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

Year 2023, Volume: 12 Issue: 1, 81 - 88, 15.03.2023

Çiğdem Özdemir , Nilhan Eryeğen , Filiz Yavaşoğlu , Mehmet Olgun Ak , Selçuk Kuzu , Mustafa Duran , Burcu Belen Aydoğmuş , Büşra Çetinkaya , Abdulkadir Bucak , Yiğit Şenol

https://doi.org/10.53424/balikesirsbd.1241429

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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