Nasopharyngeal non-Hodgkin Lymphoma Research Articles

Magnetic resonance imaging features of nasopharyngeal carcinoma and nasopharyngeal non-Hodgkin's lymphoma: Are there differences?

To describe differences in the primary tumour and distribution of cervical lymphadenopathy for cases of nasopharyngeal carcinoma (NPC) and nasopharyngeal non-Hodgkin's lymphoma (NPNHL) using magnetic resonance (MR) imaging. MR images of patients with NPC (n = 272) and NPNHL (n = 118) were independently reviewed by two experienced radiologists. NPC had a higher incidence of tumour invasion associated with the levator and tensor muscles of the velum palatine, the longus colli and medial pterygoid muscles, the base of the pterygoid process, the clivus, the base and greater wing of the sphenoid bone, the petrous apex, the foramen lacerum, the foramen ovale, the hypoglossal canal, and intracranial infiltration. In contrast, NPNHL had a higher incidence of tumour invasion associated with the hypopharynx, the palatine and lingual tonsils, as well as the ethmoid and maxillary sinuses. NPNHL also had a higher incidence of extensive and irregular bilateral lymphadenopathy, and lymphadenopathy in the parotid. NPC more often involved an unsymmetrical tumour with a propensity to invade both widely and deeply into muscle tissue, the fat space, the neural foramen, and the skull base bone. In contrast, NPNHL tended to be a symmetrical and diffuse tumour with a propensity to spread laterally through the fat space and along the mucosa to the tonsils of the oropharynx and hypopharynx. These differences facilitate a differentiation of these diseases using MR images, and enhance our understanding of the biological behavior of these malignant tumours of the nasopharynx.

Primary nasopharyngeal non Hodgkin lymphoma: A retrospective investigation of 26 patients

e19552 Background: Primary nasopharyngeal non-Hodgkin lymphoma (NNHL) was uncommon. In this retrospective study we report our experience dealing with this disease at the National Institute of Oncology. Methods: We retrospectively analyzed various characteristics of Primary NNHL: patient demographics, clinical and histological diagnosis, disease stage, treatment effects and outcome, in 26 patients treated at our institution between January 2001 and December 2007. Results: The average age of our patients was 52.7 years (range: 31 - 87 years). The male/female ratio was equal to 1.5/1. The major symptoms at first diagnosis were: nasal obstruction (88.6%), hypoacousia (88.4%), epistaxis (33.3%) and rhinorrhea (15.3%). Clinical examination founded bilateral cervical lymph nodes in 17 cases (65%). Histological analysis showed follicular lymphoma in 7 cases (26.9%), large B-cell lymphoma in 11 cases (42,3%) and T lymphoma in 4 cases ( 15,3%). Four (15.4%) of the patients were at stage I, 15 (57.6%) were at stage II, and 7 (27%) were at stage III/IV. At early stage, the patients were managed with chemo-radiotherapy and were managed with CHOP based chemotherapy at advanced stage. At the end of total treatment, 18 patients (69.2%) achieved complete response and remained disease free while 4 (15.4%) achieved partial response (>70%) and 4 (15.4%) were progressive (these patients received second line chemotherapy). After 110 months median flow-up, median disease free and overall survival were not reached. Overall, the treatment was well tolerated. Conclusions: From our study and from the literature, we conclude that histological characteristics, principle of treatment and outcome of primary NNHL patients are similar to that of patients with nodal lymphoma. No significant financial relationships to disclose.