Division of Hemato-Oncology, Department of Internal Medicine, Chi-Mei Medical Centre, Liouying, Tainan, Taiwan.
J Clin Pathol. 2010 Oct;63(10):888-93. doi: 10.1136/jcp.2010.081927.
To better understand the spectrum of primary lymphomas in the upper aerodigestive tract, a common site of extranodal lymphoma.
Lymphoma cases diagnosed at an institution in southern Taiwan from 1992 to 2007 were retrospectively studied with pathology and history review, immunohistochemistry, in situ hybridisation for Epstein-Barr virus (EBER-ISH), and statistical analysis.
70 patients were identified. The male to female ratio was 2:1, and the median age was 61.5 years (range 8-87); 73% of cases occurred in Waldeyer's ring or the oral cavity. Phenotypically, there were 45 (64%) B cell and 25 (36%) T cell or extranodal natural killer (NK)/T cell lymphoma (ENKL) including 42 (60%) diffuse large B cell lymphomas (DLBCLs), 22 (31%) ENKLs, three unspecified peripheral T cell lymphomas, two follicular lymphomas and one Burkitt lymphoma. EBER-ISH was positive in three (7%) of 42 DLBCLs and all 22 ENKLs. Most patients received chemotherapy with or without radiotherapy. The 5-year overall survival for all patients was 56.3% with B and T or NK/T cell lymphomas at 66.0% and 40.6%, respectively. Univariate analysis revealed that sinonasal presentation, T or NK/T cell phenotype, raised lactate dehydrogenase (LDH) activity, and Ann Arbor stage III/IV diseases were associated with prognostically significant higher hazard ratio (HR) of lymphoma-related death. However, only raised LDH remained significant on multivariate analysis. For DLBCLs, only raised LDH was prognostically significant on either univariate or multivariate analysis.
Only a limited number of lymphoma entities occurred primarily in this anatomical region. The 5-year overall survival rate was comparable to other reports, and raised LDH at diagnosis was the only significant prognostic factor identified. A relatively high incidence of EBV positivity was identified in DLBCLs in this anatomical region, and further studies are warranted to elucidate the clinicopathological significance of these tumours.
更好地了解上呼吸道-消化道（头颈部）这一结外淋巴瘤常见部位的原发性淋巴瘤谱。
回顾性研究了 1992 年至 2007 年在台湾南部一家医院诊断的淋巴瘤病例，通过病理和病史回顾、免疫组织化学、EB 病毒原位杂交（EBER-ISH）和统计分析。
共发现 70 例患者，男女比例为 2:1，中位年龄为 61.5 岁（8-87 岁）；73%的病例发生在瓦耳代尔氏环或口腔。表型上，有 45 例（64%）B 细胞和 25 例（36%）T 细胞或结外自然杀伤（NK）/T 细胞淋巴瘤（ENKL），包括 42 例（60%）弥漫性大 B 细胞淋巴瘤（DLBCL）、22 例（31%）ENKL、3 例未明确的外周 T 细胞淋巴瘤、2 例滤泡性淋巴瘤和 1 例伯基特淋巴瘤。EBER-ISH 在 3 例（7%）DLBCL 和所有 22 例 ENKL 中均为阳性。大多数患者接受化疗联合或不联合放疗。所有患者的 5 年总生存率为 56.3%，B 和 T 或 NK/T 细胞淋巴瘤分别为 66.0%和 40.6%。单因素分析显示，鼻旁窦表现、T 或 NK/T 细胞表型、乳酸脱氢酶（LDH）升高和安阿伯分期 III/IV 期与淋巴瘤相关死亡的风险比（HR）预后显著升高相关。然而，只有 LDH 升高在多因素分析中仍然有意义。对于 DLBCL，只有 LDH 升高在单因素或多因素分析中具有预后意义。
只有少数几种淋巴瘤实体主要发生在该解剖部位。5 年总生存率与其他报道相似，诊断时 LDH 升高是唯一显著的预后因素。在该解剖部位的 DLBCL 中发现了相对较高的 EBV 阳性率，需要进一步研究来阐明这些肿瘤的临床病理意义。
