disease: Diagnosis and Management. J Endod 2017; 43:1744-1749. [DOI: 10.1016/j.joen.2017.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/29/2017] [Accepted: 04/02/2017] [Indexed: 12/27/2022]
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Watal P, Bathla G, Thaker S, Sato TS, Moritani T, Smoker WRK. Multimodality Imaging Spectrum of the Extranodal Lymphomas in the Head and Neck-A Pictorial Review. Curr Probl Diagn Radiol 2017; 47:340-352. [PMID: 29174137 DOI: 10.1067/j.cpradiol.2017.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/14/2017] [Accepted: 07/26/2017] [Indexed: 02/06/2023]
Abstract
Lymphoma is the second most common malignant neoplasm of the head and neck region, involving the nodal and/or extranodal sites or both in a variable fashion. Lymphoma may mimic a variety of tumors in this region depending on the subsite involved. The usual presentation of lymphomatous disease is presence of multiple enlarged, often conglomerate, lymph nodes without significant necrosis. Extranodal lymphomas demonstrate more complex radiologic features, but careful evaluation can identify distinct imaging patterns to suggest extranodal lymphomatous disease from other more common lesions. Knowledge of these imaging features can help raise suspicion for lymphoma as a differential consideration. This can be of critical importance since further work-up and management can be vastly different between lymphomatous disease and other disease entities. The authors present a pictorial review of the spectrum of imaging findings in extranodal head and neck lymphomas.
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Affiliation(s)
- Pankaj Watal
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA.
| | - Girish Bathla
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Siddharth Thaker
- Department of Radiology, M P Shah Government Medical College & Government General Hospital, Jamnagar, Gujarat, India
| | - T Shawn Sato
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Toshio Moritani
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Wendy R K Smoker
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA
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Han AY, Kuan EC, Alonso JE, Badran KW, St John MA. Epidemiology of Nasopharyngeal Lymphoma in the United States: A Population-Based Analysis of 1119 Cases. Otolaryngol Head Neck Surg 2017; 156:870-876. [PMID: 28322119 DOI: 10.1177/0194599817695808] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives To describe the incidence and determinants of survival of patients with nasopharyngeal lymphoma (NPL) between 1973 and 2012 using the Surveillance, Epidemiology, and End Results (SEER) database. Study Design Retrospective cohort study using a national database. Methods The SEER registry was used to calculate survival trends for patients with NPL between 1973 and 2012. Patient data were then analyzed with respect to histopathology, age, sex, race, histologic subtype, Ann Arbor stage, and whether radiation therapy was given. Overall survival (OS) and disease-specific survival (DSS) were calculated. Results A total of 1119 cases of NPL were identified. The cohort was composed of 58.8% males. The mean age at diagnosis was 59.3 years. The median OS was 8.2 years. B-cell non-Hodgkin's lymphomas (NHLs) accounted for most cases (77.5%), with natural killer (NK)/T-cell lymphomas comprising 6.0% of cases. A total of 41.5% patients received radiation therapy. OS at 2, 5, and 10 years was 70%, 57%, and 45%, respectively. On multivariate analysis, advanced age and NK/T-cell NHL histologic subtype were associated with worse OS and DSS, while radiation therapy was associated with improved OS and DSS (all P < .05). Conclusion With the exception of NK/T-cell NHL subtypes, NPL is associated with a fair prognosis, with younger age, low Ann Arbor stage, and radiation therapy being independent positive prognosticators for survival.
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Affiliation(s)
- Albert Y Han
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Edward C Kuan
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Jose E Alonso
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Karam W Badran
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Maie A St John
- 1 Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA.,2 Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California, USA.,3 UCLA Head and Neck Cancer Program, UCLA Medical Center, Los Angeles, California, USA
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Francisconi CF, Caldas RJ, Oliveira Martins LJ, Fischer Rubira CM, da Silva Santos PS. Leukemic Oral Manifestations and their Management. Asian Pac J Cancer Prev 2017; 17:911-5. [PMID: 27039811 DOI: 10.7314/apjcp.2016.17.3.911] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Leukemia is the most common neoplastic disease of the white blood cells which is important as a pediatric malignancy. Oral manifestations occur frequently in leukemic patients and may present as initial evidence of the disease or its relapse. The symptoms include gingival enlargement and bleeding, oral ulceration, petechia, mucosal pallor, noma, trismus and oral infections. Oral lesions arise in both acute and chronic forms of all types of leukemia. These oral manifestations either may be the result of direct infiltration of leukemic cells (primary) or secondary to underlying thrombocytopenia, neutropenia, or impaired granulocyte function. Despite the fact that leukemia has long been known to be associated with oral lesions, the available literature on this topic consists mostly of case reports, without data summarizing the main oral changes for each type of leukemia. Therefore, the present review aimed at describing oral manifestations of all leukemia types and their dental management. This might be useful in early diagnosis, improving patient outcomes.
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Affiliation(s)
- Carolina Favaro Francisconi
- Bauru School of Dentistry, University of Sao Paulo, Department of Biological Sciences, Bauru, SP, Brazil E-mail :
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Solitary Supraclavicular Fossa Masses. J Craniofac Surg 2016; 27:e544-8. [PMID: 27607132 DOI: 10.1097/scs.0000000000002764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study is to present the diagnostic spectrum of solitary supraclavicular fossa (SCF) masses in a Turkish context. The demographic data of the patients and the effectivity of the diagnostic tools are also discussed to improve current diagnostic strategies. PATIENTS AND METHODS The charts of patients who underwent surgical intervention for solitary SCF mass of an unknown etiology between January 2005 and January 2015 were reviewed. Patients presenting evidences of synchronous cancers and patients with a history of previous cancers were excluded. The data encompassing the demographics of the patients, the discriminative specifications, the histopathological diagnosis of the masses, and the diagnostic tools used in the workup period were noted. The descriptive data are presented and statistical analyses were performed using the Mann-Whitney test, Fisher exact test, and Chi-squared tests. RESULTS In total, 44 male (76%) and 14 (24%) female patients were enrolled in the study. Thirty-five masses (60%) were located in the left SCF and 23 masses (40%) in the right. The masses were categorized as neoplastic (n = 31, 53%), inflammatory (n = 18, 31%), and congenital (n = 9, 16%). The 44 (76%) masses in our series were lymph nodes (LNs), and 25 (57%) of them were malign, whereas 19 (43%) were either inflammatory or benign. Male sex (P = 0.027) and the size of the mass (P = 0.017) were significantly related to malign LNs. The patients' ages and sides of the masses were not significantly different between the malign and benign LN groups. CONCLUSIONS Lymph nodes constitute the majority of solitary SCF masses. Although imaging techniques and fine needle aspirations are routinely applied, excisional biopsies are necessary in most cases to reach an exact diagnosis and to plan a definitive treatment regime in this presented series.
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Patini R, Coviello V, Riminucci M, Corsi A, Cicconetti A. Early-stage diffuse large B-cell lymphoma of the submental region: a case report and review of the literature. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/ors.12221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R. Patini
- Department of Surgical Sciences for Head and Neck Diseases; School of Dentistry; Catholic University of Sacred Heart; Rome Italy
| | - V. Coviello
- Department of Oral and Maxillofacial Sciences; School of Dentistry; ‘Sapienza’ University of Rome; Rome Italy
| | - M. Riminucci
- Department of Sperimental Medicine and Pathology; ‘Sapienza’ University of Rome; ‘Umberto I’ Polyclinic in Rome; Rome Italy
| | - A. Corsi
- Department of Sperimental Medicine and Pathology; ‘Sapienza’ University of Rome; ‘Umberto I’ Polyclinic in Rome; Rome Italy
| | - A. Cicconetti
- Department of Oral and Maxillofacial Sciences; School of Dentistry; ‘Sapienza’ University of Rome; Rome Italy
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Makino T, Hara H, Hamashima T, Mizawa M, Seki Y, Hayashi M, Shimizu T. Hodgkin's lymphoma presenting as subcutaneous masses in the left upper arm. J Dermatol 2016; 43:1244-1246. [PMID: 27060692 DOI: 10.1111/1346-8138.13378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Teruhiko Makino
- Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
| | - Hiroshi Hara
- Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Takeru Hamashima
- Department of Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Megumi Mizawa
- Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yuri Seki
- Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Masao Hayashi
- Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Tadamichi Shimizu
- Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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Bugshan A, Kassolis J, Basile J. Primary Diffuse Large B-Cell Lymphoma of the Mandible: Case Report and Review of the Literature. Case Rep Oncol 2015; 8:451-5. [PMID: 26600778 PMCID: PMC4649735 DOI: 10.1159/000441469] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In the oral cavity, extranodal non-Hodgkin's lymphoma can occur in the periapical region either in the maxilla or mandible. Also, it can mimic inflammatory lesions that arise around the teeth apices such as periapical granuloma, radicular cyst and osteomyelitis. Misdiagnosis of lymphomas in the jaws may reduce the chance of successful treatment and worsen the prognosis. Therefore, any growth of periapical tissue must be submitted for histopathological evaluation to avoid a delay in the diagnosis. We present a case of extranodal non-Hodgkin's lymphoma of a 53-year-old male in the right posterior mandible that was initially misdiagnosed as a reactive periapical lesion. This case illustrates the importance for both the pathologist and the clinician of considering malignant lesions such as lymphoma in the differential diagnosis of periapical radiolucency.
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Affiliation(s)
- Amr Bugshan
- Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, Baltimore, Md., USA
| | | | - John Basile
- Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, Baltimore, Md., USA
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34
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Intraosseous Non-Hodgkin Lymphoma Mimicking a Periapical Lesion. J Endod 2015; 41:1738-42. [DOI: 10.1016/j.joen.2015.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 06/03/2015] [Accepted: 06/04/2015] [Indexed: 12/17/2022]
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35
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Kim KH, Kim RB, Woo SH. Individual participant data meta-analysis of primary laryngeal lymphoma: Focusing on the clinical characteristics and prognosis. Laryngoscope 2015; 125:2741-8. [PMID: 26404037 DOI: 10.1002/lary.25391] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Primary lymphoma of the larynx is rare. The symptoms are ambiguous and nonspecific, and confirmation of the diagnosis is often difficult. To better understand the clinical characteristics of this distressing disease, we performed an individual participant data meta-analysis focusing on the diagnoses and treatment outcomes. STUDY DESIGN Systematic review article. METHODS A literature search of the MEDLINE, Embase, and Cochrane library databases was conducted using the following Medical Subject Headings and keywords: "primary," "lymphoma," "cancer," and "larynx." The individual data of 57 patients from 41 articles were selected based on the inclusion criteria for the analysis. RESULTS The mean age of the 57 patients at the time of diagnosis was 53.9 ± 18 years, and there was a preponderance of male patients (male:female = 35:22). The mean follow-up was 33.2 ± 40.5 months. The most common symptom was hoarseness (70.2%). Extension of the lymphoma was found in the supraglottic larynx (63.2%). B-symptoms were noted in only 14.0% of patients. The treatment method and disease extent were not significant factors. The significant prognostic factors were the biopsy frequency (P = .000), B-symptoms (P = .032), and cell type (P < .001). CONCLUSIONS From an analysis of larynx lymphoma patients, accurate biopsy, the presence of B-symptoms, and the cell type of the lymphoma are important to the prognosis. However, the treatment method was not effective in predicting the prognosis. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Kyung Hee Kim
- Department of Otolaryngology, Gyeongsang National University, Jinju.,College of Nursing, Gyeongsang National University, Jinju
| | - Rock Bum Kim
- Dong-A University Hospital Regional Cardiocerebrovascular Center (R.B.K.), Busan, South Korea
| | - Seung Hoon Woo
- Department of Otolaryngology, Gyeongsang National University, Jinju.,Institute of Health Sciences, Gyeongsang National University, Jinju
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Guimarães AC, de Carvalho GM, Correa CRS, Gusmão RJ. Association between unilateral tonsillar enlargement and lymphoma in children: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2015; 93:304-11. [DOI: 10.1016/j.critrevonc.2014.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 10/31/2014] [Accepted: 11/13/2014] [Indexed: 01/06/2023] Open
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Lubek JE, Shihabi A, Murphy LA, Berman JN. Hematopoietic neck lesions. Atlas Oral Maxillofac Surg Clin North Am 2015; 23:31-7. [PMID: 25707563 DOI: 10.1016/j.cxom.2014.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Joshua E Lubek
- Oral-Head Neck Surgery/Microvascular Surgery, Oncology Program, Greenebaum Cancer Center, University of Maryland, 650 West Baltimore Street, Room 1401, Baltimore, MD 21201, USA.
| | - Amro Shihabi
- Oral-Head Neck Surgery/Microvascular Surgery, Oncology Program, Greenebaum Cancer Center, University of Maryland, 650 West Baltimore Street, Room 1401, Baltimore, MD 21201, USA
| | - Laura A Murphy
- Department of Pediatrics, IWK Health Centre, Dalhousie University, 1348 Summer Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Jason N Berman
- Department of Pediatrics, IWK Health Centre, Dalhousie University, 1348 Summer Street, Halifax, Nova Scotia B3H 4R2, Canada; Clinician Investigator Program and Clinician Scientist Graduate Program, IWK Health Centre, Dalhousie University, 1348 Summer Street, Halifax, Nova Scotia B3H 4R2, Canada; Division of Hematology/Oncology, IWK Health Centre, Dalhousie University, 1348 Summer Street, Halifax, Nova Scotia B3H 4R2, Canada; Department of Microbiology and Immunology, IWK Health Centre, Dalhousie University, 1348 Summer Street, Halifax, Nova Scotia B3H 4R2, Canada; Department of Pathology, IWK Health Centre, Dalhousie University, 1348 Summer Street, Halifax, Nova Scotia B3H 4R2, Canada
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38
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Hodgkin Lymphoma of the Nasopharynx: Case Report with Review of the Literature. Head Neck Pathol 2015; 9:369-75. [PMID: 25643759 PMCID: PMC4542794 DOI: 10.1007/s12105-015-0611-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/28/2015] [Indexed: 11/27/2022]
Abstract
We report an uncommon case and histopathologic work-up of Hodgkin lymphoma of the nasopharynx in a 49-year old female patient who presented with a 2-year complaint of bilateral nasal congestion. Histologic study revealed a lymphocyte rich subtype of classic Hodgkin lymphoma. Immunohistochemical analysis revealed CD15, CD30, OCT-2, BOB.1, and MUM-1 expression by the neoplastic cells and a lack of expression of CD45, CD20, CD3, EMA, and EBER. The review of the literature showed that Hodgkin lymphoma of the nasopharynx is rare, the most common reported subtype is the mixed cellularity, and Hodgkin lymphoma of the nasopharynx has a favorable prognosis.
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40
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Bagan JV, Carbonell F, Gómez MJ, Sánchez M, Navarro A, Leopoldo M, Bagán L, Zapater E. Extra-nodal B-cell non-Hodgkin's lymphomas of the head and neck: a study of 68 cases. Am J Otolaryngol 2015; 36:57-62. [PMID: 25456517 DOI: 10.1016/j.amjoto.2014.10.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 10/04/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The objectives of this study are to describe the distinctive characteristics of extra-nodal B-cell non-Hodgkin's lymphomas (BNHLs) located in the head and neck in a series of patients, to discuss patient survival, and to compare the oral versus the non-oral locations of the extra-nodal BNHLs of the head and neck. MATERIAL AND METHODS We studied 68 patients with BNHL of the head and neck. We analyzed the clinical and survival characteristics. Additionally, we performed Kaplan-Meier and Cox regression analyses to determine the influence of the different factors on survival. RESULTS This study included 68 non-nodal lymphomas; 30 lymphomas (31.9%) were located intraorally, with the gingiva as the most frequent location. The oral lymphomas in stages 1 and 2 showed a prevalence of 60% (18/30). The Kaplan-Meier analysis showed that the stage of disease and the oral versus non-oral extranodal lymphomas were significant prognostic factors (p<0.05). However, the multivariate Cox analysis indicated that only complete remission and oral versus non-oral location were significant prognostic factors (p<0.01). CONCLUSIONS The gingiva was the most common location of the intraoral lymphomas. Complete remission and non-oral location were the only significant survival factors in the multivariate Cox regression analysis.
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Affiliation(s)
- Jose V Bagan
- Department of Oral Medicine, Valencia University, Valencia, Spain; Department of Oral and Maxillofacial Surgery, University General Hospital, Valencia, Spain.
| | - Felix Carbonell
- Department of Hematology, Valencia University, Valencia, Spain; Department of Hematology, University General Hospital, Valencia, Spain
| | - Maria J Gómez
- ENT Unit, University General Hospital, Valencia, Spain
| | - Magdalena Sánchez
- Department of Hematology, University General Hospital, Valencia, Spain
| | - Atilio Navarro
- Department of Pathology, University General Hospital, Valencia, Spain
| | - Manuel Leopoldo
- Department of Oral and Maxillofacial Surgery, University General Hospital, Valencia, Spain
| | - Leticia Bagán
- Department of Oral Medicine, Valencia University, Valencia, Spain
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Picard A, Cardinne C, Denoux Y, Wagner I, Chabolle F, Bach CA. Extranodal lymphoma of the head and neck: a 67-case series. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 132:71-5. [PMID: 25553969 DOI: 10.1016/j.anorl.2014.07.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/02/2014] [Accepted: 07/05/2014] [Indexed: 12/11/2022]
Abstract
UNLABELLED The present study sought to describe clinical presentation in extranodal lymphoma of the head and neck (ELHN), with the aim of improving diagnostic management. MATERIAL AND METHODS A single-center retrospective observational study was conducted over the period 2001-13. Age, gender, histologic type, location, type of clinical presentation, time interval between symptom onset and histologic diagnosis and presence of specific symptoms were recorded, as were the specialty of the physician initially consulted and of the physician taking the diagnostic sample. RESULTS Sixty-seven cases of ELHN were diagnosed: 39 male and 28 female patients, with a median age of 68 years. B-cell lymphoma (84%) was more frequent than plasmacytoma (7%) or T-cell lymphoma (6%). Location was mainly palatine tonsil (28%), nasal fossa and sinus (19%), nasopharynx (14%) or parotid (13%). Revelation often involved a mass (33%), and only rarely any specific symptoms (9%). Time interval from symptom onset to diagnosis was short in aggressive lymphoma and longer in low-grade lymphoma (mean 4 and 10 months respectively). The physician initially consulted was an ENT specialist in 67% of cases, and an ENT specialist performed diagnostic sampling in 97% of cases. CONCLUSION ELHN is a rare pathology (5 cases per year in our department) of highly variable clinical presentation depending on location and histologic type. The ENT physician should be prepared for diagnosis regardless of anatomic location, so as to optimize diagnostic management.
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Affiliation(s)
- A Picard
- Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - C Cardinne
- Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Université de Versailles Saint-Quentin-en-Yvelines, UFR de médecine Paris Ouest Saint-Quentin-en-Yvelines, 78280 Guyancourt, France
| | - Y Denoux
- Service d'anatomo-pathologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - I Wagner
- Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - F Chabolle
- Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Université de Versailles Saint-Quentin-en-Yvelines, UFR de médecine Paris Ouest Saint-Quentin-en-Yvelines, 78280 Guyancourt, France
| | - C A Bach
- Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Université de Versailles Saint-Quentin-en-Yvelines, UFR de médecine Paris Ouest Saint-Quentin-en-Yvelines, 78280 Guyancourt, France.
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Lateral skull base destruction: unusual clinical progress of lymphoma. J Craniofac Surg 2014; 25:e373-5. [PMID: 25006953 DOI: 10.1097/scs.0000000000000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Lymphoma is a common tumor especially in pediatric population. It can originate every lymphoid tissue in the head and neck region. Head and neck lymphomas usually present with a slow-growing mass. We encountered a man who had a lymphoma that destroyed all soft tissues of the left lateral skull base. The unusual clinical progress is discussed in the article.
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Maka VV, Subramanian M, Kilara N. Relapsed Hodgkin's Lymphoma Presenting with Isolated Ulcerative Lesion on Base of Tongue. Indian J Hematol Blood Transfus 2014; 30:349-52. [PMID: 25332616 DOI: 10.1007/s12288-014-0401-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 04/29/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Primary extra nodal involvement of Hodgkin's lymphoma is very uncommon and previous reports of Hodgkin's lymphoma involving the base of tongue as isolated lesion in relapsed disease are few. CASE PRESENTATION A 79-years male patient who has diagnosed and treated for stage IV Nodular sclerosis Hodgkin lymphoma 2 years back, now presented with isolated ulcerative lesion in base of tongue which was metabolically active on positron emission tomography scan, suspicious of recurrent disease and was confirmed by routine microscopy and immunohistochemistry of tissue biopsy. CONCLUSION Extra nodal relapse at base of tongue was an uncommon clinical scenario in natural history of Hodgkin's lymphoma, which can present as an unexpected challenge for diagnosis and management. So we should be aware of this uncommon but unique presentation of Hodgkin's lymphoma.
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Affiliation(s)
- Vinayak V Maka
- Department of Medical Oncology, M S Ramaiah Medical College, MSRIT Post, Bangalore, 560054 India
| | - Murali Subramanian
- Department of Medical Oncology, M S Ramaiah Medical College, MSRIT Post, Bangalore, 560054 India
| | - Nalini Kilara
- Department of Medical Oncology, M S Ramaiah Medical College, MSRIT Post, Bangalore, 560054 India
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Guimarães AC, de Carvalho GM, Bento LR, Correa C, Gusmão RJ. Clinical manifestations in children with tonsillar lymphoma: A systematic review. Crit Rev Oncol Hematol 2014; 90:146-51. [DOI: 10.1016/j.critrevonc.2013.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 11/24/2013] [Accepted: 12/04/2013] [Indexed: 12/17/2022] Open
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Guevara-Canales JO, Morales-Vadillo R, Sacsaquispe-Contreras SJ, Barrionuevo-Cornejo C, Montes-Gil J, Cava-Vergiú CE, Soares FA, Chaves-Netto HDDM, Chaves MDGAM. Malignant lymphoma of the oral cavity and the maxillofacial region: overall survival prognostic factors. Med Oral Patol Oral Cir Bucal 2013; 18:e619-26. [PMID: 23722134 PMCID: PMC3731090 DOI: 10.4317/medoral.18903] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 01/09/2013] [Indexed: 12/26/2022] Open
Abstract
Objective: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region.
Study Design: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox’s regression tests.
Results: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010).
Conclusion: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus.
Key words:Lymphoma, oral cavity, survival.
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Characteristics and prognostic factors for head and neck non-Hodgkin's lymphoma in Chinese patients. The Journal of Laryngology & Otology 2013; 127:699-704. [PMID: 23738972 DOI: 10.1017/s0022215113001217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVES The head and neck region is the second most frequent anatomical site of extranodal lymphomas. These tumours affect many individuals worldwide, justifying epidemiological studies in different countries. This study evaluated the characteristics, treatments and prognostic factors for non-Hodgkin's lymphoma of the head and neck in Chinese patients. METHOD The clinical manifestations, clinicopathological characteristics, multidisciplinary treatment and prognostic factors for 102 patients with extranodal non-Hodgkin's lymphoma of the head and neck were analysed retrospectively. RESULT The tonsil was the most commonly involved primary site, followed by the nasal cavity. The most common histological subtype was diffuse large B-cell lymphoma, followed by natural killer T-cell lymphoma. Patients receiving a combination of rituximab and chemotherapy did better than those receiving chemotherapy alone. Prognosis was significantly associated with both International Prognostic Index and histological subtype; the former was especially strongly associated with poor survival. CONCLUSION In this group of Chinese patients, diffuse large B-cell lymphoma was the most common pathological subtype, but the incidence of T-cell lymphomas was higher than that reported in the USA. Combined rituximab and chemotherapy led to better outcomes than chemotherapy alone. Prognosis depended on both International Prognostic Index and histological subtype.
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Mitsui T, Mawatari M, Koiso H, Yokohama A, Uchiumi H, Saitoh T, Handa H, Hirato J, Karasawa M, Murakami H, Kojima M, Nakamura S, Nojima Y, Tsukamoto N. Age-related Epstein-Barr Virus-positive lymphoproliferative disorders of the orbit and maxillary sinus : a case report. J Clin Exp Hematop 2013; 52:205-9. [PMID: 23269081 DOI: 10.3960/jslrt.52.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We report a rare case of age-related Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disorder (aEBVBLPD) primarily involving the orbit and maxillary sinus. Lesions in the left orbit and maxillary sinus were observed in a 59-year-old man presenting with pain in the left orbit and maxilla. Owing to the presence of Reed-Sternberg-like cells, the initial diagnosis was nodular sclerosis-type Hodgkin's lymphoma. Clinical stage was IIAE, and response to chemotherapy and radiotherapy was favorable. Further immunohistochemical and in situ hybridization analyses of the Reed-Sternberg-like giant cells revealed CD30, CD15, CD20, Bob-1, Oct-2, EBV-encoded RNAs (EBERs) and latent membrane protein-1 (LMP-1) expression. The characteristics of the present case, which included immunohistochemical findings, sites of primary lesions, absence of other lymph node lesions and relatively old age, suggested aEBVBLPD. Owing to the similarity in morphology, higher frequency at extranodal sites and poor prognosis, aEBVBLPD represents a differential diagnostic issue from classical Hodgkin's lymphoma when Reed-Sternberg cells are positive for EBV.
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Affiliation(s)
- Takeki Mitsui
- Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi, Japan
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Feinstein AJ, Ciarleglio MM, Cong X, Otremba MD, Judson BL. Parotid gland lymphoma: prognostic analysis of 2140 patients. Laryngoscope 2013; 123:1199-203. [PMID: 23576299 DOI: 10.1002/lary.23901] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Assess the demographic, clinical, and pathologic features of patients with parotid gland lymphoma and their prognostic importance using US population-based data. STUDY DESIGN Retrospective cohort study. METHODS Patients were selected from the Surveillance, Epidemiology, and End Results program database between the years of 1973 and 2008, and individual characteristics were compared using univariate and multivariate Cox proportional hazards models. Kaplan-Meier survival curves were constructed and log-rank tests were performed. RESULTS We identified 2,140 patients with primary parotid gland lymphoma. Hodgkin lymphoma was found in 3.5% of patients. More common were non-Hodgkin lymphoma subtypes: marginal zone B-cell lymphoma, follicular lymphoma, and diffuse large B cell lymphoma accounted for 27.9%, 25.8%, and 23.7% of cases, respectively. Survival was decreased with patient age over 50 years, increasing stage, male gender, non-Hodgkin histology, and status other than married. Of the patients, 72.0% received some form of surgery, and 136 patients had facial nerve sacrifice during parotidectomy. CONCLUSIONS Non-Hodgkin lymphoma is the predominant type of lymphoma seen in the parotid gland. Patient and histologic features determine survival, and surgery is often performed. Facial nerve sacrifice, which is contraindicated given the systemic nature of lymphoma and the role of chemotherapy and radiation in its treatment, is reported in 6.4% of patients with parotid gland lymphoma. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Aaron J Feinstein
- Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
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Revanappa MM, Sattur AP, Naikmasur VG, Thakur AR. Disseminated non-Hodgkin's lymphoma presenting as bilateral salivary gland enlargement: a case report. Imaging Sci Dent 2013; 43:59-62. [PMID: 23525854 PMCID: PMC3604373 DOI: 10.5624/isd.2013.43.1.59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 09/05/2012] [Accepted: 10/26/2012] [Indexed: 12/24/2022] Open
Abstract
Non-Hodgkin's lymphoma (NHL) constitutes a group of malignancies those arises from cellular components of lymphoid or extranodal tissues. The head and neck is the most common area for the presentation of these lymphoproliferative disorders. Primary involvement of salivary glands is uncommon. This report described a case of a 73-year-old female patient who presented with involvement of both nodal and extranodal sites, with predominant involvement of salivary glands. The tumor staging worked up along with imaging, histopathological, and immunohistochemical findings were discussed. Computed tomographic images showed the involvement of Waldeyer's ring, larynx, orbit, and spleen. This report described imaging and prognostic tumor markers in diagnosing, treatment planning, and prognosis.
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