Clinicopathological presentation of extranodal lymphomas of head and neck: A single institution experience over the last decade.

Abstract

e19042 Background: Non-Hodgkin’s lymphoma can have an extranodal presentation in about 33% of cases. Up to one third of these extranodal lymphomas (ENL) develop in the head and neck region. We looked at the clinicopathological presentation of ENL diagnosed at an academic institution. Methods: All patients with ENL of head and neck diagnosed between 2008 and 2016 at a single institution were included. Analysis was done for histologic subtype of lymphoma, primary site, immunohistochemical profile (Bcl-2,Bcl-6 and Ki67) and prognostic factors. Results: A total of 68 patients were included of which 41 (60%) were females and 27 (40%) were males. Median age at diagnosis was 64 (range 26 to 92) and a large number of the patients were Caucasian (74%). Diffuse Large B-Cell Lymphoma (DLBCL) was most commonly seen followed by Marginal Zone B Cell Lymphoma (MZBCL). The most common site of presentation was Tonsils/Waldeyer's ring (21%) followed by Nasopharynx (15%) and Orbital/Periorbital areas (15%). Among the patients with indolent Lymphomas (non-DLBCL), most presented with stage I (per Ann Arbor staging) at diagnosis (60%). On the other hand, stage III was the most common stage at diagnosis for the patients with DLBCL (30%). Higher Bcl-6 expression (52%) was noted in DLBCL with majority (81%) having a Ki67 expression of more than 30%. The 2-year overall survival for the DLBCL subgroup was 77% (95% CI 0.61 - 0.93). A high Neutrophil to Lymphocyte ratio (NLR) was associated with worse overall survival in patients with DLBCL. Conclusions: MZBCL was the most common indolent ENL of the head and neck, but DLBCL was the most common type of all ENL of the head and neck. NLR was associated with worse outcomes in patients with DLBCL. [Table: see text]