Lymhoma of the Oral Cavity. A Rare Entity with Favorable Prognosis. Ten-Year Experience of a Single Hematology Unit.

Abstract

Lymphomas of the oral cavity consist <5% of the malignancies of the region. B-cell lymphoma of the diffuse large cell histology is the predominant type (B-DLCL). The purpose of our study was to describe the clinicopathologic characteristics of a group of patients with oral cavity lymphomas and their treatment outcome. We reviewed the records of 46 patients (21 males and 25 females) with oral lymphomas who were diagnosed and treated in our Service, between 1993 and 2003. The mean age was 57 years and the most prevalent site of involvement was the tonsil (41.3%) followed by the tongue (15.2%), while 8.7% had >1 involved sites. Thirty six patients (pts) (78.3%) had clinical stage I or II and 10 (21.7%) advanced stage disease. A monoclonal lymphocytic population was detected in the blood of 7 pts (15.2%) by PCR (IgH or TCR rearrangement), 4 of them with early stage lymphoma. 56.5% of the lesions were diagnosed as B-DLCL and only 10.8% as peripheral T-cell lymphomas.Nineteen pts with B-DLCL received CHOP or equivalent chemotherapy regimens and 11 CHOP combined with anti-CD20. Chlorambucil was administered in 4 pts with MALT lymphoma and local radiotherapy as the sole treatment in 1. The pts with T-cell lymphoma received CHOP (3) or interferon alfa-2b (2). Thirty eight pts are in complete remission. There were 3 deaths due to the disease (1 MALT, 1 predominantly small cleaved cell and 1 B-DLCL). Three additional pts relapsed and achieved complete response with a second chemotherapy course and 2 pts developed a lymphoma of different histology. In conclusion, oral lymphoma is a rare disease mainly of a diffuse large B-cell histology and a prolonged survival, when treated with chemotherapy (10-year Event Free Survival 82.5%).