ABSTRACT
Los linfomas de las glándulas salivales son una entidad poco frecuente, estimándose una incidencia del 5 por ciento. La localización más habitual es la glándula parótida, seguida de la submaxilary la sublingual. La mayoría de los linfomas parotídeos son linfomas no Hodgkin (LNH) y se consideran derivados del tejido linfoide asociado a mucosas (MALT). Infrecuentemente se han reportado estos casos y suelen ser subdiagnosticados por su presentación relativamente benigna, comportándose de forma localizada, de lento crecimiento, con varios años de evolución. Presentamos un caso clínico de linfoma tipo MALT de parótida de acuerdo a las características clínicas, histológicas e inmunohistoquímicas de este tumor. Además una revisión de la literatura de este caso.
Lymphomas of the salivary glands are a rare entity, with an estimated incidence of 5 percent. The most frequent location is parotid gland, followed by the submandibular and sublingual. The majority of parotid lymphomas are non-Hodgkin's lymphoma NHL and are considered derived from mucosa-associated lymphoid tissue (MALT). Infrequently these cases have been reported and are often underdiagnosed for their presentation is relatively benign, localized behaving, slow growing, with several years of evolution. We report a case of parotid MALT lymphoma according to the clinical, histological and immunohistochemical characteristics of this tumor. In addition, a literature review of this case.
Subject(s)
Humans , Male , Aged , Lymphoma, B-Cell, Marginal Zone/diagnosis , Parotid Neoplasms/diagnosis , Parotid Neoplasms/surgery , Parotid Neoplasms/radiotherapy , Parotid Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Lymphoma, B-Cell, Marginal Zone/surgery , Lymphoma, B-Cell, Marginal Zone/radiotherapy , Lymphoma, B-Cell, Marginal Zone/diagnostic imaging , Immunohistochemistry , Lymphoma, B-Cell, Marginal Zone/pathology , Parotid Neoplasms/pathologyABSTRACT
BACKGROUND: There is not a gold standard in the treatment of primary gastric lymphoma (PGL). This study aimed to establish prognostic factors that should be considered for the staging and management of this disease. METHODS: We retrospectively reviewed and analyzed the clinicopathological features of patients treated for PGL in a tertiary referral center in Mexico City in a 10-year period from 1990 through 2000. Staging was performed with the Ann-Arbor system. Overall and disease-free survivals were the primary endpoints. RESULTS: We identified 41 patients of which 19 (46.3%) were classified as large-cell lymphoma, 16 (39.0%) as low-grade MALT, and 6 (14.6%) patients as lymphoma unspecified. The series included 15 (36.6%) patients with stage IV disease. Twenty patients (48.8%) underwent surgery and 34 (82.1%) received chemotherapy. Twenty-three patients were treated with at least two different types of therapy (56.1%). Actuarial 1 and 5 years survival were 77.8 and 71.2%, respectively. Early stage at presentation, surgery, normal lactic dehydrogenase (LDH) levels and good performance status were associated with longer survival in univariate analysis. Only normal LDH and good performance status retained their significance in multivariate analysis. Regarding disease-free survival in multivariate analysis, only normal LDH was associated with a better prognosis: 131 versus 12 months for LDH <197 and >or=197 mg/dl, respectively (P < 0.0001). CONCLUSIONS: Optimal treatment of PGL remains controversial. High LDH levels and poor performance status at diagnosis are associated with shorter overall and disease-free survival and should be considered for the staging and management of these patients.