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Di Santo D, Bramati C, Festa BM, Pace GM, Comini LV, Luparello P, Cascardi E, Galizia D, Galli A, De Virgilio A, Giordano L, Bondi S. Current evidence on diagnosis and treatment of parotid gland lymphomas: a systematic review. Eur Arch Otorhinolaryngol 2023; 280:5219-5227. [PMID: 37638999 DOI: 10.1007/s00405-023-08206-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/19/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND AND PURPOSE Parotid gland lymphoma (PGL) is a rare and challenging diagnosis. Different lymphomas can develop in the parotid gland, with the most common being the mucosa-associated lymphoid tissue (MALT) lymphoma, which originates directly from the glandular parenchyma. Other histologic subtypes arise from both intraglandular and extraglandular parotid lymph nodes. A consensus on diagnosis and treatment of PGL is still lacking, and published data is scarce and heterogeneous. METHODS We performed a systematic review of the literature, including studies published after 2001, when the WHO classification of lymphoid tumours was introduced. RESULTS Twenty retrospective studies were included in the analyses, eight of which focused exclusively on MALT lymphomas. Final analysis included 612 cases of PGL, with a 1.68:1 F/M ratio. MALT lymphoma was the most common histology, followed by follicular and diffuse large B-cell lymphoma. Most cases were low stages (IE/IIE acc. Ann Arbour, 76.5%) and only 10% of patients presented with symptoms, most commonly pain (4.8%) and B symptoms (2.2%). A high prevalence of associated autoimmune diseases was found, particularly Sjögren's syndrome, that affected up to 70% of patients with MALT lymphoma. In most cases diagnosis was achieved through parotidectomy (57.5%), or open biopsy (31.2%). Treatment strategies were either surgical, non-surgical or a combination of modalities. Surgery as a single-modality treatment was reported in about 20% of patients, supposing it might be a valuable option for selected patients. CONCLUSIONS Our review showed that the diagnosis and treatment of PGLs is far from being standardized and needs further, more homogeneous reports to reach consensus.
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Affiliation(s)
- Davide Di Santo
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
| | - Chiara Bramati
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
| | - Bianca Maria Festa
- Otolaryngology-Head and Neck Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gian Marco Pace
- Otolaryngology-Head and Neck Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Paolo Luparello
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
| | - Eliano Cascardi
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
| | - Danilo Galizia
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
| | - Andrea Galli
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Armando De Virgilio
- Otolaryngology-Head and Neck Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Leone Giordano
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Stefano Bondi
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
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2
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Jang HB, Lee DH, Jung EK, Lee JK, Lim SC. Diagnostic tips for parotid lymphoma. Oral Oncol 2023; 145:106525. [PMID: 37542798 DOI: 10.1016/j.oraloncology.2023.106525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES Parotid lymphoma is a rare disease and proves challenging to differentiate from other masses. In this study, we aimed to analyze the clinical characteristics of parotid lymphoma to identify diagnostic factors to facilitate a diagnosis of parotid lymphoma. MATERIALS AND METHODS We retrospectively enrolled 7 patients with parotid lymphoma, which was diagnosed at our hospital from 2012 to 2023. RESULTS All participants had a well-defined, homogeneous solid mass; moreover, 5 patients had bilateral multiple lymphadenopathy that was detected on neck computed tomography (CT). Three patients had lymphocyte-related findings in fine-needle aspiration cytology (FNAC). CONCLUSION Despite the challenges in diagnosing a parotid lymphoma, CT and FNAC findings can facilitate a differential diagnosis of parotid lymphoma.
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Affiliation(s)
- Hye-Bin Jang
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, Republic of Korea
| | - Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, Republic of Korea.
| | - Eun Kyung Jung
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, Republic of Korea
| | - Joon Kyoo Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, Republic of Korea
| | - Sang Chul Lim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Hwasun Hospital, Hwasun, Republic of Korea
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3
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Chen XL, Zhao LM, Cai YH, Li JG, Li X. Primary B-cell non-Hodgkin lymphoma of the parotid gland: An analysis based on the SEER database. Medicine (Baltimore) 2023; 102:e33098. [PMID: 37115091 PMCID: PMC10145808 DOI: 10.1097/md.0000000000033098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 04/29/2023] Open
Abstract
Primary malignant lymphoma of the parotid gland is a rare entity. The disease is often misdiagnosed, and its survival factors remain unclear. This study included patients diagnosed with primary B-cell non-Hodgkin lymphoma of the parotid gland from 1987 to 2016 in the surveillance, epidemiology, and end results program. Univariate survival analysis was conducted using the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazards regression model. A competing risks regression model was applied to estimate the specific risks associated with parotid lymphoma mortality. A total of 1443 patients were identified. The overall survival of indolent primary B-cell lymphoma of the parotid gland was higher than that of aggressive lymphoma (hazard ratio 0.53, 95% confidence interval 0.44-0.64, P < .001), and older patients (≥70 years) exhibited inferior overall survival. Histological subtype and age are important prognostic factors in patients with primary B-cell non-Hodgkin lymphoma of the parotid gland.
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Affiliation(s)
- Xiang-Lei Chen
- Department of Hematology, Weifang Yidu Central Hospital, Qingzhou, P. R. China
| | - Lu-Ming Zhao
- Department of Stomatology, Weifang Yidu Central Hospital, Qingzhou, P. R. China
| | - Yuan-Hua Cai
- Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, P. R. China
| | - Jing-Gang Li
- Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, P. R. China
| | - Xin Li
- Department of Blood Transfusion Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, P. R. China
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4
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Kaur R, Shetty D, Bagal BP, Gujral S, Sengar M, Laskar S, Nayak L, Shet T. Extranodal MALT Lymphoma in the Oral Cavity: A Series of Three Cases with Review of Literature. Head Neck Pathol 2022; 16:1242-1250. [PMID: 35674932 PMCID: PMC9729474 DOI: 10.1007/s12105-022-01461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Diagnosis of MALT lymphoma in the oral cavity is challenging. There is a great overlap in the histopathologic, immuno-histochemical and molecular features of MALT lymphoma with reactive lymphoid proliferations. The literature shows a very few case reports of primary MALT lymphoma of oral cavity. METHODS We discuss the histopathologic, immuno-histochemical, cytogenetic features, treatment and behavior of 3 cases of primary MALT lymphoma oral cavity along with review of literature. RESULTS The age ranged from 40 to 57 years (male to female ratio = 2:1). The sites involved were hard palate, bilateral gingivobuccal sulcus and right buccal mucosa. The most common histology was centrocyte-like (2 cases). Lymphoepithelial lesions were absent. On immunohistochemistry, all tumors showed diffuse strong CD20 and bcl2 expression with strong and diffuse MNDA staining in one case. IgH; MALT1 translocation was not seen in any of these cases. One patient received local radiotherapy, one received steroids; while the case 3 received RCHOP (Rituximab, cyclophosphamide, hydroxydaunorubicin hydrochloride, vincristine and prednisone) chemotherapy. Two patients had complete remission while one had recurrence. CONCLUSION MALT lymphoma of oral cavity shows a wide spectrum of morphology with presence of transformed cells, that may lead to misdiagnosis of DLBL. Treatment guidelines are not well established but a tendency to excise MALT lymphomas of oral cavity has been observed. Nevertheless, MALT lymphoma of oral cavity appears to be an indolent disease.
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Affiliation(s)
- Ramandeep Kaur
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India
| | - Dhanlaxmi Shetty
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India
| | - Bhausaheb P. Bagal
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India
| | - Sumeet Gujral
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India
| | - Manju Sengar
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India
| | - Siddhartha Laskar
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India
| | - Lingaraj Nayak
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India
| | - Tanuja Shet
- Tata Memorial Hospital, Dr E.B. Road, Parel, Mumbai, Maharashtra 400012 India ,Department of Pathology, Tata Memorial Hospital, 8th floor, Annexe building, Lower Parel, Mumbai, Maharashtra 400012 India
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5
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Investigation of the treatment modality in primary lymphoma of the salivary glands. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:248-255. [PMID: 32681985 DOI: 10.1016/j.jormas.2020.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/24/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To review our experience in managing primary lymphoma of the major salivary glands by analysing the treatment modality of patients. METHODS In this study, we reviewed the medical records of 26 patients with primary malignant lymphoma of the major salivary glands who were treated at Beijing Stomatological Hospital of Capital Medical University from January 1999 to March 2015. The predictor variable was treatment modality. The outcome variables were overall survival (OS), disease-free survival (DFS), disease-special survival (DSS) and local control (LC). Other relevant variables were as follows: age, sex, pathological pattern, tumour site, clinical features, source, IPI and Ann-Arbor stage. The data were analysed by the χ2 test, log-rank test, and univariate analysis. RESULTS Of the 26 patients, 14 received surgery only, four received initial surgery combined with adjuvant radiotherapy, five received adjuvant chemotherapy, and three received adjuvant radiochemotherapy. During the median follow-up period of 104 months, the overall estimates of OS, DFS, DSS and LC were 84.6, 84.6, 88.5 and 92.3%, respectively. Good outcomes were achieved in patients who received surgery combined with postoperative RT, followed by surgery only. MALT lymphoma had a better prognosis than the other pathological patterns. Mass, swelling, pathological pattern and Ann-Arbor stage were important prognostic factors. CONCLUSION Surgery combined with postoperative radiotherapy may be an appropriate choice for patients with MALT lymphoma. The pathological pattern, mass, swelling and Ann-Arbor stage were associated with an unfavourable prognosis.
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6
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Zhang XY, Wang ZM. Relevance on the diagnosis of malignant lymphoma of the salivary gland. World J Clin Cases 2020; 8:2717-2726. [PMID: 32742982 PMCID: PMC7360714 DOI: 10.12998/wjcc.v8.i13.2717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/13/2020] [Accepted: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
Malignant lymphoma originates from the lymphohematopoietic system. It can occur in any lymphoid tissue. Malignant lymphoma of the salivary gland is rare, but its incidence has increased in recent years. Its clinical- presentations are non-specific, and it is often manifested as a painless mass in a salivary gland, which can be accompanied by multiple swollen cervical lymph nodes. Confirmation of the diagnosis before an invasive procedure is difficult. Clinically, malignant lymphoma of the salivary gland tends to be misdiagnosed, leading to an inappropriate treatment plan and the ultimate delay in the optimal treatment of the disease. This article reviews the pathogenesis, clinical features, imaging findings, diagnosis, treatment and prognosis of malignant lymphoma of the salivary gland.
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Affiliation(s)
- Xin-Yue Zhang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zhi-Ming Wang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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7
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Travaglino A, Giordano C, Pace M, Varricchio S, Picardi M, Pane F, Staibano S, Mascolo M. Sjögren Syndrome in Primary Salivary Gland Lymphoma. Am J Clin Pathol 2020; 153:719-724. [PMID: 32076706 DOI: 10.1093/ajcp/aqaa005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Sjögren syndrome (SS) is considered as a major etiologic factor for primary salivary gland lymphoma (SGL). However, the percentage of SGL that is caused by SS (and thus the real impact of SS on SGL epidemiology) is unclear. We aimed to assess the prevalence of SS in patients with SGL through a systematic review and meta-analysis. METHODS Electronic databases were searched for studies assessing the presence of SS in patients with SGL. Pooled prevalence of SS in SGL was calculated, with a subgroup analysis based on histotype (mucosa-associated lymphoid tissue [MALT] vs non-MALT). RESULTS Sixteen studies with 665 SGLs were included. Pooled prevalence of SS in SGL was 18.2%, with high heterogeneity among studies. In MALT SGL, the prevalence of SS was 29.5%, with moderate heterogeneity. In non-MALT SGL, the prevalence of SS was 0%, with null heterogeneity. CONCLUSIONS SS seems to be responsible for a significant but minor portion of SGLs. SS appears involved in MALT-type SGL but not in other histotypes.
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Affiliation(s)
- Antonio Travaglino
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Claudia Giordano
- Department of Clinical Medicine and Surgery, Hematology Section, Federico II University of Naples, Naples, Italy
| | - Mirella Pace
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, Hematology Section, Federico II University of Naples, Naples, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, Federico II University of Naples, Naples, Italy
| | - Stefania Staibano
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Naples, Italy
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8
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Itami H, Nakamine H, Takeda M, Nakai T, Myojin T, Matsuoka M, Sasaki S, Uchiyama T, Morita K, Fujii T, Hatakeyama K, Ohbayashi C. Immunohistochemical Reappraisal Regarding the Frequency of Primary Salivary Gland Follicular Lymphoma. Int J Surg Pathol 2018; 27:48-54. [PMID: 29972093 DOI: 10.1177/1066896918784349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although it has been described that extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT lymphomas) are the most common type among primary salivary gland lymphomas (SGLs), some studies revealed that the frequency of follicular lymphomas (FLs) was as high as that of MALT lymphomas. However, it has been reported that many of these FLs may have developed in lymph nodes attached to the capsule of the glands or intraglandular lymph nodes. Clinical, histological, immunohistochemical, and cytogenetic features of 11 SGL cases, which were extracted from our surgical pathology file consisting of consecutive pathology cases, were reevaluated to further characterize whether they were actually primary SGLs. There were 3 (27%) cases of FLs, 5 (46%) cases of MALT lymphomas, and 3 (27%) cases of diffuse large B-cell lymphomas. Although all of our FL cases fulfilled the criteria of primary SGL, tumors of several FL cases were surrounded by podoplanin (by D2-40)-positive elongated vessels or linear structures indicative of nodal subcapsular sinuses (open or remnant). This finding would support the aforementioned possibility, and podoplanin staining is necessary before concluding that a FL is a primary SGL.
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Affiliation(s)
| | | | - Maiko Takeda
- 1 Nara Medical University, Kashihara, Japan.,3 National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
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9
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Abstract
Purpose This meta-analysis aimed to review the published outcomes of parotid
non-Hodgkin lymphoma (NHL) pertaining to different treatment modalities. Materials and Methods A total of 48 journal articles published between 1993 and 2015, comprising
742 cases of parotid NHL, were initially evaluated. In total, 108 patients
from 12 studies who had sufficient data for analysis, including age, tumor
histopathology, treatment modality, and outcome at final follow-up, were
included. Patients were randomly assigned to different categories on the
basis of histopathology and treatment modality. Groups were compared using
Kaplan-Meier survival curve analysis and the Mann-Whitney U
test. Results Log-rank tests demonstrated that for early-stage (I and II) parotid NHL of
all histopathology variants, radiation therapy significantly improved the
survival rate versus chemotherapy (P = .043), as well as
combined treatment with chemotherapy and radiation therapy
(P = .023). For early-stage diffuse large B-cell
lymphoma, combined treatment significantly improved survival versus single
treatment (P = .028). No treatment was received by seven
patients with early-stage mucosa-associated lymphoid tissue lymphoma after
undergoing parotidectomy. When the clinical outcomes of these patients were
compared with those of other patients with the same histology who underwent
further treatment, no significant differences were noted in survival
outcomes. Conclusion Radiation therapy seems to be a valid treatment of early-stage parotid NHL.
However, for diffuse large B-cell lymphoma, survival was higher with
combined treatment versus single treatment. For early-stage parotid
mucosa-associated lymphoid tissue lymphoma, complete excision of the tumor
through superficial parotidectomy may have similar survival outcome.
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Affiliation(s)
- Basem Jamal
- Basem Jamal, King Abdulazziz University, Jeddah, Makkah, Saudi Arabia
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10
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Yonal-Hindilerden I, Hindilerden F, Arslan S, Turan-Guzel N, Dogan IO, Nalcaci M. Primary B-Cell Mucosa-Associated Lymphoid Tissue Lymphoma of the Hard Palate and Parotid Gland: Report of One Case and Review of the Literature. J Clin Med Res 2016; 8:824-830. [PMID: 27738485 PMCID: PMC5047022 DOI: 10.14740/jocmr2733w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 12/15/2022] Open
Abstract
A 61-year-old woman was admitted to our hospital with an ulcerated palate mass and swelling of the right parotid gland. Incisional biopsy from the hard palate revealed an extranodal marginal zone B-cell lymphoma, also called mucosa-associated lymphoid tissue (MALT) lymphoma. Final diagnosis was MALT lymphoma of the parotid gland with concomitant involvement of an extremely seldom site of involvement: the hard palate. To our knowledge, this report illustrates the first case of MALT lymphoma of the hard palate and parotid gland without an underlying autoimmune disease. Rituximab-based combination regimen (R-CHOP) provided complete remission with total regression of mass lesions at the hard palate and parotid gland. At 44-month follow-up, there is no disease relapse. We adressed the manifestations and management of MALT lymphoma patients with involvement of salivary gland and oral cavity.
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Affiliation(s)
- Ipek Yonal-Hindilerden
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Fehmi Hindilerden
- Hematology Clinic, Istanbul Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Serkan Arslan
- Radiology Clinic, Istanbul Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nalan Turan-Guzel
- Department of Pathology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Ibrahim Oner Dogan
- Department of Pathology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Meliha Nalcaci
- Division of Hematology, Department of Internal Medicine, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
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11
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Di Napoli A, Mallel G, Bartolazzi A, Cavalieri E, Becelli R, Cippitelli C, Ruco L. Nodular Lymphocyte-Predominant Hodgkin Lymphoma in a Warthin Tumor of the Parotid Gland: A Case Report and Literature Review. Int J Surg Pathol 2016; 23:419-23. [PMID: 26169920 DOI: 10.1177/1066896915582263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hodgkin lymphoma (HL) associated with Warthin tumor (WT) is extremely rare, accounting for only 3 cases of classical HLs. Here, we report for the first time the occurrence of a nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) involving the lymphoid stroma of a WT of the parotid gland. Pathogenesis of WT is controversial, with both a nodal and a parenchymal possible origin. On the other hand, extranodal involvement by HLs is uncommon. In our case, the coexistence of a WT and of a NLPHL within its stroma and in cervical lymph node emphasizes the importance of a careful evaluation of the lymphoid tissue in WT in order to exclude the possibility of an associated lymphoid malignancy.
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Affiliation(s)
| | | | | | | | | | | | - Luigi Ruco
- Sant'Andrea Hospital, Sapienza University, Rome, Italy
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12
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Extranodal Marginal Zone Lymphoma of the Parotid Gland. J Maxillofac Oral Surg 2016; 15:346-50. [PMID: 27408468 DOI: 10.1007/s12663-016-0882-x] [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: 07/21/2014] [Accepted: 02/05/2016] [Indexed: 10/22/2022] Open
Abstract
Non Hodgkin lymphomas correspond to 25 % of all head and neck cancers. These rare tumors only include less than 5 % of malign tumors in parotid region. Differential diagnosis of these tumors cover many malign and benign tumors of the parotid gland. Definite diagnosis depends on sufficient tissue material of parotidectomy specimen. Treatment modality is surgical removal of the lesion with or without additional radiation and chemotherapy depending on the stage of the tumor. Prognosis is better than other forms of the B-cell lymphoma. We present a 54 year old woman who suffered from progressively and slowly growing mass on parotid region, without any inflammatory disease or chronic infection, diagnosed with mucosa associated lymphoid tissue lymphoma of the parotid gland. Parotid gland was totally excised by superficial parotidectomy and there is no recurrence after 5 years postoperative period.
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13
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Giran G, Merlet FL, Bonnet R, Guiziou N, Clairand R, Arzul L. [Diffuse enlargement of salivary glands]. ACTA ACUST UNITED AC 2014; 115:e43-5. [PMID: 25458597 DOI: 10.1016/j.revsto.2014.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 08/12/2014] [Accepted: 09/26/2014] [Indexed: 11/16/2022]
Affiliation(s)
- G Giran
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - F L Merlet
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - R Bonnet
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - N Guiziou
- Service de médecine polyvalente d'urgence, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - R Clairand
- Service de médecine polyvalente d'urgence, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - L Arzul
- Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
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14
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Nocturne G, Mariette X. Sjögren Syndrome-associated lymphomas: an update on pathogenesis and management. Br J Haematol 2014; 168:317-27. [PMID: 25316606 DOI: 10.1111/bjh.13192] [Citation(s) in RCA: 183] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary Sjögren Syndrome (pSS) is an autoimmune disease associated with an increased risk of lymphoma. Lymphomas complicating pSS are mostly low-grade B cell non-Hodgkin lymphomas, predominantly of marginal zone histological type. Mucosal localization is predominant, notably mucosa-associated lymphoid tissue lymphomas. Lymphomas often develop in organs where pSS is active, such as salivary glands. Germinal centre (GC)-like structures, high TNFSF13B (BAFF) and Flt3-ligand (FLT3LG) levels and genetic impairment of TNFAIP3 are new predictors of lymphoma development. These new findings allow a better understanding of the pathogenic mechanisms leading to lymphoma. We propose the following scenario: auto-immune B cells with rheumatoid factor (RF) activity are continuously stimulated by immune complexes containing antibodies against more specific auto-antigens, such as SSA/Ro, SSB/La or others. Germline abnormality of TNFAIP3 leads to a decreased control of the NF-kB pathway and thus promotes survival of B cells and oncogenic mutations especially in GC structure. Moreover, B cells are stimulated by a positive loop of activation induced by BAFF secretion. Thus, lymphomagenesis associated with pSS exemplifies the development of antigen-driven B-cell lymphoma. The control of disease activity by a well-targeted immunosuppressor is the primary objective of the management of the patient in order to repress chronic B cell stimulation.
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15
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Hsu YC, Lin YT, Yeh DW, Wang CP. Follicular Lymphoma in Bilateral Submandibular Glands and Thyroid Gland. J Med Ultrasound 2014. [DOI: 10.1016/j.jmu.2014.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Vazquez A, Khan MN, Sanghvi S, Patel NR, Caputo JL, Baredes S, Eloy JA. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the salivary glands: A population-based study from 1994 to 2009. Head Neck 2014; 37:18-22. [DOI: 10.1002/hed.23543] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/23/2013] [Accepted: 10/30/2013] [Indexed: 12/22/2022] Open
Affiliation(s)
- Alejandro Vazquez
- Department of Otolaryngology - Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey
| | - Mohemmed N. Khan
- Department of Otolaryngology - Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey
| | - Saurin Sanghvi
- Department of Otolaryngology - Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey
| | - Neal R. Patel
- Department of Otolaryngology - Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey
| | - Joseph L. Caputo
- Department of Otolaryngology - Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey
- Division of Otolaryngology; Department of Surgery - Veterans Affairs Health Care System of New Jersey; East Orange; New Jersey
| | - Soly Baredes
- Department of Otolaryngology - Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey, Rutgers New Jersey Medical School; Newark New Jersey
| | - Jean Anderson Eloy
- Department of Otolaryngology - Head and Neck Surgery; Rutgers New Jersey Medical School; Newark New Jersey
- Center for Skull Base and Pituitary Surgery; Neurological Institute of New Jersey, Rutgers New Jersey Medical School; Newark New Jersey
- Department of Neurological Surgery; Rutgers New Jersey Medical School; Newark New Jersey
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17
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Corti M, Villafañe M, Bistmans A, Narbaitz M, Gilardi L. Primary extranodal non-hodgkin lymphoma of the head and neck in patients with acquired immunodeficiency syndrome: a clinicopathologic study of 24 patients in a single hospital of infectious diseases in Argentina. Int Arch Otorhinolaryngol 2014; 18:260-5. [PMID: 25992103 PMCID: PMC4297006 DOI: 10.1055/s-0034-1373782] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 03/01/2014] [Indexed: 12/14/2022] Open
Abstract
Introduction Extranodal non-Hodgkin lymphomas (NHLs) are commonly described in patients with acquired immunodeficiency syndrome (AIDS) and are related with an atypical morphology and aggressive clinical course. AIDS-associated lymphomas are characterized by their rapid progression, frequent extranodal manifestations, and poor outcome. Objective The aim of this article is to remake the clinical features of head and neck (HN) NHL in patients with AIDS to facilitate early diagnosis and treatment. Methods We evaluated the epidemiologic, clinical, immunologic, virologic, and histopathologic characteristics of 24 patients with human immunodeficiency virus (HIV)/AIDS with primary HN NHL treated at a single institution between 2002 and 2012. Histopathologic diagnosis was made according to the criteria of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. Additional immunohistochemical stains were applied in all cases. Results Eighteen patients (75%) were men and the median of age was 39 years. The gingiva and the hard palate were the most common sites of the lesions (15 patients, 62.5%). Lactate dehydrogenase levels were elevated in 16 cases (84%). Bone marrow infiltration was detected only in 4 cases (16.6%). The median CD4 T-cell count was 100 cells/µL. According to the histopathologic evaluation, the most common subtype was diffuse large B-cell lymphoma (12 cases, 50%), followed by plasmablastic lymphoma (9 cases, 37.5%) and Burkitt lymphoma (3 cases, 12.5%). Conclusion HN NHL is a severe complication of advanced HIV/AIDS disease. Early diagnosis followed by chemotherapy plus highly active antiretroviral treatment is necessary to improve the prognosis and the survival of these patients.
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Affiliation(s)
- Marcelo Corti
- Department of HIV/AIDS, Infectious Diseases F. J. Muñiz Hospital, Buenos Aires, Argentina ; Department of Internal Medicine, University of Buenos Aires School of Medicine, Paraguay, Buenos Aires, Argentina
| | - María Villafañe
- Department of HIV/AIDS, Infectious Diseases F. J. Muñiz Hospital, Buenos Aires, Argentina
| | - Alicia Bistmans
- Department of Oncology, Ramos Mejía Hospital, Buenos Aires, Argentina
| | - Marina Narbaitz
- Department of Histopathology, National Academy of Medicine, Buenos Aires, Argentina
| | - Leonardo Gilardi
- Department of Scientific Coordinator, Sociedad Iberoamericana de Información Científica, Buenos Aires, Argentina
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18
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Mian M, Capello D, Ventre MB, Grazio D, Svaldi M, Rossi A, Tsang R, Gospodarowicz MK, Oldani E, Federico M, Luminari S, Marcheselli L, Pogliani EM, Rossini F, Cabrera ME, Martelli M, Gutierrez-Garcia G, Busetto M, Visco C, Fiegl M, Rossi D, Gaidano G, Cavalli F, Zucca E, Rambaldi A, Cortelazzo S. Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biological characterization and 18 year follow-up of 488 patients (IELSG 23 study). Ann Hematol 2013; 93:221-231. [PMID: 23959436 DOI: 10.1007/s00277-013-1856-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 07/18/2013] [Indexed: 11/30/2022]
Abstract
It is known that extranodal head and neck diffuse large B cell lymphomas (eHN-DLBCL) can affect various anatomical structures what is not well-known, however, is whether they differ in terms of clinical presentation and outcome. Clinical data of the multi-institutional series, the largest of its kind as yet, has been analysed with the aim of answering these open questions and providing long-term follow-up information. Data from 488 patients affected by stage I/II eHN-DLBCL was collected: 300 of the Waldeyer's Ring (WR), 38 of the parotid and salivary glands (PSG), 48 of the thyroid gland (TG), 53 of the nasal cavity and paranasal sinuses (NPS), 24 of the palate and oral cavity (POC) and 25 with more than one involved site. Different eHN-DLBCL arising have distinct characteristics at presentation. The intermediate high risk-modified IPI was 67 % in TG, 44 % in WR, 38 % in PSG and POC and 20 % in MS. The worst 5-year survival rate had TG-DLBCL (61 %) due to the 61 % of patients with a mIPI >1. The addition of radiotherapy (cRT) to remitters did not translate into a survival advantage (5-year disease-free survival of 67 % in the cRT group vs. 70 % in the other). Three of four central nervous system recurrences occurred in NPS-DLBCL. Survival of HN-DLBCL was inferior to nodal DLBCL. This study showed that eHN-DLBCL remitters have an inferior survival when compared to nodal DLBCL, and that the addition of cRT does not provide a survival advantage. Since the standard of care nowadays is chemo-immunotherapy, survival of these patients might have been improved.
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Affiliation(s)
- M Mian
- Division of Hematology, Azienda Ospedaliera S. Maurizio, Bolzano/Bozen, Italy,
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19
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Salivary gland lymphoproliferative disorders: a Canadian tertiary center experience. Head Neck Pathol 2013; 7:381-8. [PMID: 23821219 PMCID: PMC3824808 DOI: 10.1007/s12105-013-0468-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 06/21/2013] [Indexed: 10/26/2022]
Abstract
Salivary gland lymphoproliferative disorders (SGLD) are very rare tumors and clinicopathological data is sparse. In a Canadian series of 30 cases, extracted from the surgical pathology files of The Ottawa Hospital between 1990 and 2010, a clinical, histopathological, and immunophenotypic analysis was conducted. Tumors were staged using the Ann Arbor staging and classified using the World Health Organization 2008 classification. There were 15 salivary gland (SG) primary lymphomas with localized disease, predominantly mucosa associated lymphoid tissue type marginal zone lymphoma (MALT-L), but with a significant incidence of low grade follicular lymphoma (FL) and diffuse large B cell phenotype as well. There were 7 systemic SG lymphomas and 5 patients were diagnosed with lymphoproliferative disorders originating from intra-parotid lymph nodes. Finally, the remaining 3 cases represented reactive sialadenitis. A literature review was conducted and our primary lymphoma group was compared to those from other countries. SGLDs are predominantly B cell lymphomas that develop in older adults. Primary tumors, which have MALT-L and low grade FL characteristics, have a favorable survival, however MALT-L have a high rate of relapse. A minority of SG lesions are excised secondary to lymphomas that definitely arose from intra-parotid lymph nodes.
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20
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Rasmussen PK. Diffuse large B-cell lymphoma and mantle cell lymphoma of the ocular adnexal region, and lymphoma of the lacrimal gland: an investigation of clinical and histopathological features. Acta Ophthalmol 2013; 91 Thesis 5:1-27. [PMID: 24041159 DOI: 10.1111/aos.12189] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
UNLABELLED Diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL) constitute two distinct subtypes of non-Hodgkin lymphoma (NHL) associated with considerable morbidity and mortality. Marked diversities with regard to molecular biology and clinical features are recognized in different subsets of the two lymphomas. Because these differences could be related to the location of the lymphoma, it is of interest to investigate the clinical and histopathological features of DLBCL and MCL involving the ocular adnexal region (i.e. the orbit, eyelids, conjunctiva, lacrimal gland and lacrimal sac). Similarly, the lacrimal gland is the only glandular structure within the orbit. Because the lacrimal gland represents an important part of the immunological system, it is of interest to investigate lymphomas involving this location with regard to clinical and histological characteristics. PURPOSE To characterize the clinical and histopathological features of Danish patients with DLBCL of the ocular adnexal region between 1980 and 2009 and of Danish ocular adnexal MCL patients from 1980 to 2005. Furthermore, the aim of this PhD was to review all specimens from patients with lymphoma of the lacrimal gland in Denmark between 1975 and 2009 to determine the distribution of lymphoma subtypes of the lacrimal gland and to describe the clinicopathological features of these patients. RESULTS A total of 34 patients with DLBCL and 21 with MCL of the ocular adnexal region were identified. Twenty-seven patients had lacrimal gland lymphoma, including four DLBCLs and three MCLs from studies I and II. Elderly patients predominated in all three groups, with median ages of 78, 75 and 69 years in the DLBCL, the MCL and the lacrimal gland lymphoma groups, respectively. MCL patients had a preponderance of males, whereas females prevailed among lacrimal gland lymphoma patients. The orbit was the most common site of involvement in DLBCL and MCL. Most DLBCL patients had unilateral involvement, while MCL patients had a high frequency of bilateral involvement. Similarly, localized lymphoma was relatively frequently seen in DLBCL patients in contrast to the predominance of disseminated lymphoma in the MCL group. The majority of lacrimal gland lymphomas were low grade, and the distribution of subtypes was as follows: extranodal marginal zone lymphoma, 10 (37%); follicular lymphoma, 5 (19%); DLBCL, 4 (15%); MCL, 3 (11%); chronic lymphocytic leukaemia/small lymphatic lymphoma, 2 (7%); and unclassified B-cell lymphoma, 3 (11%). The overall survival rates at 3 and 5 years for the entire study group of DLBCL were 42% and 20%, whereas 58% and 22% of MCL patients were alive 3 and 5 years after the time of diagnosis. The 5-year overall survival rate of lacrimal gland lymphoma patients was 70%. Concordant bone marrow involvement and the International Prognostic Index score were predictive factors for the overall survival in the DLBCL group in Cox regression analysis. Rituximab-containing chemotherapy was associated with an improved survival rate in MCL patients. CONCLUSIONS Diffuse large B-cell lymphoma and MCL involving the ocular adnexal region and lymphoma of the lacrimal gland are prevalent among elderly patients. The overall prognosis in DLBCL and MCL was poor, whereas the prognosis for lacrimal gland lymphoma patients was relatively good. Concordant bone marrow involvement and the International Prognostic Index score were independent predictive factors for mortality in the DLBCL group. Chemotherapy containing rituximab significantly improved survival in the MCL group.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Agents/therapeutic use
- Female
- Humans
- Lacrimal Apparatus/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Mantle-Cell/mortality
- Lymphoma, Mantle-Cell/pathology
- Male
- Middle Aged
- Morbidity
- Orbital Neoplasms/drug therapy
- Orbital Neoplasms/mortality
- Orbital Neoplasms/pathology
- Prevalence
- Prognosis
- Registries
- Rituximab
- Survival Rate
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Affiliation(s)
- Peter Kristian Rasmussen
- Eye Pathology Institute, Department of Neuroscience and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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21
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Keszler A, Adler LI, Gandolfo MS, Masquijo Bisio PA, Smith AC, Vollenweider CF, Heidenreich AM, de Stefano G, Kambo MV, Cox DP, Narbaitz M, Lanfranchi HE. MALT lymphoma in labial salivary gland biopsy from Sjögren syndrome: importance of follow-up in early detection. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e28-33. [PMID: 23157989 PMCID: PMC3593994 DOI: 10.1016/j.oooo.2012.07.481] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 06/27/2012] [Accepted: 07/24/2012] [Indexed: 02/07/2023]
Abstract
Mucosa-associated lymphoid tissue (MALT) lymphomas are known to occur in Sjögren syndrome (SS) patients, but reported cases in labial salivary glands (LSG) are rare. We report a case of 60-year-old female patient with SS who developed MALT lymphoma in the labial salivary glands during a 2-year time interval when she was participating in the Sjögren's International Clinical Collaborative Alliance, an ongoing longitudinal multisite observational study funded by the National Institutes of Health of the United States. At follow-up exam, LSG biopsy showed atypical diffuse infiltration by mononuclear cells of variable size and atypical nuclei affecting the whole specimen with destruction of glandular architecture, leading to a diagnosis of B-cell MALT lymphoma. Computerized tomography and bone marrow biopsy failed to show additional evidence of disease. Clinical, serologic, ocular, histologic and immunohistochemical findings are presented. A "watch and wait" policy was adopted with regular examinations.
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Affiliation(s)
- A Keszler
- Department of Oral Pathology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina.
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22
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Beasley M. Lymphoma of the Thyroid and Head and Neck. Clin Oncol (R Coll Radiol) 2012; 24:345-51. [DOI: 10.1016/j.clon.2012.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 01/31/2012] [Accepted: 02/29/2012] [Indexed: 01/08/2023]
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23
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Kurashige M, Yokoo T, Miyazaki Y, Tsuboi N, Hayakawa H, Utsunomiya Y, Hosoya T. [Case report; a case of MALT lymphoma related cryoglobulinemic MPGN responded to combined chemotherapy with rituximab]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2011; 100:1054-7. [PMID: 21626845 DOI: 10.2169/naika.100.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mahiro Kurashige
- Department of Internal Medicine, The Jikei University School of Medicine, Japan
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24
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Etemad-Moghadam S, Tirgary F, Keshavarz S, Alaeddini M. Head and neck non-Hodgkin's lymphoma: a 20-year demographic study of 381 cases. Int J Oral Maxillofac Surg 2010; 39:869-72. [PMID: 20538427 DOI: 10.1016/j.ijom.2010.03.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2009] [Revised: 12/14/2009] [Accepted: 03/16/2010] [Indexed: 12/21/2022]
Abstract
Malignant lymphoma is a lymphoreticular malignancy with considerable geographic variation. The objective of the present study was to provide a preliminary report on patients with head and neck non-Hodgkin's lymphoma (NHL) in a selected Iranian population. In a retrospective review from 1981 through 2001, all cases of NHL occurring in the head and neck region were selected. Histological slides were reviewed and classified according to the Working Formulation. Clinical data including patients' age, sex, initial anatomic site of disease and presenting symptoms were also recorded. Information on 381 cases of NHL was retrieved from the archived medical records; 281 cases were nodal and 100 extranodal. The mean age of the patients with nodal and extranodal disease was 39.3 and 47.7 years, respectively. A significant difference in gender was noted in the nodal group (P<0.001), but not in the extranodal cases. The most common site of involvement in the extranodal subjects was Waldayer's ring. According to histopathologic evaluation, 72% of the specimens were intermediate-, 14% were high-, and 12% were low-grade malignancies. Considering the relative frequency of head and neck lymphoma, establishment of a uniform reporting method seems necessary in order to compare different reports from various populations.
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25
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Extranodal follicular lymphoma exclusively featured by diffuse pattern originating from multiple vertebral bones. Ann Hematol 2008; 87:581-3. [PMID: 18172643 DOI: 10.1007/s00277-007-0433-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Accepted: 12/14/2007] [Indexed: 10/22/2022]
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26
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Roh JL, Huh J, Suh C. Primary non-hodgkin's lymphomas of the major salivary glands. J Surg Oncol 2008; 97:35-39. [DOI: 10.1002/jso.20901] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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27
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Kojima M, Shimizu K, Nishikawa M, Tamaki Y, Ito H, Tsukamoto N, Masawa N. Primary salivary gland lymphoma among Japanese: A clinicopathological study of 30 cases. Leuk Lymphoma 2007; 48:1793-8. [PMID: 17786716 DOI: 10.1080/10428190701528509] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To clarify the clinicopathological findings of primary salivary gland lymphoma as defined by the World Health Organization (WHO) classification, 30 Japanese patients with this disease were studied. The male to female ratio was 1:1.7 and median patient age was 57 years. The parotid gland (n = 22) was involved most frequently, followed by the submandibular gland (n = 5) and minor salivary gland (n = 3). Twenty-four (80%) cases demonstrated Stage IE, whereas only six (20%) had Stage IIE-1. None of the 30 cases had "B" symptoms or a poor performance status. The 5-year overall survival of 31 cases was 96% and 5-year failure-free survival was 77%. Histologically, 15 cases were mucosa-associated lymphoid tissue (MALT) lymphoma, seven were follicular lymphoma (FL), and six were diffuse large B-cell lymphoma (DLBCL) + MALT lymphoma and only two were DLBCL without a MALT lymphoma component. MALT lymphoma is the most frequent type of primary salivary gland lymphoma. However, FL comprised 20% of primary salivary gland lymphoma. The majority of the primary salivary gland DLBCL appear to arise from MALT type lymphoma. When appropriate therapy for histologic subtype is used, outcome of the primary salivary gland B-cell lymphoma appears excellent whether histologically indolent or aggressive.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Female
- Follow-Up Studies
- Humans
- Immunohistochemistry
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, B-Cell, Marginal Zone/mortality
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Male
- Middle Aged
- Salivary Gland Neoplasms/mortality
- Salivary Gland Neoplasms/pathology
- Salivary Gland Neoplasms/therapy
- Survival Rate
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Affiliation(s)
- Masaru Kojima
- Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan.
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28
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Firat Y, Kizilay A, Sogutlu G, Mizrak B. Primary mucosa-associated lymphoid tissue lymphoma of hypopharynx. J Craniofac Surg 2007; 18:1189-93. [PMID: 17912113 DOI: 10.1097/scs.0b013e31815783ab] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Mucosa-associated lymphoid tissue lymphomas are low-grade B-cell lymphomas that arise from a number of extranodal sites, including both nonmucosal and mucosal organs such as the hypopharynx. We reported a patient with a primary hypopharynx mucosa-associated lymphoid tissue lymphoma presenting with a swallowing dysfunction and severe throat pain. The clinical, radiologic, and histopathologic findings are presented. The patient was followed up for 5 years and treated with nonspecific antibiotics, chemotherapy, and radiation therapy. Because of prevertebral fascia invasion at the initial presentation, surgical treatment was not preferred. The last biopsies of the hypopharynx revealed no evidence of lymphoid infiltrate. Mucosa-associated lymphoid tissue lymphoma involving the hypopharynx is rare and there is no consensus on its treatment. The treatment protocol is presented and the relevant literature is reviewed.
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Affiliation(s)
- Yezdan Firat
- Department of Otorhinolaryngology, Inonu University School of Medicine, Malatya, Turkey.
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29
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Nakamura S, Ichimura K, Sato Y, Nakamura S, Nakamine H, Inagaki H, Sadahira Y, Ohshima K, Sakugawa S, Kondo E, Yanai H, Ohara N, Yoshino T. Follicular lymphoma frequently originates in the salivary gland. Pathol Int 2006; 56:576-83. [PMID: 16984613 DOI: 10.1111/j.1440-1827.2006.02011.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to examine the clinicopathological presentations of follicular lymphomas (FL) of the salivary glands, as compared to mucosa-associated lymphoid tissue (MALT) lymphomas. A total of 27 primary salivary gland lymphomas were examined: 6 FL (five, grade 1; one, grade 2); 19 MALT lymphomas; and two diffuse large B-cell lymphomas. The FL patients ranged in age from 24 to 73 years, with a mean of 49 years, which was younger than that of MALT patients (mean: 64 years; P < 0.05). Four of the six FL arose from the submandibular gland, which was the origin of only five out of a total of 19 MALT lymphomas. One FL patient was in clinical stage (CS) IE, two in CS IIE, and two in CS III and IV. As regards the MALT lymphoma patients, 13 (68%) were in CS IE and five (26%) in CS IIE. None of the FL patients had clinical diagnosis of autoimmune disease but eight MALT lymphoma patients had autoimmune disease. The present study found a relatively high incidence of FL in the salivary glands. The observed differences in age of onset, background of autoimmune disease, and lesion site suggests that the pathogenesis of FL may differ from that of MALT lymphoma.
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MESH Headings
- Adult
- Age of Onset
- Aged
- Autoimmune Diseases
- CD79 Antigens/genetics
- CD79 Antigens/metabolism
- Cell Transformation, Neoplastic/metabolism
- Cell Transformation, Neoplastic/pathology
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphoma, B-Cell, Marginal Zone/etiology
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Follicular/etiology
- Lymphoma, Follicular/metabolism
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Neprilysin/genetics
- Neprilysin/metabolism
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Proto-Oncogene Proteins c-bcl-2/genetics
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Salivary Gland Neoplasms/etiology
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
- Salivary Glands/metabolism
- Salivary Glands/pathology
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Affiliation(s)
- Satoko Nakamura
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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30
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Bialek EJ, Jakubowski W, Zajkowski P, Szopinski KT, Osmolski A. US of the major salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls. Radiographics 2006; 26:745-63. [PMID: 16702452 DOI: 10.1148/rg.263055024] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ultrasonography (US) is useful for differential diagnosis of diseases of the salivary glands. In acute inflammation, salivary glands are enlarged and hypoechoic with increased blood flow; they may contain multiple small, oval, hypoechoic areas. In chronic inflammation, salivary glands are normal sized or smaller, hypoechoic, and inhomogeneous. Sialolithiasis appears as markedly hyperechoic lines or points with distal acoustic shadowing. Sialosis appears as enlarged hyperechoic glands without focal lesions or increased blood flow. The US features of advanced Sjögren syndrome include inhomogeneous salivary glands with scattered small, oval, hypoechoic or anechoic areas, usually well defined, and increased parenchymal blood flow. Pleomorphic adenomas are usually hypoechoic, well-defined, lobulated lesions with posterior acoustic enhancement that may contain calcifications; Warthin tumors are usually oval, hypoechoic, well-defined lesions that often contain anechoic areas and are often hypervascularized. Malignant neoplasms of the salivary glands may have irregular shapes, irregular borders, blurred margins, and a hypoechoic inhomogeneous structure or may have a benign appearance. Salivary gland cysts have well-defined margins, anechoic contents, posterior acoustic enhancement, and no internal blood flow. However, US appearances of some diseases may overlap, thus producing diagnostic pitfalls.
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Affiliation(s)
- Ewa J Bialek
- Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland.
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Manganaris A, Patakiouta F, Kiziridou A, Manganaris T. Concurrent primary Hodgkin's lymphoma and recurrent pleomorphic adenoma of the ipsilateral parotid gland: report of a rare case. Eur Arch Otorhinolaryngol 2006; 264:71-4. [PMID: 16896749 DOI: 10.1007/s00405-006-0132-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2006] [Accepted: 07/11/2006] [Indexed: 10/24/2022]
Abstract
The synchronous occurrence of two histologically different and morphologically distinct tumours in a single parotid gland is an exceptionally rare and probably coincidental event. We have recently experienced such a case initially suspected of being a recurrent pleomorphic adenoma. Superficial parotidectomy, however, revealed two separate masses. Postoperative histopathological examination diagnosed the presence of a pleomorphic adenoma with a concurrent primary parotid gland Hodgkin's lymphoma arising from an intraglandular lymph node. The management of this case is presented along with a brief review of the literature concerning the evaluation and management of this rare entity.
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Affiliation(s)
- Argyrios Manganaris
- ENT Department, "THEAGENIO" Anticancer Hospital, 2 Alexandrou Simeonidi Str., Thessaloniki, Greece.
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Shine NP, Blake SP, O'Leary G. Extranodal lymphoma: clinical presentation and diagnostic pitfalls. Br J Hosp Med (Lond) 2005; 66:341-5. [PMID: 15974162 DOI: 10.12968/hmed.2005.66.6.18402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Non-Hodgkin's lymphomas (NHL) are known to present extranodally in 25% of cases, in contrast to Hodgkin's disease which rarely involves extranodal sites. In this article, the authors will to review the presentation of extranodal head and neck NHL and the difficulties that can be encountered in making the diagnosis in these cases.
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