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de Oliveira EM, de Cáceres CVBL, Santos-Silva AR, Vargas PA, Lopes MA, Pontes HAR, Pontes FSC, Mesquita RA, de Sousa SF, Abreu LG, Xavier JCC, de Andrade BAB, Lacerda JCT, Resende RG, Tomasi RA, Fonseca FP. Clinical diagnostic approach for oral lymphomas: a multi-institutional, observational study based on 107 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:427-435. [PMID: 37150653 DOI: 10.1016/j.oooo.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/07/2023] [Accepted: 03/31/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To evaluate oral lymphomas' clinical manifestations and investigate whether clinical features are associated with lymphoma subtypes. STUDY DESIGN Oral lymphomas with at least 1 representative clinical image were evaluated. They were classified according to their microscopic grade (high vs low), predominant cell size (small vs medium/large), and cellular lineage (B cell vs T cell). Clinical images were described according to tumor location, number, swelling, ulcer, necrosis, telangiectasia, predominant color, and lobulation. Lymphomas affecting the palate were compared with salivary gland tumors (SGTs) affecting this location. RESULTS Data from 107 cases were included. High-grade subtypes (80.4%), with medium/large-sized cells (52.3%), and diagnosed as diffuse large B cell lymphomas (29%) predominated. High-grade lymphomas often presented as painful, ulcerative, and osteolytic diseases (P < .05). Tumors predominantly composed of medium/large-sized cells were associated with painful lesions, ulcerated, with necrosis and bone destruction (P < .05). When only palate tumors were considered, multiple and bilateral lesions, the presence of pain, ulceration, and necrosis were significantly more associated with a diagnosis of lymphoma than SGT (P < .001). CONCLUSION High-grade oral lymphomas are more associated with destructive presentation than low-grade subtypes, and bilateral lesions in the palate are more associated with a lymphoma diagnosis than SGT.
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Affiliation(s)
| | | | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | | | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Silvia Ferreira de Sousa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - José Cândido Caldeira Xavier
- Pathology Institute of Araçatuba and School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, Brazil
| | | | | | | | | | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Cheah CY, Seymour JF. Marginal zone lymphoma: 2023 update on diagnosis and management. Am J Hematol 2023; 98:1645-1657. [PMID: 37605344 DOI: 10.1002/ajh.27058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023]
Abstract
DISEASE OVERVIEW Marginal zone lymphomas (MZL) are collectively the second most common type of indolent lymphoma. DIAGNOSIS Three subtypes of MZL are recognized: splenic, extranodal, and nodal. The diagnosis is secured following biopsy of an involved nodal or extranodal site demonstrating a clonal B-cell infiltrate with CD5 and CD10 negative immunophenotype most common. Some cases will features IgM paraprotein, but MYD88 L256P mutations are less frequent than in Waldenstrom macroglobulinemia. Prognostication Several prognostic models have been developed, including the MALT-IPI and the MZL-IPI. The latter is broadly applicable across MZL subtypes and incorporates elevated serum LDH, anemia, lymphopenia, thrombocytopenia and nodal or disseminated subtypes as independent predictors of outcome. TREATMENT We discuss suggested approach to therapy for both early and advanced-stage disease, with reference to chemo-immunotherapy, radiotherapy, and emerging treatments in relapsed/refractory disease such as BTK inhibitors.
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Affiliation(s)
- Chan Y Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Australia
- Medical School, University of Western Australia, Crawley, Australia
| | - John F Seymour
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
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Hua J, Lia Z, Ma C, Zhang X, Li Q, Duan X, Xiao T, Geng X. Risk factors analysis and establishment of predictive nomogram of extranodal B-cell lymphoma of mucosal-associated lymphoid tissue. Cancer Radiother 2023; 27:126-135. [PMID: 36894407 DOI: 10.1016/j.canrad.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE The role of radiation therapy in mucosa-associated lymphoid tissue (MALT) lymphoma is poorly defined. The objective of this study was to explore the factors associated with the performance of radiotherapy and to assess its prognostic impact in patients with MALT lymphoma. PATIENTS AND METHODS Patients with MALT lymphoma diagnosed between 1992 and 2017 were identified in the US Surveillance, Epidemiology, and End Results database (SEER). Factors associated with the delivery of radiotherapy were assessed by chi-square test. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between patients with and without radiotherapy, using Cox proportional hazard regression models, in patients with early stage as well as those with advanced stage. RESULTS Of the 10,344 patients identified with a diagnosis of MALT lymphoma, 33.6% had received radiotherapy; this rate was 38.9% for stage I/II patients and 12.0% for stage III/IV patients, respectively. Older patients and those who already received primary surgery or chemotherapy had a significantly lower rate of receiving radiotherapy, regardless of lymphoma stage. After univariate and multivariate analysis, radiotherapy was associated with improved OS and LSS in patients with stage I/II (HR=0.71 [0.65-0.78]) and (HR=0.66 [0.59-0.74]), respectively, but not in patients with stage III/IV (HR=1.01 [0.80-1.26]) and (HR=0.93 [0.67-1.29]). The nomogram built from the significant prognostic factors associated with overall survival of stage I/II patients had a good concordance (C-index=0.749±0.002). CONCLUSION This cohort study shows that radiotherapy is significantly associated with a better prognosis in patients with early but not advanced MALT lymphoma. Prospective studies are needed to confirm the prognostic impact of radiotherapy in patients with MALT lymphoma.
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Affiliation(s)
- J Hua
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Z Lia
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - C Ma
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Zhang
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Q Li
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Duan
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - T Xiao
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Geng
- Department of Radiotherapy, Liaocheng People's Hospital, 252000 Shan Dong, China.
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Cao N, Shi H, Chen C, Xie L, Wang Z, Zheng L, Yu C. Characterization of comprehensive dynamic epigenetic changes during human primary Sjögren's syndrome progression. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1044. [PMID: 34422956 PMCID: PMC8339825 DOI: 10.21037/atm-21-1754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/24/2021] [Indexed: 11/06/2022]
Abstract
Background Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by reduced exocrine gland (principally the salivary and lacrimal glands) activity caused by chronic lymphocytic infiltration. Although pSS has been closely associated with an increased risk of mucosa-associated lymphoid tissue (MALT) lymphoma, the dynamic epigenetic changes in the gland cells that accompany the pathogenesis are not entirely understood. Methods In this study, we harvested tissue samples from the labial gland with (LG_pSS) or without pSS (LG_NC) before MALT development, as well as the parotid gland with tumor tissues (PG_MALT) and paracancerous tissues (PG_NC) of two pSS patients with MALT lymphoma, and conducted RNA-seq and ChIP-seq for tri-methylated histone 3 lysine 4, 9, 27, 36, and 79 (H3K4/9/27/36/79me3). Results Transcriptome landscapes indicated two outcomes of pSS progression with or without MALT lymphoma represented by distinct populations of differentially expressed genes and their functions. Furthermore, the epigenetic atlas of genome-wide H3K4/9/27/36/79me3 was in different stages for various samples, indicating that the variance of H3K4me3 was the earliest event, followed by selective alterations of H3K9/27/36/79me3. These four epigenetic modifications determine the final outcome of pSS progression. Conclusions Our results not only advance the understanding of the dynamics of pSS progression and highlight the importance of epigenetic alterations in regulating transcription during this pathological process, but also identify potential therapeutic targets for pSS treatment and lymphoma intervention.
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Affiliation(s)
- Ningning Cao
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Huan Shi
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chan Chen
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lisong Xie
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhijun Wang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lingyan Zheng
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chuangqi Yu
- Department of Oral and Maxillofacial Surgery, College of Stomatology, the Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,National Clinical Research Center of Oral Disease, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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