Non-Hodgkin's lymphoma involving the tonsil: an immunohistochemical study

Twenty-one patients with non-Hodgkin's lymphoma involving the palatine tonsil were studied in an attempt to relate pathological data to clinical outcome. Eleven tumours were classified as low-grade and ten as high-grade on morphological criteria. The results of immunohistochemical investigations are presented; all tumours but one were of B-cell origin. None of the pathological factors studied were found to be useful prognostic indicators.     

Malignant lymphoma of the faucial tonsil.

Ten cases of malignant lymphoma of the faucial tonsil treated in the R.U.H., Bath, during 1965--1975 are reviewed. Dysphagia and irritation in the throat are predominant symptoms. Enlarged tonsil is the commonest feature. Radiotherapy is the treatment of choice and the prognosis has improved considerably with modern supervoltage radiotherapy.     

Medical treatment of stage I nasal polyposis over a 3-year follow-up period

PURPOSE: To determine the effects of a standardized therapeutic protocol (short-term oral administration of prednisolone and daily intranasal spray of beclometasone) on stage I nasal polyposis over a follow-up period of 3 years. PROCEDURES: Assessments (evaluation of nasal function and drug consumption) were conducted at baseline and every 3 months on 54 consecutive patients with stage I nasal polyposis during 3 years. RESULTS: Over the follow-up period of 3 years, this dual modality proved to be successful in 87% of the subjects; only 13% had to undergo surgery after its failure. The average symptom reduction reached an improvement rate varying from 66 to 94.8%, according to the symptom type. The daily dosage of prednisolone and beclometasone was progressively decreased, while the gain in nasal comfort was being preserved. CONCLUSION: Management of stage I nasal polyps should be primarily medical.     

Carcinoma of the pyriform sinus: a retrospective analysis of treatment results over a 20-year period

One hundred and one patients with pyriform sinus carcinoma treated at the Netherlands Cancer Institute were studied retrospectively. The patients were staged according to the UICC criteria of 1987: there were no stage I, 23 stage II, 30 stage III, and 48 stage IV patients. The treatment consisted of radiotherapy (n= 45), a planned combination of surgery and post-operative radiotherapy (n= 47) or surgery alone (< = 9). The crude 5-year survival was 27%, whereas the 5-year disease-free survival was 37%. The locoregional disease-free survival was 52%. Stage according to the UICC 1987 criteria is an important prognostic variable (P= 0.0026). Furthermore, significantly less locoregional recurrences and a better disease-free survival were seen in the combined surgery and radiotherapy group than in the exclusively irradiated group (P < 0.0001).     

Burkitt lymphoma of a palatine tonsil

Non-Hodgkin lymphoma (NHL) comprise 7-10% of all malignant tumors in childhood. Early systems of classification (Rappaport, Luke-Collins) have been improved with the Working Formulation. NHL are classified into low, intermediate and high-grade disease. Head and neck manifestations of Burkitt's lymphoma are encountered in less than a quarter of the reported cases and usually present as cervical adenopathy. Parapharyngeal space and extranodal disease are unusual sites of involvement. We present a case of tonsillar lymphoma diagnosed with fine-needle biopsy and confirmed with excisional biopsy. Accurate staging (stage IV) and chemotherapy regimen was promptly begun. We review the clinical aspects, pathologic features and treatment of this disease.     

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.     

Non-Hodgkin's lymphoma of the parotid gland

Since 1969 we have seen 17 patients with non-Hodgkin's lymphoma of the parotid gland. Retrospective analysis of these patients reveals that the primary diagnosis was established in 14 patients by parotid surgery. In 10 (58.8%) cases there was a single focus of NHL in the parotid gland proven by extensive medical and radiological examinations. Histology showed that 14 (82.3%) of the tumors were low grade and 3 (17.7%) were high grade (Kiel classification). In 5 specimens myoepithelial sialadenitis was found in the parotid gland tissue. Six patients died within 1.5 years on average, 4 of them without evidence of disease. Four of the 7 patients alive have been followed for an average of 3.1 years without evidence of disease. Primary radiation of the parotid region in stage IE in cases of parotid gland NHL seems to be an effective therapy. NHL presenting in myoepithelial sialadenitis seems to be rare, but offers the opportunity of observing an organ specific malignant process.     

Non-Hodgkin's lymphoma of the sinonasal tract

OBJECTIVES: A review of the presenting features, management, and outcome of extranodal non-Hodgkin's lymphoma (NHL) of the sinonasal tract during a 10-year period in Nottingham, UK. STUDY DESIGN: Twenty-four patients received a diagnosis of extranodal NHL of the nasal cavity, paranasal sinuses, or both, from 1987 to 1996. The patients' data were collected prospectively in the Nottinghamshire Lymphoma Registry. METHODS: All patients' records and their histology were reviewed along with data entered into the Nottinghamshire Lymphoma Registry, noting the patient's age, sex, presenting symptoms and signs, staging, computed tomography findings, histology, treatment, complications, and outcome. RESULTS: The 24 patients with extranodal NHL of the sinonasal tract represent 1.63% of the 1,457 patients with NHL seen in the 10-year period of this study in Nottinghamshire. The median age was 72 years (range, 42-96 y), with a male dominance (male-to-female ratio: 15:9). Most patients presented with nonspecific nasal symptoms such as nasal obstruction and epistaxis. Only one patient had a relapse involving the central nervous system after treatment. All the histology was reviewed and showed a predominance of large B-cell subtype (21 patients). The overall 5-year survival was 40% (95% CI, 19%-61%) and 33% for 10-year (95% CI, 12%-54%). The cause-specific survival at 5 years and 10 years was 62% (95% CI, 39%-86%). CONCLUSIONS: A high degree of suspicion and appropriate use of computed tomography scans and surgical biopsy are the keys to the management of NHL.     

Non-Hodgkin's lymphoma of the maxillary sinuses. Pathological clinical study and current status of the treatment

Primary non-Hodgkin lymphoma (NHL) of the maxillary sinus is an infrequent neoplasm that represents about 8% of all malignancies in this area. A review was made of 74 patients diagnosed as malignancy of the maxillary sinus in a 20-year period. Five cases of primary extraganglionar NHL of the maxillary sinus were found. We describe all the cases and their extension in detail. The clinical manifestations, treatment, and long-term survival of these patients are discussed.     

Otoplasty: an analysis of technique over a 33-year period

OBJECTIVE: To compare the merits of otoplasty technique with a diverse patient population as experienced spanning a period greater 30 years. STUDY DESIGN: A review of a series of otoplasty cases that occurred in two distinctly different clinical settings during a 33-year period. METHODS: A retrospective analysis of 211 patients undergoing otoplasty from 1969 to 1982 in a military hospital setting was compared with 118 patients receiving otoplasty from 1982 to 2002 in a university/private practice setting. The patient population consisted of 180 adults and 149 children. RESULTS: Otoplasty patients in the military setting were primarily adults, whereas those in the university/private practice setting were primarily children. In the adult population, 98.9% of patients required use of lateral conchal cartilage resection combined with a mattress suture technique. In the pediatric population, all patients required use of a mattress suture technique and in 83.2% of selected cases limited lateral conchal cartilage resection was required. CONCLUSION: Otoplasty technique involving lateral conchal cartilage resection, mattress suture fixation, or a combination of both is applicable to diverse patient populations.     

Speech perception after cochlear implantation over a 4-year time period

OBJECTIVE: To evaluate the long-term speech perception of cochlear implantees and to compare the developing auditory performance patterns of prelingual children and postlingual deaf adults. MATERIAL AND METHODS: Twenty-nine prelingually deaf children and 17 postlingually deaf adults who had been followed up for 4 years were included in the study. Speech perception ability was assessed by means of vowel and consonant confusion tests and the Korean version of the Central Institute of Deafness (K-CID) test (performed without visual cues). The test results were analyzed at 3 and 6 months after implantation and then annually. RESULTS: In the prelingually deaf children, the average results continuously improved over the 4-year period. In the postlingually deaf adults, the average results did not improve further after the first 2 years. Individuals with < 5 years of deafness had a faster rate of recovery of speech perception than those who had been deaf for > 5 years. The K-CID scores were negatively correlated with age at implantation for the prelingually deaf group and with the duration of deafness in the postlingually deaf group. Children fitted with implants at a younger age showed better speech perception ability than those fitted with implants at an older age. Interestingly, prelingually deaf children aged 5-7 years at implantation showed the widest variation in individual outcomes. Amongst this group of children with highly variable outcomes, the metabolic status of brain cortices determined by means of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was available for three patients. The individual with the widest hypometabolic area had the best speech perception ability. CONCLUSION: The extent of hypometabolism as assessed by FDG-PET seemed to be one of the major factors predicting the outcome of cochlear implantation.     

Non-Hodgkin's lymphoma of the larynx in children

Non-Hodgkin's lymphomas (lymphosarcomas) of the larynx are rare occurrences in children. This paper reports a child 9 years 3 months of age with isolated non-Hodgkin's lymphoma of the larynx, and gives a 15-year follow-up report of a previously published case of a child 4 years 7 months of age. Both children presented with the chief complaint of progressive airway obstruction, and both cases were misdiagnosed, as chronic allergic epiglottitis in the first patient, and nonresponsive croup in the second patient. Once we established a histologic diagnosis and excluded disseminated disease, we instituted treatment with local irradiation and systemic multiagent chemotherapy. Complete remission was achieved, and the two patients have been free of disease since their treatments were started 2 years and 9 years ago, respectively.     

A retrospective study of nasopharyngeal carcinoma presenting over a 10-year period

67 cases of nasopharyngeal tumours presenting at the Royal National Throat, Nose and Ear Hospital over a 10-year period were examined, of which 47 were poorly differentiated carcinomas. The population under review could be subdivided into three separate groups on the basis of geographical origin: Northern European, Southern European and Middle Eastern. The proportion of poorly differentiated carcinomas in each geographical area was calculated and was found to differ significantly between the Northern European and Middle Eastern groups.     

Non-Hodgkin's lymphoma: a differential diagnosis of otogenic facial paralysis

Of all the neoplastic conditions of the lymphatic system, Non-Hodgkin's lymphoma (NHL) represents a heterogenous group. As well as lymph nodes NHL can involve extranodal sites, including regions in head and neck. The mouth and oropharynx are typical extranodal sites, and the ENT surgeon should be aware of this possibility of the swift diagnosis of NHL is to be made. We report two patients with rare invasion of the middle ear, facial nerve paresis, and asymptomatic cerebral involvement by Non-Hodgkin's lymphoma.