Non-Hodgkin's Lymphoma of The Tonsil: Clinical Features, Treatment Response and Prognosis

Abstract

Aim: Tonsillar lymphomas, specifically non-Hodgkin lymphomas in extranodal regions, are a significant subset of malignancies in the head and neck. Understanding the clinical and radiological characteristics of these lymphomas is pivotal for augmenting current knowledge and refining treatment approaches, particularly considering the notable incidence and distinctive pathophysiology of these malignancies. Materials and Methods: A retrospective study encompassing 45 patients diagnosed with tonsillar lymphoma across two university hospitals was undertaken. Comprehensive data, including demographics, symptoms, clinical and pathological findings, and treatment details, were analyzed. Various statistical tests explored factors influencing treatment responses and prognosis. Results: Patients predominantly presented with dysphonia, dysphagia, and dyspnea, alongside a notable prevalence of comorbidities such as hypertension and diabetes mellitus. Diagnosis largely leaned on excisional biopsy, revealing diffuse large B-cell lymphoma as the most common subtype. Treatment was majorly initiated with R-CHOP, witnessing an encouraging initial response. A mean time to progression was 13 months, with a median progression-free survival of 10 months and median overall survival of 55.8 months. Variables such as age, Ann Arbor stage, lymphoma subtype, R-IPI scores, double expression status, and presence of objective response to first line treatment status evidently influenced progression-free survival and overall survival, albeit none was an independent factor in multivariate analysis. Conclusion: The findings underscore the importance of comprehensive multi-faceted analyses in understanding tonsillar lymphomas. Although there was no independent risk factor for survival analyses, variables such as age, Ann Arbor stage, lymphoma subtype, R-IPI scores, double expression status, and presence of objective response to first line treatment were instrumental in influencing progression-free survival and overall survival, offering valuable insights for future research and potential tailoring of treatment approaches.