Abstract
Eighteen extranodal non-Hodgkin's lymphomas of the head and neck except for Waldeyer's ring seen at our department from June 1976 to May 1988 were reviewed for their diagnostic problem, classification, pathological findings, treatment results and prognosis. Sites were located at nose and paranasal sinus in 7 cases, palate 5, parotid gland 3, sublingual gland 1, buccal submucosa 1 and larynx 1, respectively.According to Ann-Arbor classification, 8 cases were Stage I, 5 Stage II, 2 Stage III and 3 Stage IV.Histologically 14 cases (78%) in our series were classified following Rappaport as diffuse histiocytic, 3 nodular mixed and 1 diffuse lymphoblastic. Detection of the cell surface marker was available in 7 cases, resulting in 5 cases of B cell type, 1 T cell type and 1 Null cell type.Biopsy had to be repeated more than twice in 2 cases to obtain the correct pathological diagnosis, because of necrotic debris at the nasal cavity and erosive inflammatory change at the parotid region. Thus, carefull removal of the biopsy specimens was of great importance, especially in differential dianosis of Wegener's granulomatosis and other malignancies.Chemotherapy including ADM and VCR or combination with radiotherapy encompassing the wide field of affected site ranging basically from 40 to 50Gy as total dose were our initial treatment of choice. Relapse rate after the initial treatment was 10% in Stage I and II, whereas 80% in Stage III and IV. It suggested the necessity of the chemotherapy in addition to radiotherapy even in Stage I and II.Ten years survival rate was 76% according to Kaplan-Meier's method, but relapse have happened in 2 cases over 10 years with bone marrow or other lymphnode involvement.These results demonstrated importance of long term followup and difficulty in management of non-Hodgkin's lymphomas.
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