Abstract
Malignant lymphomas are not rare in the otorhinolaryngological region. We report two cases of lymphoproliferative disorder initially suspected as malignant. In immunological stains of both frozen and paraffin sections, monoclonal lymphocyte proliferation was not confirmed.Moreover, Southern blot analysis did not show JH and TCR-β gene rearranged bands, although both patients had abnormal chromosomal patterns. Three possible theories are presented to account for these paradoxical data. 1) The amount of tissue for histological study and for Southern blot was inadequate; 2) the enzymes used in the Southern blot test were unsuitable in these cases; 3) mutation occurred before gene rearrangement. The last is the most reasonable explanation.Should these cases be regarded as malignant? Radiation and chemotherapy were effective in these patients, and these treatments are not thought to be a poor first choice. We emphasize the importance of careful studies of these border-malignant disorders when the histological findings cannot prove monoclonal proliferation.
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