Primary Nasopharyngeal non-Hodgkin lymphomas: a retrospective review of 26 Moroccan patients

Abstract

BackgroundNasopharyngeal non-Hodgkin lymphomas (NNHL) are extremely rare. In this study, we will report the progress achieved in the management of this disease in our institute.MethodsWe retrospectively reviewed the records of 26 patients having primary NNHL who were managed between January 1997 and December 2008, to evaluate and compare their clinical characteristics and treatment outcome. Clinical variables, including age, sex, stage, and treatment modality, were assessed. Disease free survival and overall survival were measured. Survival curves were constructed using the KaplanMeier method. The log-rank test was used to compare them.ResultsMedian age of our patients was 52.7 years. Nasal obstruction, nasal discharge and epistaxis were the frequent symptoms in NNHL patients. Histology of NNHL were mainly large B-cell and follicular lymphoma. Four patients (15.4%) were at stage I, 15 (57.6%) at stage II, and 7 (27%) were at stage III/IV. The patients were treated with chemotherapy alone (27%) or chemotherapy plus radiotherapy (73%). At early stage (stage I/II), the patients were managed with chemo-radiotherapy. When the whole treatment was completed, 18 patients (69.2%) achieved complete response and remained disease free. After 25.9 months median follow-up, overall survival at 1 year was 87% and disease free survival at 1 year was 71%. The difference in term of overall and disease free survival between stage I, II, III and IV was significant (Log rank test: p = 0.02 for overall survival and p = 0.01 for disease free survival).ConclusionFrom our study, we conclude that histological characteristics, principle of treatment and outcome of primary NNHL patients are particular and more studies have to be directed.

Nasopharyngeal B-cell lymphoma with pan-hypopituitarism and oculomotor nerve palsy: a case report and review of the literature

“…A few studies are reporting the clinical characteristics of NH lymphomas [ 22 , 23 ]. Hsueh et al reported that in 35 cases of NPL during 22 years’ follow-up with the average age of 59.6 years, WBC of 12,992/mm 3 , LDH of 337.7 U/L, and the meantime from initial symptoms to diagnosis of 2.6 months, neck lymph nodes involvement or other distant involvements were detected in less than a third of patients at the time of diagnosis.…”

“…NHL of the nasopharyngeal region is usually invasive and has a strikingly poor prognosis than other extranodal lymphomas [ 24 ]. Also, localized disease and low-grade NPL are associated with a better prognosis [ 22 ]. Moreover, B symptoms have been reported to be associated with poor prognosis [ 25 ].…”

Diffuse Large B‐Cell Lymphoma of the Nasopharynx Presenting With Cluster‐Like Headache

“…). Nasal endoscopic biopsy pathologically confirmed diffuse large B‐cell lymphoma . Our case emphasizes the importance of thorough history‐taking and clinical examination to identify “red flags” in patients with cluster‐like headache.…”

“…Nasal endoscopic biopsy pathologically confirmed diffuse large B-cell lymphoma. 3,4 Our case emphasizes the importance of thorough history-taking and clinical examination to identify "red flags" in patients with cluster-like headache. Neuroimaging should always be closely reviewed in patients with cluster-like headache to ensure that a secondary headache is not overlooked.…”

The Value of PET-CT Scan in Determining Remission Status in Lymphoma Patients Involving the Head & Neck Region

“…Surveillance scans are performed at 6 monthly or yearly intervals, or as clinically indicated and the surveillance policy may vary between institutions. In the head & neck region, the sites commonly infiltrated by lymphoma include Waldeyer's ring, tonsils, nasopharynx and the base of the tongue (Wafa et al 2009). Anatomically, Waldeyer's ring form the opening to the upper aerodigestive tract and is the initial site of contact between the mucosa-associated lymphoid tissue antigens and the inhaled, ingested or exogeneous antigens.…”