Fierstein J T, Thawley S E
Laryngoscope. 1978 Apr;88(4):582-93. doi: 10.1002/lary.1978.88.4.582.
The natural history of 88 cases of non-Hodgkin's lymphoma of the head and neck were reviewed. An analysis is presented of the histopathologic, clinical, and prognostic features of these patients which presented to the Washington University Affiliated Hospitals between 1955-1975. All biopsies were histologically classified according to the criteria of Rappaport and staged accordingly to the Ann Arbor Classification. There were 38 histiocytic lymphomas, 29 poorly differentiated lymphocytic lymphomas, 16 well differentiated lymphocytic lymphomas, and 5 mixed lymphomas. The lesions were equally divided between Waldeyer's ring and other head and neck sites. Most of the lymphomas were extranodal in presentation. Sixty-one percent of all cases presented with disease localized to the site of origin; 17% had extension to regional nodes and 21% had generalized disease (Stage III and IV). In terms of treatment, localized well differentiated lymphocytic lymphoma was treated with radiation therapy. Generalized well differentiated lymphocytic lymphomas were treated with radiation and chemotherapy. Most patients with histiocytic and poorly differentiated lymphocytic lymphoma limited to the site of origin were treated with radiation and all others with combined therapy. Over 90% of patients with Stage I disease were considered cured at the end of three years while the overall survival was 72%.
回顾了88例头颈部非霍奇金淋巴瘤的自然病史。对1955年至1975年间在华盛顿大学附属医院就诊的这些患者的组织病理学、临床和预后特征进行了分析。所有活检标本均根据拉帕波特标准进行组织学分类，并根据安阿伯分类法进行分期。其中有38例组织细胞淋巴瘤、29例低分化淋巴细胞淋巴瘤、16例高分化淋巴细胞淋巴瘤和5例混合性淋巴瘤。病变在瓦尔代尔环和其他头颈部部位之间平均分布。大多数淋巴瘤在临床表现上为结外病变。所有病例中有61%表现为疾病局限于起源部位；17%有区域淋巴结转移，21%有全身性疾病（Ⅲ期和Ⅳ期）。在治疗方面，局限性高分化淋巴细胞淋巴瘤采用放射治疗。全身性高分化淋巴细胞淋巴瘤采用放疗和化疗。大多数局限于起源部位的组织细胞淋巴瘤和低分化淋巴细胞淋巴瘤患者采用放疗，其他所有患者采用联合治疗。超过90%的Ⅰ期疾病患者在三年末被认为已治愈，总体生存率为72%。
