Upper aerodigestive tract lymphoma in Taiwan. Issue 10 (27th September 2010)

• Record Type: Journal Article
• Authors: Chen, Shang-Wen; Chang, Sheng-Tsung; Lu, Chin-Li; Hwang, Wei-Shou; Tsao, Chao-Jung; Huang, Wen-Tsung; Chang, Kwang-Yu; Chuang, Shih-Sung
• Is Part Of: Journal of clinical pathology. Volume 63:Issue 10(2010)
• Page Start: 888
• Page End: 893
• Publication Date: 2010-09-27
• Subjects: Diffuse large B cell lymphoma -- EBV -- extranodal NK/T cell lymphoma -- lymphoma -- Taiwan -- upper aerodigestive tract -- Waldeyer's ring -- lymphoma; Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jcp.2010.081927
• Languages: English
• ISSNs: 0021-9746

Abstract

Abstract : Aim: To better understand the spectrum of primary lymphomas in the upper aerodigestive tract, a common site of extranodal lymphoma. Materials and methods: Lymphoma cases diagnosed at an institution in southern Taiwan from 1992 to 2007 were retrospectively studied with pathology and history review, immunohistochemistry, in situ hybridisation for Epstein–Barr virus (EBER-ISH), and statistical analysis. Results: 70 patients were identified. The male to female ratio was 2:1, and the median age was 61.5 years (range 8–87); 73% of cases occurred in Waldeyer's ring or the oral cavity. Phenotypically, there were 45 (64%) B cell and 25 (36%) T cell or extranodal natural killer (NK)/T cell lymphoma (ENKL) including 42 (60%) diffuse large B cell lymphomas (DLBCLs), 22 (31%) ENKLs, three unspecified peripheral T cell lymphomas, two follicular lymphomas and one Burkitt lymphoma. EBER-ISH was positive in three (7%) of 42 DLBCLs and all 22 ENKLs. Most patients received chemotherapy with or without radiotherapy. The 5-year overall survival for all patients was 56.3% with B and T or NK/T cell lymphomas at 66.0% and 40.6%, respectively. Univariate analysis revealed that sinonasal presentation, T or NK/T cell phenotype, raised lactate dehydrogenase (LDH) activity, and Ann Arbor stage III/IV diseases were associated with prognostically significant higher hazard ratio (HR) of lymphoma-related death. However, only raised LDH remained significant on multivariate analysis. For DLBCLs, only raised LDH was prognostically significant on either univariate or multivariate analysis. Conclusions: Only a limited number of lymphoma entities occurred primarily in this anatomical region. The 5-year overall survival rate was comparable to other reports, and raised LDH at diagnosis was the only significant prognostic factor identified. A relatively high incidence of EBV positivity was identified in DLBCLs in this anatomical region, and further studies are warranted to elucidate the clinicopathological significance of these tumours.