Lennert's lymphoma (lympho-epithelioid cellular lymphoma)

The authors describe a case of Lennert's lymphoma occurring in a 64-year-old male patient. After a comprehensive examination of the world literature on the disease, clinical and pathologic problems, as well as differential diagnoses from other malignant lymphoid proliferations, are discussed. This is the first observation to be reported in the otorhinolaryngologie literature.     

Extranodal lymphoma

Lymphomas in the extranodal sites are usually of Non-Hodgkin’s variety Maxilla and mandibular involvement are usually far and few and GIT involvement with primary paranasal lympphomas are nearly unheard of.     

Burkitt's lymphoma

Cancer is the second leading cause of death in children and, among cancers, lymphoma is the third most frequently diagnosed type. The majority of these are non-Hodgkin's lymphomas (NHL). Although NHL have been grouped in a variety of confusing ways, recent research in cytogenetics and immunology, coupled with a better understanding of the normal pathways of lymphoid differentiation, has greatly lessened this confusion. Burkitt's lymphoma (BL) is a type of B-cell NHL which is sub-classified as either endemic (African) or non-endemic (American). Kinetic studies have demonstrated a doubling time of only 24 h. As a result of this extremely rapid growth, symptomatic complaints occur early in the disease course. Structures contiguous to the primary become compressed and metabolic derangements occur. Signs of chronic debilitation such as cachexia, diarrhea, generalized lymphadenopathy, and weight loss usually are not found. Thirteen cases of American BL have been treated since 1980 at the Texas Children's Hospital and form the basis of this review. Ten patients had obstructive abdominal symptoms including constipation and pain, and 3 had masses in the neck, maxilla, or tonsil. Systemic manifestations included ascites, jaundice, fever, and hepatosplenomegaly. Two patients ultimately developed central facial nerve paralysis.     

Primary laryngeal lymphoma

We report a new case of supraglottic primary laryngeal lymphoma. The tumor was a B-cell, non-Hodgkin lymphoma with good response to polychemotherapy and radiotherapy. Although the head and neck region is a frequent site of origin of extranodal non-Hodgkin lymphomas, laryngeal involvement is exceptional. Including this case, 88 primary laryngeal lymphomas have been reported in the literature.     

Isolated laryngeal lymphoma

Isolated laryngeal lymphoma is a rare occurrence. We found a total of 14 previously reported cases. These plus our additional case are reviewed in order to make recommendations for diagnosis, therapy, and follow-up. Histologic classification and clinical staging of lymphomas have limited usefulness, because the tumor can change cell type during the clinical course of the disease. Once histologic proof of the tumor exists, adequate evaluation consists of physical examination to detect adenopathy elsewhere, bone marrow biopsy, urinalysis, blood uric acid levels, liver biopsy, and liver and kidney function tests. The search must continue in the chest by X-ray, the retroperitoneal nodes by lymphangiography and the abdominal visera by contrast radiography. Radiation therapy is the best initial treatment for isolated laryngeal lymphoma. If the tumor does not respond to irradiation, then operation to remove the lesion is required. This tumor has a tendency to recur at distant sites many years later. As with all cancer patients life-long follow-up is required.     

Anticonvulsant-induced lymphoma.

Patients with cervical adenopathy of obscure etiology may present a diagnostic problem to the otolaryngologist. The hydantoin family of anticonvulsants is a rare cause of adenopathy that may range from histologically simple lymphoid hyperplasia to true lymphoma. Between these two extremes is a benign clinical entity with the histologic characteristics of lymphoma. A patient on diphenylhydantoin (Dilantin) therapy developed bilateral true vocal cord paralysis and cervical adenopathy. On pathological examination the lesion was interpreted first as malignant lymphoma and later as hydantoin-induced pseudolymphoma. He has now been followed for over two years. Hydantoin-induced adenopathy may vary clinically from a benign condition to a true lymphoma. The malignant form may present long after the anticonvulsant treatment is discontinued. A 10-fold increase in the expected incidence of malignant lymphoma in epileptic patients on hydantoin therapy has been reported; therefore, these patients required long-term follow-up. The otolaryngologist should be aware of this rare clinical entity as an unusual cause of cervical adenopathy associated with vocal cord paralysis.     

Nasal T lymphoma

Nasal T lymphoma constitute a type of lymphoproliferative very infrequent symdrome. One of the fondamental problems it presents to bring a high probability of survival obtain a precocious diagnose. It is due that it originates inespecific histologic lesions, and to its clinic. Only the close cooperation between the otorhinolaryngologist and the anatomopathologist can arrive to obtain a very speedy diagnose and in that way the possibility of a correct treatment, because newly treatments appear, to which this type of disease every day better respond. We present the cases of nasal T lymphomas diagnosticated in the ORL Service of the Toledo area during 15 years, their symptomotology, treatment, evolution and survival. Besides a up to date bibliographic revision on this controversial syndrome.     

Malignant non-Hodgkin's lymphoma

Rapid regression of all symptoms was obtained after moderate chemotherapy in two women aged 69 and 77 years respectively with malignant non-Hodgkin's lymphomas. Cervico-facial locations of these tumors are discussed in relation to definition, etiology, geographic factors, genetic markers, and associated immunologic disorders. Diagnosis requires a series of explorations including, obviously as a last resort, exploratory cervicotomy. Other regions may be involved and must be investigated, but lesions not affecting lymph nodes occur in only approximately 2 p. cent of patients with cervico-facial malignant non-Hodgkin's lymphoma (approximately 10 p. cent of all malignant non-Hodgkin's lymphomas). Other localizations include the hard palate, gums, sinuses, and salivary glands. Burkitt's lymphoma represents, on the contrary, 30 p. cent of malignant non-Hodgkin's lymphoma seen in European children. The different therapeutic modalities available are discussed.     

眼内淋巴瘤1例

眼内淋巴瘤是指发生于葡萄膜、视网膜及玻璃体的淋巴瘤,与中枢神经系统淋巴瘤密切相关.该病临床表现呈多样性,诊断较为困难,常易误诊为葡萄膜炎、视网膜血管炎等而延误诊治.本病预后不良,生存期短,常因中枢神经系统并发症而死亡.我们曾诊治1例眼内淋巴瘤,报告如下.     

Burkitt's lymphoma of the tonsil

A case of Burkitt's lymphoma involving the tonsil in a 10-year-old Bedouin boy, is presented. The biological behaviour and the clinical presentation of this unusual neoplasm are discussed and the English language literature is reviewed. The diagnosis was made by histological examination, electron microscopy and confirmed by immunohistochemistry. The patient showed an excellent symptomatic response to surgery and chemotherapy.     

MALT lymphoma of the orbit

MALT lymphomas of the orbit are rare orbital tumors; the differential diagnosis needs to exclude inflammatory pseudotumors of the orbit, but also benign lymphoproliferations, pseudolymphomas, and other orbital neoplasms. After histological confirmation of the diagnosis staging is necessary, and – as long as the disease is localized exclusively in the orbit – radiation therapy should be started. The clinical picture of MALT lymphoma and its differential diagnosis and treatment are discussed with reference to an actual case.     

Extranodal non-Hodgkins lymphoma of larynx

Non-Hodgkins lymphoma is found in the older age group with extranoda involvement more commonly seen than in Hodgkins lymphomna. It isusually of B-cell type which has a better prognosis than T-cell type, Extranodal Non-Hodkin’s lymphomas of larynx are rare. they can present as isolated lesions in larynx or associated with multiple involvement. They are usually found in the supraglottic region of the larynx. We present a case of 70-year-old female with extranodal Hodgkins lymphoma of epiglottis with metastasis in the liver.