Primary malignant lymphomas of the salivary glands.

Primary malignant lymphomas of the salivary glands are rare, and only 43 possible cases have been reported. Four new cases from the Johns Hopkins Hospital are described, including clinical presentation, histologic findings, and subsequent course. The literature on this subject is reviewed, including cases arising in preexisting benign lymphoepithelial lesion with or without Sj?gren's syndrome. Although the number of reported cases with complete documentation and follow-up information is too small for significant statistical analysis, these patients appear to have a better prognosis than the usual lymphoma patient. The possible reasons for this are discussed.     

Primary non-Hodgkin's lymphomas of the major salivary glands

BACKGROUND: The clinical course of primary salivary gland lymphomas has received little attention. METHODS: We retrospectively assessed 20 patients with previously untreated non-Hodgkin's lymphomas (NHLs) and histologically confirmed as having parenchymal involvement of the salivary glands. The clinical presentation, therapy, and outcomes were compared between the 12 patients with mucosa-associated lymphoid tissue (MALT) lymphomas and the 8 patients with other NHLs. RESULTS: At diagnosis, the 12 patients with MALT lymphoma had a greater mean age and longer duration than did the 8 patients with other NHLs (P < 0.05). Eight of the 12 MALT lymphoma patients had recurrent episodes of salivary gland swelling and 5 had myoepithelial sialadenitis, Sj?gren syndrome, or gastric MALT lymphoma; these were not observed in the 8 other NHL patients. Compared with the latter group, the MALT lymphoma group had significantly greater five-year relapse-free (37.5% vs. 91.7%, P < 0.05) and disease-free (35.0% vs. 90.9%, P < 0.05) survival rates. However, two MALT lymphoma patients with high-grade transformation had recurrences beyond the head and neck region. CONCLUSION: Understanding the distinct clinical presentation and course of primary salivary gland lymphomas may help guide the proper diagnosis and management of patients with these tumors.     

Primary tuberculosis of bilateral submandibular salivary glands

A rare case of primary tuberculosis of bilateral submandibular salivary glands is presented with review of relevant literature. The patient was managed on conservative therapy.     

Primary malignant lymphoma of the mandible

From 1945 through 1985, 32 cases of primary lymphoma of bone were treated at the University of Iowa Hospitals and Clinics. Sixteen cases (50%) demonstrated the lesion in the long tubular bones with a predilection for the lower and upper extremities. The frequently involved flat bones (six cases) were the bones of the pelvis. There were only three cases (9%) where the mandible was the primary site. In this report, the literature is reviewed and three cases with primary lymphoma of the mandible are presented.     

甲状腺原发性恶性淋巴瘤

目的　探讨甲状腺原发性恶性淋巴瘤的病因、误诊原因及影响预后因素。方法　对 8例甲状腺原发性恶性淋巴瘤的临床病理资料进行回顾性分析。结果　甲状腺原发性恶性淋巴瘤好发于中老年女性。临床确诊率为12 .5 % (1/8) ,病理误诊率为 37.5 % (3/8)。 8例中 2例为结外 MAL T型边缘区 B细胞淋巴瘤 ;6例为弥漫性大 B细胞淋巴瘤。 6例伴有 Hashimoto's甲状腺炎。 2例 MAL T型淋巴瘤分别随访 12年、2年零 8个月均存活 ,现健在。 6例弥漫性大 B细胞性淋巴瘤平均存活期为 35 .9个月。结论　甲状腺原发性恶性淋巴瘤致病因素与自身免疫性疾病有关 ;临床及病理均易误诊。其预后与临床分期、病理组织学类型及治疗方法等有关     

Primary malignant lymphoma of parotid gland

Primary malignant lymphoma of the parotid gland is uncommon and rare among extranodal lymphoma of the head and neck. A case of primary parotid lymphoma in a 65 year old woman is reported here, who presented as right parotid swelling. She was treated with radiotherapy and chemotherapy and swelling subsided. Patient is doing well with no evidence of disease for last 4 years.     

Primary malignant lymphoma of the rectum--a case report

The patient was a 69-year-old woman who complained of bloody stools and abdominal pain. A tumor was removed with abdominoperineal excision, and histologic examination revealed malignant lymphoma associated with reactive lymphoreticular hyperplasia. The lesion was of the diffuse, medium-sized cell type according to the classification of the Japan Lymphoma Study Group.     

Primary malignant lymphoma of the central nervous system

Between 1960 and 1983, 19 patients with primary malignant lymphoma of the central nervous system (CNS) were seen at McGill University Hospitals. The diagnosis was made at autopsy in 3 patients, and by biopsy in 16. Results of treatment were poor. All four patient who underwent surgery alone died within 2 months of diagnosis. Of 12 patients who underwent surgery and postoperative radiotherapy, 11 died between 2 and 56 months (median, 12 months) following diagnosis, and one is alive with disease at 47 months. Patterns of involvement at first recurrence and/or at autopsy were analyzed for 13 patients. Failure at the original site of involvement was unusual after treatment consisting of surgery and radiotherapy. In contrast, failure in the brain at sites other than those originally involved was common in spite of the use of whole brain irradiation. Local leptomeningeal involvement was seen in one patient whose diagnosis was made at autopsy, and cerebral spinal fluid seeding was seen in two additional patients, one within 1 month of diagnosis and one at relapse at 6 months after diagnosis. No patient developed disease outside the CNS. The limitations of current therapy for this disease are discussed, and certain suggestions made regarding the management of future patients with this diagnosis.     

The place of irradiation in the treatment of malignant tumors of the salivary glands

1. Radiation therapy is not indicated after surgical removal with adequate margins of low-grade tumor. 2. Radiation therapy is indicated with a) Inadequate surgical margins in low-grade tumors b) All high-grade tumors c) All recurrent malignant tumors 3. Irradiation of nerve pathways is indicated with demonstrated nerve and perineural invasion and/or with adenoicystic carcinoma. 4. Irradiation of the entire ipsilateral neck is indicated a) Wtih high-grade tumors unless radical neck dissection shows negative nodes b) In the place of radical neck dissection.     

Lymphomas of salivary glands

Primary lymphomas arising in salivary glands are very uncommon. The histologic classification of 40 cases of lymphomas in salivary gland tissue submitted to the British Salivary Gland Tumour Panel is reported, and, for 30 of the patients for whom adequate information was available, the clinical presentation, management, and outcome have been analyzed. Lymphomas in salivary glands represented 1.7% of all reported salivary neoplasms. The majority developed in the parotid glands of patients aged between 50 and 70 years. Only four cases gave a premorbid history compatible with sicca syndrome. In this series, non-Hodgkin's lymphomas predominated; 23 were Grade I, and 13 were Grade II. Treatment regimens were not uniform, but are outlined. Survival ranged from 5 to 111 months. Median survival for the group was 49 months. Prognosis was not influenced by the clinical stage of disease at presentation. Four cases of lymphoma arising in benign lymphoepithelial lesions are included. None had clinical symptoms of sicca complex. Prognosis for this group was found to be as favorable as the others.