Top

Head & Face Medicine

Published in:

Open Access 01-12-2019 | Lymphoma | Research

Clinical presentation and characteristics of lymphoma in the head and neck region

Authors: Katharina Storck, Markus Brandstetter, Ulrich Keller, Andreas Knopf

Published in: Head & Face Medicine | Issue 1/2019

Abstract

Background

The study analyses clinical characteristics of histologically defined head and neck (H&N) lymphoma to raise the awareness of ENT specialists to the leading symptoms.

Method

From 2003 to 2011, all patients with histologically defined H&N lymphoma from our clinic were evaluated.

Results

This study identified 221 patients with H&N lymphoma comprising 193 non-Hodgkin lymphomas (NHL) and 28 Hodgkin lymphomas (HL). Among NHL there were 77 indolent (iNHL), 110 aggressive (aNHL), six highly aggressive NHL and further 28 HL. Patients with highly aggressive NHL and HL were significantly younger (p < 0.0001). Corresponding to the leading symptoms, we found nodal and extranodal involvement. NHL demonstrated manifestation in neck lymph nodes, tonsils, major salivary glands, sinonasal-system and hypopharynx/larynx. HL showed exclusive manifestation in lymph nodes of the neck and the tonsils (p < 0.0001). The mean time from first symptoms to diagnosis ranged from 1.5 ± 0.7 months in highly aggressive lymphoma to 7.5 ± 11.5 months in iNHL.

Conclusions

The variable clinical presentation of lymphoma is a challenge for the ENT specialist. Fast diagnosis is crucial for rapid treatment, especially in highly aggressive NHL like the Burkitt-lymphoma and HL. A standardized medical history, clinical examination and imaging evaluations paired with patient’s signs, symptoms and demographic knowledge might indicate lymphoma. Biopsies in the H&N region should always be immediately performed in suspicious findings.

Mawardi H, Cutler C, Treister N. Medical management update: non-Hodgkin lymphoma. Oral Surg Oral med Oral Pathol Oral Radiol Oral. J Endod. 2009;107(1):19–33.

Harris NL, Jaffe ES, Stein H, Banks PM, Chan JKC, Cleary M, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the international lymphoma study group. Blood. 1994;84:1361–92.PubMed

Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. In: Bosman FT, Jaffe ES, Lakhani SR, Ohgaki H, editors. World Health Organization classification of Tumours. Lyon. France: IARC; 2008.

Swerdlow ST, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375–90.CrossRef

Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391–405.CrossRef

Harris NL, Jaffe ES, Stein H, et al. A revised European American classification of lymphoid neoplasm: a pro- posal from the international lymphoma study group. Blood. 1994;84:1361–92.PubMed

Jaffe ES, Harris NL, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues. A progress report. Am J Clin Pathol. 1999;111(Suppl):8–12.

Weber AL, Rahemtullah A, Ferry JA. Hodgkin and non-Hodgkin lymphoma of the head and neck: clinical, pathologic, and imaging evaluation. Neuroimaging Clin N Am. 2003;13:371–92.CrossRef

Wulfrank D, Pauwels C, Roels H, De Schryver A. Extranodal non-Hodgkin’s lymphoma of the head and neck. Radiother Oncol. 1987;8(3):199–207.CrossRef

10.

Sohani AR, Hasserjian RP. Diagnosis of Burkitt lymphoma and related high-grad B-cell neoplasms. Surg Pathol Clin. 2010;3(4):1035–59.CrossRef

11.

Toader C, Toader M, Stoica A, Pop G, Oprea A, Constantin AS, Niculescu L, Vivisenco IC, Drăghici MS, Osman A, Mogoantă CA. Tonsillar lymphoma masquerading as obstructive sleep apnea - pediatric case report. Rom J Morphol Embryol. 2016;57(2 Suppl):885–91.PubMed

12.

Hiddemann W, Longo DL, Coiffier B, Fisher RI, Cabanillas F, Cavalli F, Nadler LM, De Vita VT, Lister TA, Armitage JO. Lymphoma classification--the gap between biology and clinical management is closing. Blood. 1996;88(11):4085–9.PubMed

13.

Cooper JS, Porter K, Mallin K, Hoffman HT, Weber RS, Ang KK, Gay EG, Langer CJ. National Cancer Database report on cancer of the head and neck: 10-year update. Head Neck. 2009;31(6):748–58.CrossRef

14.

Iyengar P, Mazloom A, Shihadeh F, Berjawi G, Dabaja B. Hodgkin lymphoma involving extranodal and nodal head and neck sites: characteristics and outcomes. Cancer. 2010;116(16):3825–9. https://doi.org/10.1002/cncr.2513.CrossRefPubMed

15.

Urquhart A, Berg R. Hodgkin’s and non-Hodgkin’s lymphoma of the head and neck. Laryngoscope. 2001;111:1565–9.CrossRef

16.

A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin's lymphoma. The non-Hodgkin's lymphoma classification project. Blood 1997; 89(11):3909–18.

17.

Simonitsch-Klupp I, Hauser I, Ott G, Drach J, Ackermann J, Kaufmann J, Weltermann A, Greinix HT, Skrabs C, Dittrich C, Lutz D, Pötter R, Mannhalter C, Lechner K, Chott A, Jaeger U. Diffuse large B-cell lymphomas with plasmablastic/plasmacytoid features are associated with TP53 deletions and poor clinical outcome. Leukemia. 2004;18(1):146–55.CrossRef

18.

Wolvius EB, van der Valk P, van der Wal JE, et al. Primary non-Hodgkin’s lymphoma of the salivary glands. An analysis of 22 cases. J Oral Pathol Med. 1996;25:177–81.CrossRef

19.

Kemp S, Gallagher G, Kabani S, Noonan V, O'Hara C. Oral non-Hodgkin's lymphoma: review of the literature and World Health Organization classification with reference to 40 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):194–201 Epub 2007 Jun 29.CrossRef

20.

Silva TD, Ferreira CB, Leite GB, de Menezes Pontes JR, Antunes HS. Oral manifestations of lymphoma: a systematic review. Ecancermedicalscience. 2016;17(10):665. https://doi.org/10.3332/ecancer.2016.665 eCollection 2016.CrossRef

21.

Picard A, Cardinne C, Denoux Y, Wagner I, Chabolle F, Bach CA. Extranodal lymphoma of the head and neck: a 67-case series. Eur Ann Otorhinolaryngol Head Neck Dis. 2015;132(2):71–5. https://doi.org/10.1016/j.anorl.2014.07.005 Epub 2014 Dec 29.CrossRefPubMed

22.

Hart S, Horsman JM, Radstone CR, Hancock H, Goepel JR, Hancock BW. Localised extranodal lymphoma of the head and neck: the Sheffield lymphoma group experience (1971-2000). Clin Oncol (R Coll Radiol). 2004;16(3):186–92.CrossRef

23.

Møller MB, Pedersen NT, Christensen BE. Diffuse large B-cell lymphoma: clinical implications of extranodal versus nodal presentation--a population-based study of 1575 cases. Br J Haematol. 2004;124(2):151–9.CrossRef

24.

Corti M, Minué G, Campitelli A, Narbaitz M, Gilardi L. An aggressive Plasmablastic lymphoma of the Oral cavity as primary manifestation of acquired immunodeficiency syndrome: case report and literature review. Int Arch Otorhinolaryngol. 2015;19(4):354–8. https://doi.org/10.1055/s-0034-1397335 Epub 2015 Jan 8.CrossRefPubMedPubMedCentral

25.

Jaffe ES, Harris NL, Stein H, Vardiman JW. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. World Health Organization classification of tumours IARC press. France: Lyon; 2008.

26.

Brady G, MacArthur JG, Farrell PJ. Epstein-Barr virus and Burkitt lymphoms. J Clin Pathol. 2007;60:1397–402.PubMedPubMedCentral

27.

Castillo JJ, Winer ES, Olszewski AJ. Population-based prognostic factors for survival in patients with Burkitt lymphoma: an analysis from the surveillance, epidemiology, and End Results database. Cancer. 2013;119(20):3672–9. https://doi.org/10.1002/cncr.28264 Epub 2013 Jul 30.CrossRefPubMed

28.

Hoelzer D, Walewski J, Döhner H, Viardot A, Hiddemann W, Spiekermann K, Serve H, Dührsen U, Hüttmann A, Thiel E, Dengler J, Kneba M, Schaich M, Schmidt-Wolf IG, Beck J, Hertenstein B, Reichle A, Domanska-Czyz K, Fietkau R, Horst HA, Rieder H, Schwartz S, Burmeister T, Gökbuget N. German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood. 2014;124(26):3870–9. https://doi.org/10.1182/blood-2014-03-563627 Epub 2014 Oct 30.CrossRefPubMedPubMedCentral

Title: Clinical presentation and characteristics of lymphoma in the head and neck region
Authors: Katharina Storck
Markus Brandstetter
Ulrich Keller
Andreas Knopf
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Lymphoma
Non-Hodgkin Lymphoma
Hodgkin Lymphoma
Key Symptom
Published in: Head & Face Medicine / Issue 1/2019
Electronic ISSN: 1746-160X
DOI: https://doi.org/10.1186/s13005-018-0186-0

At a glance: The STEP trials

Springer Medicine

Clinical presentation and characteristics of lymphoma in the head and neck region

Abstract

Background

Method

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

Skeletal open bite with amelogenesis imperfecta treated with compression osteogenesis: a case report

Pain perception and functional/occlusal parameters in sleep bruxism subjects following a therapeutic intervention

Three-dimensional quantitative assessment of palatal bone height for insertion of orthodontic implants - a retrospective CBCT study

Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate

Simultaneous, radiation-free registration of the dentoalveolar position and the face by combining 3D photography with a portable scanner and impression-taking

Occlusal height difference between maxillary central and lateral incisors: should aesthetic perception influence bracket placement?