Malignant lymphoma of the oral cavity and the maxillofacial region: Overall survival prognostic factors

Abstract

Objective: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. Study Design: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox’s regression tests. Results: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). Conclusion: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus. Key words:Lymphoma, oral cavity, survival.

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

“…Lymphomas are heterogeneous malignancies of the immune system that are classically grouped into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) based on differences in genetics, biology, histopathology, immunophenotype and clinical behaviour 1. HL and NHL constitute 10–14% and 86–90%, respectively, of all lymphomas 1 2.…”

“…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.…”

“…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.…”

“…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. DLBCL is most commonly seen in men above the age of 50 (60–70) years 2.…”

“…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. Typical oral symptoms include non-specific swelling, abscess, ulcer or a non-healing extraction socket 2.…”