Sirsath Nagesh T, Lakshmaiah K C, Das Umesh, Lokanatha D, Chennagiri S Premlatha, Ramarao Clementina
Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Banglore, Karnataka, India.
J Cancer Res Ther. 2014 Oct-Dec;10(4):945-50. doi: 10.4103/0973-1482.136024.
Extra nodal involvements of non-Hodgkin's lymphomas (NHL) are not so uncommon, but the involvement of oral cavity by NHL is very rare.
The present study involved retrospective analysis of patients from year 2001 to 2011, who presented with oral mass and on evaluation were diagnosed to have primary extranodal NHL of oral cavity at a tertiary cancer care centre in South India.
There were seven patients treated for primary NHL of oral cavity at our institute in last 10 years. The median age at presentation was 43.2 years (range 29-65 years). There were five males and two females. Oral tongue was the most common site (three patients) followed by alveolus (two patients). The other sites of involvement included gingivobuccal sulcus in one patient and hard palate in one patient. All patients were initially evaluated at oral oncology department for gradually increasing ulcerative mass in oral cavity. None of the patients had B symptoms. In our study, plasmablastic lymphoma was the most common type of NHL, followed by diffuse large B cell lymphoma (DLBCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). Out of seven patients, two were HIV positive, both having plasmablastic lymphoma. Four out of the seven patients received a combination of chemotherapy and radiotherapy and three patients received only chemotherapy. Only three patients could complete the prescribed chemotherapy and radiotherapy schedule and were alive and diseases free with a median follow-up of 21 months.
Involvement of oral cavity by lymphoma is rare. Plasmablastic lymphoma was the most common oral cavity NHL in our patients. Although number of cases in present study was less, our data suggests that oral NHL has aggressive course with less favorable outcome. Further large sample studies incorporating rituximab-based chemotherapy and more aggressive chemotherapy for plasmablastic lymphoma will be helpful for better understanding of treatment outcome.
非霍奇金淋巴瘤(NHL)的结外受累并不罕见,但NHL累及口腔则非常罕见。
本研究对2001年至2011年期间在印度南部一家三级癌症护理中心就诊的患者进行回顾性分析,这些患者出现口腔肿物,经评估被诊断为原发性口腔结外NHL。
过去10年中,我院有7例患者接受了原发性口腔NHL的治疗。就诊时的中位年龄为43.2岁(范围29 - 65岁)。男性5例,女性2例。口腔舌部是最常见的部位(3例患者),其次是牙槽(2例患者)。其他受累部位包括1例患者的龈颊沟和1例患者的硬腭。所有患者最初在口腔肿瘤科接受评估,均因口腔内逐渐增大的溃疡性肿物就诊。所有患者均无B症状。在我们的研究中,浆母细胞淋巴瘤是最常见的NHL类型,其次是弥漫性大B细胞淋巴瘤(DLBCL)和未另行指定的外周T细胞淋巴瘤(PTCL,NOS)。7例患者中有2例HIV阳性,均为浆母细胞淋巴瘤。7例患者中有4例接受了化疗和放疗联合治疗,3例患者仅接受了化疗。只有3例患者能够完成规定的化疗和放疗疗程,存活且无疾病,中位随访时间为21个月。
淋巴瘤累及口腔罕见。浆母细胞淋巴瘤是我们患者中最常见的口腔NHL类型。尽管本研究中的病例数较少,但我们的数据表明口腔NHL病程侵袭性强,预后较差。进一步纳入基于利妥昔单抗的化疗和对浆母细胞淋巴瘤更积极化疗的大样本研究,将有助于更好地了解治疗结果。