Malignant Lymphomas in the Head and Neck Region - a Retrospective, Single-Center Study over 41 Years

Abstract

Objectives: Non-Hodgkin lymphomas are malignant neoplastic proliferations of the immune system that can manifest as nodal or extranodal lymphomas. The aim of this study was to retrospectively investigate the site of occurrence of lymphomas in the head and neck area and to analyze the typical symptoms of patients who presented at an oral and maxillofacial surgical department.Material and Methods: All patient files from1971 until 2012 from an Oral and Maxillofacial Surgery of a University were analyzed for the diagnosis non-Hodgkin lymphoma. Epidemiologic data and data regarding the localization of the malignant lymphoma were evaluated.Results: 62 patients, 34 women and 28 men with a non-Hodgkin lymphoma in the head and neck area were treated in the 41 years analyzed. In 87% of the cases the lymphoma belonged to B-cell and in 12% to the T-cell lineage. The average age at the time of diagnosis was 67 years for women (n=34) and 56 years for men. With 22 patients each, the non-Hodgkin lymphoma was localized in either the soft tissues or osseous structures. In the remaining 18 cases, multiple structures were affected. In 33 patients no accompanying nodal manifestation was noticed. In 33 cases the lymphoma was located in the oral cavity. The most common symptoms were swelling (97%), pain (40%) and the existence of an ulcer (11%).Conclusion: In the present study more than 50% of the lymphomas were located in the oral cavity. Due to the unspecific symptoms, a histopathological verification of the diagnosis is crucial.

Clinical diagnostic dilemma in an uncharacteristic rapidly enlarging swelling of the anterior maxilla: extranodal diffuse large B cell lymphoma

“…HL and NHL constitute 10–14% and 86–90%, respectively, of all lymphomas 1 2. HL most commonly occurs in the cervical and mediastinal lymph nodes, whereas NHL commonly occurs in extranodal locations, with 2.2% appearing in the oral mucosa, jaw bones, salivary glands in the maxillofacial region, paranasal sinus, Waldeyer's ring, and the orbit 1 2. Some 85–90% of all NHL arise from B lymphocytes and the rest from T cells and natural killer cells 2.…”

“…HL most commonly occurs in the cervical and mediastinal lymph nodes, whereas NHL commonly occurs in extranodal locations, with 2.2% appearing in the oral mucosa, jaw bones, salivary glands in the maxillofacial region, paranasal sinus, Waldeyer's ring, and the orbit 1 2. Some 85–90% of all NHL arise from B lymphocytes and the rest from T cells and natural killer cells 2. Extranodal NHL is rare in the oral cavity, with the most frequently reported subtype being diffuse large B cell lymphoma (DLBCL) 1 2.…”

“…Some 85–90% of all NHL arise from B lymphocytes and the rest from T cells and natural killer cells 2. Extranodal NHL is rare in the oral cavity, with the most frequently reported subtype being diffuse large B cell lymphoma (DLBCL) 1 2. The most common sites are the palatal mucosa, gingiva, tongue, buccal mucosa, and floor of the mouth 1.…”

“…The most common sites are the palatal mucosa, gingiva, tongue, buccal mucosa, and floor of the mouth 1. DLBCL is most commonly seen in men above the age of 50 (60–70) years 2. The aetiology of DLBCL is uncertain and includes exposure to pesticides and radiation; long-term immunosuppression; autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and Sjögren syndrome; viruses including Epstein-Barr virus (EBV), human T cell lymphotropic virus (HTLV-1), HIV, human herpes virus (HHV-8), and hepatitis B and C; and microorganisms like Helicobacter pylori and chlamydia 1 3.…”

“…The aetiology of DLBCL is uncertain and includes exposure to pesticides and radiation; long-term immunosuppression; autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and Sjögren syndrome; viruses including Epstein-Barr virus (EBV), human T cell lymphotropic virus (HTLV-1), HIV, human herpes virus (HHV-8), and hepatitis B and C; and microorganisms like Helicobacter pylori and chlamydia 1 3. Typical oral symptoms include non-specific swelling, abscess, ulcer or a non-healing extraction socket 2. A literature review revealed that in the last 45 years fewer than 450 cases of primary oral NHL have been reported in the indexed scientific literature, although recently the incidence of lymphomas has been rapidly increasing to epidemic proportions worldwide.…”