Lymphoma presenting to a head and neck clinic.

Lymphomas generally have a good prognosis compared with squamous carcinomas. The present study investigates a series of 185 lymphomas of the head and neck seen over a 30-year-period. The records of 236 patients were examined and the histology slides reviewed. The lymphomas were classified according to the working formulation method and staged using the Ann Arbor system. A total of 185 patients had a non-Hodgkin's lymphoma, of those 43 were low grade, nine intermediate and 103 high grade. The histology slides of 30 patients were not available for review. In addition, 51 patients had Hodgkin's disease. One hundred and fifty patients were stage 1 or 2 and 74 stage 3 or 4. In 12 patients insufficient data was available for staging; 152 were extranodal and 84 nodal. The 5-year survival of those patients with Hodgkin's disease was 73%. For the patients with non-Hodgkin's lymphoma the 5-year survival was 43% for low grade and 48% for high grade lesions. The survival of patients with Hodgkin's disease was significantly better than for non-Hodgkin's lymphoma (P < 0.01). The 5-year survival of patients with extranodal disease was 54% and for patients with nodal disease 65% (P = NS). Treatment was by irradiation for localized lesions and by chemotherapy or a combination for more advanced lesions. Lymphomas have a relatively good prognosis in the head and neck as elsewhere in the body and every effort should be made to provide adequate diagnosis and treatment in combined clinics.