La Quaglia M P
Department of Pediatric Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Semin Pediatr Surg. 1994 Aug;3(3):207-15.
Non-Hodgkin's lymphomas (NHL) in childhood account for approximately 10% of solid tumors reported for this age group, and almost 10% of all these lymphomas arise in the head and neck. Most head and neck NHL is a B-cell phenotype (70%) and is characterized by diffuse involvement of anatomic structures. Analysis of the cell surface expression of specific molecules of interest, including immunoglobulins, T-cell receptor components, and antigens specific for immunoblastic cells at discrete points in ontogenic development, has resulted in a greater understanding of the origins and biological behavior of childhood lymphomas. This has significance for the surgeon because specialized studies including immunophenotyping, cytogenetics, and Southern analysis require adequate amounts of tissue that has been properly processed after removal from the patient. In addition, because chemotherapy is the mainstay of lymphoma treatment, the surgical oncologist must avoid the postoperative morbidity inherent in en-bloc resection of other malignancies of the head and neck and thereby facilitate initiation of therapy. This article discusses the clinical presentation, imaging, treatment, and outcome of NHL primary in the head and neck region. Individual characteristics peculiar to specific anatomic sites are reviewed.
儿童非霍奇金淋巴瘤（NHL）约占该年龄组实体瘤报告病例的10%，且所有这些淋巴瘤中近10%发生于头颈部。大多数头颈部NHL为B细胞表型（70%），其特征为解剖结构的弥漫性受累。对特定感兴趣分子的细胞表面表达进行分析，包括免疫球蛋白、T细胞受体成分以及在个体发育离散点上免疫母细胞特异性抗原，有助于更深入了解儿童淋巴瘤的起源和生物学行为。这对外科医生具有重要意义，因为包括免疫表型分析、细胞遗传学和Southern分析在内的专业研究需要足够数量的组织，这些组织在从患者身上切除后需经过妥善处理。此外，由于化疗是淋巴瘤治疗的主要手段，外科肿瘤学家必须避免对头颈部其他恶性肿瘤进行整块切除所固有的术后并发症，从而便于开始治疗。本文讨论了头颈部原发性NHL的临床表现、影像学、治疗及预后。还回顾了特定解剖部位特有的个体特征。
