Clinicopatological Examination of Waldeyer’s Ring Lymphomas: A Cross-Sectional Study in Turkey

Abstract

Objective: Waldeyer's ring (WR) is the second most common site of extranodal lymphomas. Its clinical course may resemble those of nodal lymphomas. We evaluated the histopathological and clinical findings, Epstein-Barr virus (EBV) presence, and overall survival of WR lymphomas diagnosed in our department. Materials and Methods: Retrospectively, 32 patients were included. The demographic and clinical data of the patients and lymphoma types, the presence of EBV [EBV early RNAs (EBER)] by chromogenic in-situ hybridization (CISH) method were examined. Kaplan-Meier analysis was used for the survival rate. A P value less than 0.05 was considered statistically significant. Results: 23 of 32 cases were male. The mean age was 57.97±16.15 years. The preliminary clinical diagnosis was carcinoma in 46.9% of the cases. Tonsil and nasopharynx had equal proportions as lymphoma origin. Only 3 (9.4%) cases are classic Hodgkin lymphoma (CHL). 16 cases (50.0%) were diffuse large B-cell lymphoma (DLBCL). EBER was detected only in tonsillar CHL cases. The survival of patients with nasopharyngeal lymphoma was shorter than those of tonsillar origin (p=0.037). Conclusion: DLBCL is the most common lymphoma type of this localization. EBER positivity has been detected only in CHL. Survival is lower in lymphomas originating from the nasopharynx

Keywords

• Non-Hodgkin Lymphoma
• Tonsil
• Hodgkin Lymphoma
• Nasopharynx

Waldeyer Halkası Lenfomalarının Klinikopatolojik İncelenmesi: Türkiye’de Kesitsel Bir Çalışma

Abstract

ÖZ Amaç: Waldeyer halkası (WH), ekstranodal lenfomaların ikinci sıklıkta görüldüğü yerdir. Klinik seyri nodal lenfomalara benzeyebilmektedir. Bu çalışmada WH lenfomalarının histopatolojik ve klinik bulgularını, Epstein-Barr virüsü (EBV) varlığını, genel sağ kalım verilerini değerlendirdik. Gereç ve yöntem: Çalışmamız retrospektiftir. WH lenfoma tanılı 32 hastaya ait demografik, klinik veriler, lenfoma tipleri ve kromojenik in-situ hibridizasyon yöntemi (KİSH) ile EBV (EBER) varlığı incelendi. Tanımlayıcı istatistikler yapıldı. Hayatta kalma oranı için Kaplan-Meier analizi kullanıldı. P değerinin 0.05'ten küçük olması anlamlı kabul edildi. Bulgular: Çalışmamızdaki 32 vakanın 23’ü erkek, 9’u kadın olup, hastaların yaş ortalaması 57.97±16.15’di. Vakaların %46.9’unda klinik ön tanı karsinomdu. Lenfoma yerleşimi tonsil ve nazofarenkste eşitti. Vakaların sadece 3’ü klasik hodgkin lenfoma (KHL), diğerleri Non-Hodgkin lenfoma (NHL) tanılıydı. NHL tanılı olguların 16’sı diffüz büyük B hücreli lenfoma (DBBHL) idi. DBBHL’ların %50.0’si germinal merkez B (GMB) hücre kökenli iken, %50.0’si non-GMB’kökenli idi. EBER pozitifliği sadece tonsil KHL vakalarında izlendi. Ann Arbor evreleme sistemine göre vakaların %58.3’ünün evresi I-II idi. Nazofaringeal kaynaklı lenfoma hastalarının sağ kalımı tonsil kaynaklı olanlardan anlamlı olarak kısa idi (p=0.037). Sonuç: WH lenfomaları klinik olarak en sık karsinomlar ile karıştırılmaktadır. Tonsil ve nazofarenks kaynaklı olanlar oranca birbirine yakındır. EBER pozitifliği sadece KHL’larda tespit edilmiştir. Nazofarenksten kaynaklanan lenfomalarda sağ kalım daha düşüktür.

Keywords

• Non-Hodgkin Lenfoma
• Waldeyer Halkası
• Nazofarenks
• Tonsil
• EBER

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