Hodgkin's and Non‐Hodgkin's Lymphoma of the Head and Neck

Laryngoscope - Tập 111 Số 9 - Trang 1565-1569 - 2001
Andrew C. Urquhart1, Richard L. Berg2
1Department of Otolaryngology—Head and Neck Surgery, Marshfield Clinic, Marshfield, Wisconsin, U.S.A.
2Department of Biostatistics, Marshfield Medical Research and Education Foundation, Marshfield, Wisconsin, U.S.A.

Tóm tắt

AbstractObjectives/Hypothesis Lymphomas are a frequent cause of malignant lymphadenopathy in the head and neck. This study was performed to evaluate the head and neck manifestations of lymphomas and to emphasize the different presentations of Hodgkin's disease (HD) and non‐Hodgkin's lymphoma (NHL).Study Design Retrospective review.Methods A retrospective review was made of all cases of lymphomas involving the head and neck at Marshfield Clinic (Marshfield, WI) between 1988 and 1996. Specifically, the clinical presentations, staging, and prognosis for HD and NHL with head and neck involvement were sought.Results Three hundred eleven patients were included in the study, 76 with HD and 235 with NHL. The median age at diagnosis for patients with HD was 27.7 years, and for patients with NHL, 67.2 years. This difference was highly significant (P <.001). No significant difference in gender was noted, with male patients occurring in 59% with HD and 49% with NHL (P = .135). Extranodal involvement including the oral cavity, oropharynx, nasopharynx, paranasal sinuses, and larynx occurred with HD in 3 patients (4%) and with NHL in 54 patients (23%P <.001). Cervical adenopathy consisted of a single node in 24% of patients with HD and 33% of those with NHL (no significant difference, P = .236). The difference in mediastinal nodal involvement was highly significant, occurring in 65% of patients with HD and 38% of patients with NHL (P <.001). Abdominal nodes occurred in 20% of cases of HD and 45% of cases of NHL ( P < .001). A significant difference in constitutional symptoms was noted with 41% of cases in HD and 27% of cases in NHL (P = .020). For the percentage of patients with stage IV disease, there was a highly significant difference by diagnosis with 10% in HD and 36% in NHL (P <.001). The median follow‐up time was 51 months, and 12% of patients with HD and 41% of patients with NHL died of their disease. Both the overall survival and survival from death attributable to disease were significantly better for HD (P < .001).Conclusions Hodgkin's disease presents at a younger age and is less common than NHL. Cervical lymphadenopathy is the most common head and neck presentation for both diseases. Associated mediastinal adenopathy was more common with HD, and abdominal adenopathy with NHL. Constitutional symptoms were more common with HD. More advanced disease with a decreased overall survival was seen with NHL.

Từ khóa


Tài liệu tham khảo

10.3322/canjclin.44.1.7

American Cancer Society.Non‐Hodgkin's lymphoma. Available at:http://www.cancer.org. Accessed February 24 2001.

American Cancer Society.Hodgkin's disease. Available at:http://www.cancer.org. Accessed February 24 2001.

American Cancer Society.Oral cavity and oropharyngeal cancer. Available at:http://www.cancer.org. Accessed February 24 2001.

American Cancer Society.Laryngeal and hypopharyngeal cancer. Available at:http://www.cancer.org. Accessed February 24 2001.

American Cancer Society.Thyroid cancer. Available at:http://www.cancer.org. Accessed February 24 2001.

10.1001/jama.1989.03420050069041

KaplanLD.HIV‐associated lymphoma. AIDS Clin Rev1993‐94:145–166.

Knowles DM, 1997, Molecular pathology of acquired immunodeficiency syndrome related non‐Hodgkin's lymphoma, Semin Diagn Pathol, 14, 67

10.1093/oxfordjournals.jncimonographs.a024181

10.1097/00002030-200012220-00015

10.1288/00005537-199504001-00001

Centers for Disease Control and Prevention, 1991, Current trends: opportunistic non‐Hodgkin's lymphomas among severely immunocompromised HIV‐infected patients surviving for prolonged periods on antiretroviral therapy—United States, MMWR, 40, 591

10.1182/blood.V96.8.2730

10.1136/sti.76.5.335

10.1258/0956462001916362

10.1056/NEJM198204153061506

Ridge JA, 2000, Cancer Management: A Multidisciplinary Approach

10.1097/00005537-200007000-00010

10.1002/(SICI)1097-0347(199812)20:8<674::AID-HED3>3.0.CO;2-H

10.1288/00005537-199301000-00005

Freedman AS, 1998, Harrison's Principles of Internal Medicine, 695

10.1002/1097-0142(19820515)49:10<2112::AID-CNCR2820491024>3.0.CO;2-2

Marion J, 1999, Comprehensive Management of Head Neck Tumors, 1840

10.1017/S0022215100082207

Kapadia SB, 2001, Surgical Pathology of the Head Neck, 1045

10.1007/978-3-642-80274-4

10.1002/1097-0142(19860801)58:3<699::AID-CNCR2820580317>3.0.CO;2-E

10.1177/000348940010901217

10.1016/S0360-3016(00)00597-6

10.1148/radiographics.21.1.g01ja02161

Colby TV, 1979, Malignant lymphomas involving the salivary glands, Pathol Annu, 14, 307

10.1288/00005537-199004000-00002

La Quaglia MP, 1994, Non‐Hodgkin's lymphoma of the head and neck in childhood, Semin Pediatr Surg, 3, 207

Becker SP, 1990, Nonsquamous tumors of the head and neck in the geriatric population, Otolaryngol Clin North Am, 23, 1141, 10.1016/S0030-6665(20)31195-6

10.1002/1097-0142(20001215)89:12<2667::AID-CNCR21>3.0.CO;2-P

10.7326/0003-4819-89-6-888

Gannot G, 2000, Clinical course of primary Sjogren's syndrome: salivary, oral and serologic aspects, J Rheumatol, 27, 1905

10.1016/0049-0172(89)90033-4

10.1093/ajcp/65.4.421

Hauser WA, 1997, Seizures and Epilepsy in the Elderly, 7

10.1016/S0030-6665(05)70093-1

Dyer MJ, 1999, The role of CAMPATH‐1 antibodies in the treatment of lymphoid malignancies, Semin Oncol, 26, 52

Thông tin
Thông tin xuất bản

Laryngoscope

Tập 111 Số 9

1565-1569

Thông tin tác giả