Öz
Objective: Waldeyer's ring (WR) is the second most common site of extranodal lymphomas. Its clinical course may resemble those of nodal lymphomas. We evaluated the histopathological and clinical findings, Epstein-Barr virus (EBV) presence, and overall survival of WR lymphomas diagnosed in our department. Materials and Methods: Retrospectively, 32 patients were included. The demographic and clinical data of the patients and lymphoma types, the presence of EBV [EBV early RNAs (EBER)] by chromogenic in-situ hybridization (CISH) method were examined. Kaplan-Meier analysis was used for the survival rate. A P value less than 0.05 was considered statistically significant. Results: 23 of 32 cases were male. The mean age was 57.97±16.15 years. The preliminary clinical diagnosis was carcinoma in 46.9% of the cases. Tonsil and nasopharynx had equal proportions as lymphoma origin. Only 3 (9.4%) cases are classic Hodgkin lymphoma (CHL). 16 cases (50.0%) were diffuse large B-cell lymphoma (DLBCL). EBER was detected only in tonsillar CHL cases. The survival of patients with nasopharyngeal lymphoma was shorter than those of tonsillar origin (p=0.037). Conclusion: DLBCL is the most common lymphoma type of this localization. EBER positivity has been detected only in CHL. Survival is lower in lymphomas originating from the nasopharynx
Anahtar Kelimeler
Kaynakça
- REFERENCES Alaggio, R., Amador, C., Anagnostopoulos, I., Attygalle, A. D., Araujo, I. B. O., Berti, E., Bhagat, G., Borges, A. M., Boyer, D., Calaminici, M., Chadburn, A., Chan, J. K. C., Cheuk, W., Chng, W. J., Choi, J. K., Chuang, S. S., Coupland, S. E., Czader, M., Dave, S. S., . . . Xiao, W. (2022). The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia, 36(7), 1720-1748. https://doi.org/10.1038/s41375-022-01620-2
- Clarke, J., Medford, S., Islam, S., Ramsingh, C., & Christopher, M. (2019). Extranodal lymphoma of the tongue, a very rare entity-report of two cases with literature review. International journal of surgery case reports, 54, 70-74.
- d'Amore, F., Christensen, B. E., Brincker, H., Pedersen, N. T., Thorling, K., Hastrup, J., Pedersen, M., Jensen, M. K., Johansen, P., Andersen, E., & et al. (1991). Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Danish LYFO Study Group. Eur J Cancer, 27(10), 1201-1208. https://doi.org/10.1016/0277-5379(91)90081-n
- de Leval, L., Bonnet, C., Copie-Bergman, C., Seidel, L., Baia, M., Brière, J., Molina, T. J., Fabiani, B., Petrella, T., Bosq, J., Gisselbrecht, C., Siebert, R., Tilly, H., Haioun, C., Fillet, G., & Gaulard, P. (2012). Diffuse large B-cell lymphoma of Waldeyer's ring has distinct clinicopathologic features: a GELA study. Ann Oncol, 23(12), 3143-3151. https://doi.org/10.1093/annonc/mds150 Hans, C. P., Weisenburger, D. D., Greiner, T. C., Gascoyne, R. D., Delabie, J., Ott, G., Müller-Hermelink, H. K., Campo, E., Braziel, R. M., Jaffe, E. S., Pan, Z., Farinha, P., Smith, L. M., Falini, B., Banham, A. H., Rosenwald, A., Staudt, L. M., Connors, J. M., Armitage, J. O., & Chan, W. C. (2004). Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood, 103(1), 275-282. https://doi.org/10.1182/blood-2003-05-1545
- Herbst, H., Steinbrecher, E., Niedobitek, G., Young, L. S., Brooks, L., Müller-Lantzsch, N., & Stein, H. (1992). Distribution and phenotype of Epstein-Barr virus-harboring cells in Hodgkin's disease. Blood, 80(2), 484-491. Hoppe, R. T., Burke, J. S., Glatstein, E., & Kaplan, H. S. (1978). Non-Hodgkin's lymphoma: involvement of Waldeyer's ring. Cancer, 42(3), 1096-1104. https://doi.org/10.1002/1097-0142(197809)42:3<1096::aid-cncr2820420310>3.0.co;2-z
- Iyengar, P., Mazloom, A., Shihadeh, F., Berjawi, G., & Dabaja, B. (2010). Hodgkin lymphoma involving extranodal and nodal head and neck sites: characteristics and outcomes. Cancer, 116(16), 3825-3829. KAYGUSUZ, G., CANSIZ, C., KUZU, I., & SAK, D. S. (2008). Tonsil maligniteleri arasında lenfoproliferatif hastalıkların dağılımı. Türk Patoloji Dergisi, 24(3), 166-173.
- Ma, Z., Shi, Y., Pang, X., Li, X., Cui, W., & Zhang, W. (2020). Clinicopathologic features and prognostic analysis of Waldeyer ring B-cell lymphoma. Medicine (Baltimore), 99(2), e18670. https://doi.org/10.1097/md.0000000000018670
- Mian, M., Capello, D., Ventre, M. B., Grazio, D., Svaldi, M., Rossi, A., Tsang, R., Gospodarowicz, M. K., Oldani, E., Federico, M., Luminari, S., Marcheselli, L., Pogliani, E. M., Rossini, F., Cabrera, M. E., Martelli, M., Gutierrez-Garcia, G., Busetto, M., Visco, C., . . . Cortelazzo, S. (2014). Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biologicalcharacterizationn and 18 year follow-up of 488 patients (IELSG 23 study). Ann Hematol, 93(2), 221-231. https://doi.org/10.1007/s00277-013-1856-4
- Monabati, A., Safaei, A., Noori, S., Mokhtari, M., & Vahedi, A. (2016). Subtype distribution of lymphomas in South of Iran, analysis of 1085 cases based on World Health Organization classification. Ann Hematol, 95(4), 613-618. https://doi.org/10.1007/s00277-016-2590-5
- O'Malley, D. P., Dogan, A., Fedoriw, Y., Medeiros, L. J., Ok, C. Y., & Salama, M. E. (2019). American Registry of Pathology Expert Opinions: Immunohistochemical evaluation of classic Hodgkin lymphoma. Ann Diagn Pathol, 39, 105-110. https://doi.org/10.1016/j.anndiagpath.2019.02.001
- Qin, Y., Lu, L., Lu, Y., & Yang, K. (2018). Hodgkin lymphoma involving the tonsil misdiagnosed as tonsillar carcinoma: A case report and review of the literature. Medicine (Baltimore), 97(7), e9761. https://doi.org/10.1097/md.0000000000009761
- Quiñones-Avila, M. d. P., Gonzalez-Longoria, A. A., Admirand, J. H., & Medeiros, L. J. (2005). Hodgkin lymphoma involving Waldeyer ring: a clinicopathologic study of 22 cases. American journal of clinical pathology, 123(5), 651-656.
- Shi, Y., Han, Y., Yang, J., Liu, P., He, X., Zhang, C., Zhou, S., Zhou, L., Qin, Y., Song, Y., Liu, Y., Wang, S., Jin, J., Gui, L., & Sun, Y. (2019). Clinical features and outcomes of diffuse large B-cell lymphoma based on nodal or extranodal primary sites of origin: Analysis of 1,085 WHO classified cases in a single institution in China. Chin J Cancer Res, 31(1), 152-161. https://doi.org/10.21147/j.issn.1000-9604.2019.01.10
- Sun, J., Yang, Q., Lu, Z., He, M., Gao, L., Zhu, M., Sun, L., Wei, L., Li, M., Liu, C., Zheng, J., Liu, W., Li, G., & Chen, J. (2012). Distribution of lymphoid neoplasms in China: analysis of 4,638 cases according to the World Health Organization classification. Am J Clin Pathol, 138(3), 429-434. https://doi.org/10.1309/ajcp7yltqpusdq5c
- Swerdlow SH, C. E., Harris NL, Jaffe ES, Pileri SA, Stein H, Thit Rele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, Sieber. (2017). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (C. E. Swerdlow SH, Harris NL, Jaffe ES, Pileri SA, Stein H, Thit Rele J, Ed. Revised 4th ed.). International Agency for Research on Cancer.
- Teh, C. S., Jayalakshmi, P., & Chong, S. Y. (2014). Waldeyer ring lymphoma: a case series. Ear Nose Throat J, 93(9), E22-25. https://doi.org/10.1177/014556131409300905
- Völker, H., Becker, E., Müller-Hermelink, H., & Scheich, M. (2020). Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region. HNO, 68(1), 32-39.
- Völker, H. U., Becker, E., Müller-Hermelink, H. K., & Scheich, M. (2020). [Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region]. HNO, 68(1), 32-39. https://doi.org/10.1007/s00106-019-00781-4 (Extranodale Manifestation klassischer Hodgkin-Lymphome im HNO-Bereich.)
- Wang, J., Tang, W., Zhang, W., Wang, J., Chen, F., Zhong, L., Chen, Y., & Chen, G. (2021). Clinicopathologicalcharacterizationn of follicular helper T-cell-derived peripheral T-cell lymphoma involving Waldeyer's ring. Virchows Arch, 479(2), 355-363. https://doi.org/10.1007/s00428-021-03071-z
Öz
ÖZ
Amaç: Waldeyer halkası (WH), ekstranodal lenfomaların ikinci sıklıkta görüldüğü yerdir. Klinik seyri nodal lenfomalara benzeyebilmektedir. Bu çalışmada WH lenfomalarının histopatolojik ve klinik bulgularını, Epstein-Barr virüsü (EBV) varlığını, genel sağ kalım verilerini değerlendirdik. Gereç ve yöntem: Çalışmamız retrospektiftir. WH lenfoma tanılı 32 hastaya ait demografik, klinik veriler, lenfoma tipleri ve kromojenik in-situ hibridizasyon yöntemi (KİSH) ile EBV (EBER) varlığı incelendi. Tanımlayıcı istatistikler yapıldı. Hayatta kalma oranı için Kaplan-Meier analizi kullanıldı. P değerinin 0.05'ten küçük olması anlamlı kabul edildi. Bulgular: Çalışmamızdaki 32 vakanın 23’ü erkek, 9’u kadın olup, hastaların yaş ortalaması 57.97±16.15’di. Vakaların %46.9’unda klinik ön tanı karsinomdu. Lenfoma yerleşimi tonsil ve nazofarenkste eşitti. Vakaların sadece 3’ü klasik hodgkin lenfoma (KHL), diğerleri Non-Hodgkin lenfoma (NHL) tanılıydı. NHL tanılı olguların 16’sı diffüz büyük B hücreli lenfoma (DBBHL) idi. DBBHL’ların %50.0’si germinal merkez B (GMB) hücre kökenli iken, %50.0’si non-GMB’kökenli idi. EBER pozitifliği sadece tonsil KHL vakalarında izlendi. Ann Arbor evreleme sistemine göre vakaların %58.3’ünün evresi I-II idi. Nazofaringeal kaynaklı lenfoma hastalarının sağ kalımı tonsil kaynaklı olanlardan anlamlı olarak kısa idi (p=0.037). Sonuç: WH lenfomaları klinik olarak en sık karsinomlar ile karıştırılmaktadır. Tonsil ve nazofarenks kaynaklı olanlar oranca birbirine yakındır. EBER pozitifliği sadece KHL’larda tespit edilmiştir. Nazofarenksten kaynaklanan lenfomalarda sağ kalım daha düşüktür.
Anahtar Kelimeler
Non-Hodgkin Lenfoma Waldeyer Halkası Nazofarenks Tonsil EBER
Kaynakça
- REFERENCES Alaggio, R., Amador, C., Anagnostopoulos, I., Attygalle, A. D., Araujo, I. B. O., Berti, E., Bhagat, G., Borges, A. M., Boyer, D., Calaminici, M., Chadburn, A., Chan, J. K. C., Cheuk, W., Chng, W. J., Choi, J. K., Chuang, S. S., Coupland, S. E., Czader, M., Dave, S. S., . . . Xiao, W. (2022). The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia, 36(7), 1720-1748. https://doi.org/10.1038/s41375-022-01620-2
- Clarke, J., Medford, S., Islam, S., Ramsingh, C., & Christopher, M. (2019). Extranodal lymphoma of the tongue, a very rare entity-report of two cases with literature review. International journal of surgery case reports, 54, 70-74.
- d'Amore, F., Christensen, B. E., Brincker, H., Pedersen, N. T., Thorling, K., Hastrup, J., Pedersen, M., Jensen, M. K., Johansen, P., Andersen, E., & et al. (1991). Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Danish LYFO Study Group. Eur J Cancer, 27(10), 1201-1208. https://doi.org/10.1016/0277-5379(91)90081-n
- de Leval, L., Bonnet, C., Copie-Bergman, C., Seidel, L., Baia, M., Brière, J., Molina, T. J., Fabiani, B., Petrella, T., Bosq, J., Gisselbrecht, C., Siebert, R., Tilly, H., Haioun, C., Fillet, G., & Gaulard, P. (2012). Diffuse large B-cell lymphoma of Waldeyer's ring has distinct clinicopathologic features: a GELA study. Ann Oncol, 23(12), 3143-3151. https://doi.org/10.1093/annonc/mds150 Hans, C. P., Weisenburger, D. D., Greiner, T. C., Gascoyne, R. D., Delabie, J., Ott, G., Müller-Hermelink, H. K., Campo, E., Braziel, R. M., Jaffe, E. S., Pan, Z., Farinha, P., Smith, L. M., Falini, B., Banham, A. H., Rosenwald, A., Staudt, L. M., Connors, J. M., Armitage, J. O., & Chan, W. C. (2004). Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood, 103(1), 275-282. https://doi.org/10.1182/blood-2003-05-1545
- Herbst, H., Steinbrecher, E., Niedobitek, G., Young, L. S., Brooks, L., Müller-Lantzsch, N., & Stein, H. (1992). Distribution and phenotype of Epstein-Barr virus-harboring cells in Hodgkin's disease. Blood, 80(2), 484-491. Hoppe, R. T., Burke, J. S., Glatstein, E., & Kaplan, H. S. (1978). Non-Hodgkin's lymphoma: involvement of Waldeyer's ring. Cancer, 42(3), 1096-1104. https://doi.org/10.1002/1097-0142(197809)42:3<1096::aid-cncr2820420310>3.0.co;2-z
- Iyengar, P., Mazloom, A., Shihadeh, F., Berjawi, G., & Dabaja, B. (2010). Hodgkin lymphoma involving extranodal and nodal head and neck sites: characteristics and outcomes. Cancer, 116(16), 3825-3829. KAYGUSUZ, G., CANSIZ, C., KUZU, I., & SAK, D. S. (2008). Tonsil maligniteleri arasında lenfoproliferatif hastalıkların dağılımı. Türk Patoloji Dergisi, 24(3), 166-173.
- Ma, Z., Shi, Y., Pang, X., Li, X., Cui, W., & Zhang, W. (2020). Clinicopathologic features and prognostic analysis of Waldeyer ring B-cell lymphoma. Medicine (Baltimore), 99(2), e18670. https://doi.org/10.1097/md.0000000000018670
- Mian, M., Capello, D., Ventre, M. B., Grazio, D., Svaldi, M., Rossi, A., Tsang, R., Gospodarowicz, M. K., Oldani, E., Federico, M., Luminari, S., Marcheselli, L., Pogliani, E. M., Rossini, F., Cabrera, M. E., Martelli, M., Gutierrez-Garcia, G., Busetto, M., Visco, C., . . . Cortelazzo, S. (2014). Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biologicalcharacterizationn and 18 year follow-up of 488 patients (IELSG 23 study). Ann Hematol, 93(2), 221-231. https://doi.org/10.1007/s00277-013-1856-4
- Monabati, A., Safaei, A., Noori, S., Mokhtari, M., & Vahedi, A. (2016). Subtype distribution of lymphomas in South of Iran, analysis of 1085 cases based on World Health Organization classification. Ann Hematol, 95(4), 613-618. https://doi.org/10.1007/s00277-016-2590-5
- O'Malley, D. P., Dogan, A., Fedoriw, Y., Medeiros, L. J., Ok, C. Y., & Salama, M. E. (2019). American Registry of Pathology Expert Opinions: Immunohistochemical evaluation of classic Hodgkin lymphoma. Ann Diagn Pathol, 39, 105-110. https://doi.org/10.1016/j.anndiagpath.2019.02.001
- Qin, Y., Lu, L., Lu, Y., & Yang, K. (2018). Hodgkin lymphoma involving the tonsil misdiagnosed as tonsillar carcinoma: A case report and review of the literature. Medicine (Baltimore), 97(7), e9761. https://doi.org/10.1097/md.0000000000009761
- Quiñones-Avila, M. d. P., Gonzalez-Longoria, A. A., Admirand, J. H., & Medeiros, L. J. (2005). Hodgkin lymphoma involving Waldeyer ring: a clinicopathologic study of 22 cases. American journal of clinical pathology, 123(5), 651-656.
- Shi, Y., Han, Y., Yang, J., Liu, P., He, X., Zhang, C., Zhou, S., Zhou, L., Qin, Y., Song, Y., Liu, Y., Wang, S., Jin, J., Gui, L., & Sun, Y. (2019). Clinical features and outcomes of diffuse large B-cell lymphoma based on nodal or extranodal primary sites of origin: Analysis of 1,085 WHO classified cases in a single institution in China. Chin J Cancer Res, 31(1), 152-161. https://doi.org/10.21147/j.issn.1000-9604.2019.01.10
- Sun, J., Yang, Q., Lu, Z., He, M., Gao, L., Zhu, M., Sun, L., Wei, L., Li, M., Liu, C., Zheng, J., Liu, W., Li, G., & Chen, J. (2012). Distribution of lymphoid neoplasms in China: analysis of 4,638 cases according to the World Health Organization classification. Am J Clin Pathol, 138(3), 429-434. https://doi.org/10.1309/ajcp7yltqpusdq5c
- Swerdlow SH, C. E., Harris NL, Jaffe ES, Pileri SA, Stein H, Thit Rele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, Sieber. (2017). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (C. E. Swerdlow SH, Harris NL, Jaffe ES, Pileri SA, Stein H, Thit Rele J, Ed. Revised 4th ed.). International Agency for Research on Cancer.
- Teh, C. S., Jayalakshmi, P., & Chong, S. Y. (2014). Waldeyer ring lymphoma: a case series. Ear Nose Throat J, 93(9), E22-25. https://doi.org/10.1177/014556131409300905
- Völker, H., Becker, E., Müller-Hermelink, H., & Scheich, M. (2020). Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region. HNO, 68(1), 32-39.
- Völker, H. U., Becker, E., Müller-Hermelink, H. K., & Scheich, M. (2020). [Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region]. HNO, 68(1), 32-39. https://doi.org/10.1007/s00106-019-00781-4 (Extranodale Manifestation klassischer Hodgkin-Lymphome im HNO-Bereich.)
- Wang, J., Tang, W., Zhang, W., Wang, J., Chen, F., Zhong, L., Chen, Y., & Chen, G. (2021). Clinicopathologicalcharacterizationn of follicular helper T-cell-derived peripheral T-cell lymphoma involving Waldeyer's ring. Virchows Arch, 479(2), 355-363. https://doi.org/10.1007/s00428-021-03071-z
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Mart 2023 |
| Gönderilme Tarihi | 24 Ocak 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 12 Sayı: 1 |
Bu eser Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı ile lisanslanmıştır.