Primary salivary gland lymphoma among Japanese: A clinicopathological study of 30 cases

Abstract

To clarify the clinicopathological findings of primary salivary gland lymphoma as defined by the World Health Organization (WHO) classification, 30 Japanese patients with this disease were studied. The male to female ratio was 1:1.7 and median patient age was 57 years. The parotid gland (n = 22) was involved most frequently, followed by the submandibular gland (n = 5) and minor salivary gland (n = 3). Twenty-four (80%) cases demonstrated Stage IE, whereas only six (20%) had Stage IIE-1. None of the 30 cases had "B" symptoms or a poor performance status. The 5-year overall survival of 31 cases was 96% and 5-year failure-free survival was 77%. Histologically, 15 cases were mucosa-associated lymphoid tissue (MALT) lymphoma, seven were follicular lymphoma (FL), and six were diffuse large B-cell lymphoma (DLBCL) + MALT lymphoma and only two were DLBCL without a MALT lymphoma component. MALT lymphoma is the most frequent type of primary salivary gland lymphoma. However, FL comprised 20% of primary salivary gland lymphoma. The majority of the primary salivary gland DLBCL appear to arise from MALT type lymphoma. When appropriate therapy for histologic subtype is used, outcome of the primary salivary gland B-cell lymphoma appears excellent whether histologically indolent or aggressive.

Salivary Gland Lymphoproliferative Disorders: A Canadian Tertiary Center Experience

“…This is in keeping with other studies that have reported a rate of 8-46 % of primary SG MALT-L patients with Sjogren's syndrome [10][11][12][13]. None of our lesions were bilateral.…”

“…Within the limited literature, there is some variability in the reported histological distribution of primary SG lymphomas (Table 3), but on the whole, low grade B-cell lymphomas predominate [10-13, 27, 28]. The majority of SG lymphomas are reported to originate in the parotid gland, which is consistent with our results [2,7,12,29]. As expected, all our primary lymphomas were B-cell lymphomas.…”

“…Although several studies have reported primary DLBCL of the SG, most of these studies included patients with systemic disease in their definition of primary SG lymphoma (see Table 3, column 4). Of the studies that had stricter definitions of primary SG lymphoma, only one reported a significant incidence of DLBCL that is comparable to ours and three quarters of their DLBCLs represented transformed cases in a background of MALT-L [12]. None of our DLBCL cases had an identifiable background of MALT-L.…”

“…Furthermore, the SG can be a secondary extranodal site of involvement for patients with systemic lymphoma. Primary salivary gland lymphomas usually occur in the parotid gland, can be bilateral, and most are classified as extranodal marginal-zone B-cell lymphoma, MALT-type (MALT-L) [2,[10][11][12][13]. Sjogren's syndrome, a chronic immune mediated disease localized to the exocrine glands that produce tears and saliva, is a well accepted risk factor for acquiring salivary gland lymphoma [14,15].…”

The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas

“…[1][2][3][4] However, there are only limited data available on the prognostic impact of various sites of extralymphatic involvement in the rituximab era, 5,6 and none from patients exclusively treated within prospective trials. 5,[7][8][9][10][11][12][13][14] An increased risk of central nervous system (CNS) disease has been reported for DLBCL of the paranasal sinuses, but not for other sites of extralymphatic craniofacial involvement (E CFI ), 9,10 and combined chemoradiotherapy has been recommended for these sites. 14 We now report the results of an analysis of 11 consecutive trials of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL), describe clinical characteristics, and identify factors that affect the outcome of patients with E CFI treated with and without rituximab.…”