Primary extranodal non-Hodgkin's lymphoma: clinicopathological features, survival and treatment outcome in two cancer centers of southern Turkey.

Huseyin Mertsoylu,Ali Murat Sedef,Ozgur Ozyilkan,Sadik Muallaoglu,Ali Arican,Ayberk Ali Besen,Fatih Kose,Suleyman Erdogdu,Ahmet Sezer

doi:10.7314/apjcp.2014.15.17.7207

Huseyin Mertsoylu, Ali Murat Sedef + Show 7 more

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https://doi.org/10.7314/apjcp.2014.15.17.7207

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Abstract

The aim of this study was to assess the epidemiological and clinicopathological characteristics of primary extranodal non-Hodgkin's lymphoma (pENL) patients, focusing on treatment and survival outcome. Between October 2003 and March 2012, 802 patients with non-Hodgkin's lymphoma (NHL) were diagnosed and treated in two different cancer centers of Southern Turkey. pENL, constituted 12.4% (100/802) of all NHL studied during this period. Median age of the patients was 56 years (range 17-87 years) and the male: female distribution was 3:2. Eighty-five of 100 patients (85%) were in stage I/II, 9/100 (9%) in stage III, whereas 6/100 (6%) were in stage IV. Head and neck constituted the most common site (51/100, 51%), followed by gastrointestinal tract (GIL) (37/100, 37%), and cerebrum (CL) (5/100, 5%). Diffuse large B cell lymphoma (DLBCL) was the most common histological type, observed in 53% of patients, followed by marginal zone extranodal lymphoma (13%). Most of patients (76%) received a CHOP containing regimen. Complete remission (CR) were achieved in 71% of patients. The median follow-up duration of all patients was reported as 37.6 months (range, 0.8-165 months). This period was reported as 137.5 months (range, 117.5- 1578.6 months) in gastrointestinal lymphoma (GIL) patients, 119.0 months (range, 91.8-146.1 months) in head and neck lymphoma (HNL) patients, and 18.4 months (range, 12.6-24.1 months) in cerebral lymphoma (CL) patients. Head and neck, and the gastrointestinal tract were the two most common extranodal sites observed. Histologically DLBC accounted for the majority of cases. Most patients were on earlier stages, had low-low intermediate IPI scores and had a favorable prognosis.

Highlights

Most non-Hodgkin’s Lymphomas (NHL) arise in lymph nodes or other lymphatic tissues such as the spleen, Waldeyer’s ring and thymus
Results: primary extranodal non-Hodgkin’s lymphoma (pENL), constituted 12.4% (100/802) of all non-Hodgkin’s lymphoma (NHL) studied during this period
As per Dowson criteria, lymphoma is said to be primarily extranodal in 1) absence of palpable superficial lymph nodes on first physical examination; 2) absence of mediastinal lymphadenopathy detected on plain chest x-ray; 3) dominant lesion at extranodal sites; 4) involvement of lymph nodes in the vicinity of the primary lesion; 5) white blood cell (WBC) count within normal range

Summary

Introduction

Most non-Hodgkin’s Lymphomas (NHL) arise in lymph nodes or other lymphatic tissues such as the spleen, Waldeyer’s ring and thymus. A substantial percentage of NHL arises from tissues other than lymph nodes and even from sites, which normally contain no lymphoid tissue. These forms are referred to as primary extranodal lymphomas (pENL). Head and neck constituted the most common site (51/100, 51%), followed by gastrointestinal tract (GIL) (37/100, 37%), and cerebrum (CL) (5/100, 5%). The median follow-up duration of all patients was reported as 37.6 months (range, 0.8-165 months) This period was reported as 137.5 months (range, 117.51578.6 months) in gastrointestinal lymphoma (GIL) patients, 119.0 months (range, 91.8-146.1 months) in head and neck lymphoma (HNL) patients, and 18.4 months (range, 12.6-24.1 months) in cerebral lymphoma (CL) patients. Most patients were on earlier stages, had low-low intermediate IPI scores and had a favorable prognosis

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