Oral Medicine
Characteristics of oral and paraoral malignant lymphoma: A population-based review of 361 cases*

https://doi.org/10.1067/moe.2001.116062Get rights and content

Abstract

Background: Lymphoma is the second most common neoplasm of the head and neck; almost 50% of all lymphomas occur in this region. Waldeyer's ring is the most common site of lymphomas involving the oral region. The purpose of this study was to review the characteristics of a large series of malignant lymphoma of the oral region. Methods: Three hundred sixty-one consecutive cases of malignant lymphoma of the oral region were identified in the Tumor Registry between 1969 and 1998. Results: The 361 cases (200 males and 161 females) of malignant lymphoma of the oral region accounted for 3.5% of all oral malignancies. The mean age was 62.5 years and the most prevalent site of involvement was the tonsil (32.7%), followed by the parotid gland (16.1%). Sixty-five percent of the lesions were diagnosed as large-cell (38%) or small-cell (27%) lymphoma. One quarter of the patients died of the disease in a mean of 2.78 years after diagnosis. Of a total 26 patients who died from other causes, 12 died because of other cancers, including 7 (27%) with leukemia and 5 (19%) with oral carcinoma. The prognosis is based, at least partially, on the histologic grading (low, intermediate, or high) and the anatomic stage of the disease. Localized low-grade lymphomas have a more favorable prognosis compared with those that are disseminated and/or have high-grade cellular changes. Conclusion: Lymphoma is the second most common malignant oral disease. Thorough head and neck and oral examination is necessary to identify lesions that may represent lymphoma.(Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:519-25)

Section snippets

Material and methods

Patients diagnosed with lymphoma of the oral region, including the pharynx and salivary glands, were identified from the Tumor Registry and the computer files of the British Columbia Cancer Agency between the beginning of January 1969 and the end of February 1998. The Tumor Registry records all malignant diagnoses for the population of British Columbia. Documentation in the Registry is based on the first malignant diagnosis. Complete records were available beginning in January 1969.

The criteria

Results

Between January 1, 1969, and February 28, 1998, the total number of cases of malignant disease in British Columbia was 362,531. Of the total cases of cancer, 16,598, or 4.6%, were cases of head and neck cancer. The total number of cases of malignant lymphoma (ML) diagnosed during those years was 14,452 cases, which represented 4% of the total malignancies.

Intraoral malignancies were diagnosed in 10,190 cases between 1969 and 1998, which represent 61.39% of all head and neck cases. Of the head

Discussion

The lymphomas are a group of neoplasms arising in the reticuloendothelial and lymphatic system. The lymphomas are the seventh most common cancers in the United Sates, but because of a younger average age of diagnosis, lead to more years of potential life lost than many adult cancers.14, 15, 16 The cell of origin of Hodgkin's disease appears to be from the monocyte-histiocyte series manifesting in the disease as Reed-Sternberg cells. Hodgkin's disease accounts for approximately 14% of all ML.14,

References (36)

  • E Baden et al.

    Hodgkin's lymphoma of the oropharyngeal region: report of four cases and diagnostic value of monoclonal antibodies in detecting antigens associated with Reed-Sternberg cells

    Oral Surg Oral Med Oral Pathol

    (1987)
  • SK Shrivastava et al.

    Head and neck extranodal non-Hodgkin's lymphomas in Indian patients

    Radiol Oncol

    (1988)
  • AD Rapidis et al.

    Tumors of the head and neck in children. A clinico-pathological analysis of 1,007 cases

    J Craniomaxillofac Surg

    (1998)
  • C Kaplinsky et al.

    Childhood B-cell non-Hodgkin's Lymphoma in Israel

    Leuk Lymphoma

    (1994)
  • CD Ruijs et al.

    Treatment of localized non-Hodgkin's lymphomas of the head and neck

    Cancer

    (1994)
  • V Donato et al.

    Radiation therapy and chemotherapy in the treatment of head and neck extranodal non-Hodgkin's lymphoma in early stage with a high grade of malignancy

    Anticancer Res

    (1998)
  • H Rowley et al.

    Lymphoma presenting to a head and neck clinic

    Clin Otolaryngol

    (1995)
  • T Economopoulos et al.

    Primary extranodal non-Hodgkin's lymphoma of the head and neck

    Oncology

    (1992)
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    *

    Reprint requests: Joel Epstein, Department of Dentistry, BC Cancer Agency, 600 West 10th Ave, Vancouver, BC, V5Z 4E6, [email protected]

    a

    Medical/Dental Staff, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Head, Department of Dentistry, Vancouver Hospital and Health Sciences Centre; Professor, University of British Columbia, Vancouver, BC, Canada; Research Associate Professor, University of Washington, Seattle.

    b

    Research Assistant, Department of Dentistry, Vancouver Hospital and Health Sciences Center, Vancouver, BC, Canada.

    c

    Research Scientist, Department of Epidemiology and Biometry, British Columbia Cancer Agency, Vancouver, BC, Canada.

    d

    Professor, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel

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