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1.
Laryngoscope ; 123(3): 662-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23203388

RESUMO

OBJECTIVES/HYPOTHESIS: Lymphoma of the parotid gland (LPG) is a rare disease. Clinical diagnosis is difficult, due to a lack of specific symptoms and findings. The aim of this study is to evaluate the diagnostic workup based on the analysis of our cases of LPG and to present the stage-dependent treatment outcome. STUDY DESIGN: Retrospective case-control study. METHODS: From 1992 to 2008, 697 patients at our institution underwent surgery because of a parotid tumor. Among 246 malignancies, an LPG was found histologically in 28 cases (4%). Staging was performed according to the Ann Arbor classification, and treatment was performed by radiotherapy and/or chemo/immunotherapy. The patients were retrospectively analyzed. RESULTS: No specific symptoms were found, with the main finding being a unilateral, painless, slowly progressing parotid mass. The sensitivities of imaging and fine-needle aspiration cytology in detecting LPG were 41% and 12%, respectively. Histology was the key to diagnosis, and frozen sections often revealed the diagnosis during surgery, which obviated the need for more extensive surgery in 89% of cases. The 5-year disease-specific survival estimates were 100% and 75% for early tumor stages (I and II) and advanced stages (III and IV), respectively. CONCLUSIONS: When the precise nature of a parotid mass remains obscure after fine-needle aspiration cytology and imaging, but LPG is clinically suspected, surgical tissue sampling with frozen sections appears to be a valid option and can prevent the need for more extensive surgery. The treatment outcome for LPG is favorable.


Assuntos
Linfoma/diagnóstico , Linfoma/cirurgia , Neoplasias Parotídeas/diagnóstico , Neoplasias Parotídeas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Feminino , Secções Congeladas , Humanos , Linfoma/mortalidade , Linfoma/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Parotídeas/mortalidade , Neoplasias Parotídeas/patologia , Análise de Sobrevida
2.
Oral Maxillofac Surg ; 16(1): 69-74, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20981461

RESUMO

BACKGROUND: Most of the lymphomas arising in the oral cavity are of B-cell origin. Among these, diffuse large B-cell lymphomas are the most common. Diffuse large B-cell lymphomas may exhibit more than one chromosomal rearrangement and are then referred to as 'double-hit' or 'triple-hit' lymphomas. CASE REPORT: We present a case of an intraoral 'double-hit' lymphoma in a 76-year-old male who had been referred by an oral surgeon in private practice. Intraoral examination exhibited a firm, exophytic lesion in the region of the right hard palate and buccal mucosa with extension to the soft palate. Radiographic examination exhibited a massive thickening of the right sinus membrane, and arrosion of the lateral and basal cortical sinus walls in the right maxilla. After diagnosis of the lesion, the patient was treated with six cycles of chemotherapy. DISCUSSION: Lymphomas arising within the oral cavity account for less than 5% of all oral malignancies and typically affect the palatine tonsils and the palate. 'Double-hit' lymphomas are associated with older age, usually present with an advanced stage of disease, and show an aggressive clinical behaviour. They normally have a poor prognosis, even when treated with intensive chemotherapy regimens. Nevertheless, in the case presented, the patient was free of symptoms 1 year after initial diagnosis.


Assuntos
Bochecha , Proteínas de Ligação a DNA/genética , Rearranjo Gênico do Linfócito B/genética , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/genética , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/genética , Neoplasias Palatinas/diagnóstico , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-myc/genética , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Seguimentos , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Masculino , Neoplasias Bucais/tratamento farmacológico , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Neoplasias Palatinas/tratamento farmacológico , Neoplasias Palatinas/patologia , Proteínas Proto-Oncogênicas c-bcl-6 , Tomografia Computadorizada por Raios X
3.
Ther Umsch ; 67(10): 497-500, 2010 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-20886454

RESUMO

After decades of confusion in lymphoma classification clearness was achieved with the publication of the REAL classification 1994 and of the WHO classification 2001. The revised 4th edition 2008 features some additional new categories. The WHO classification comprises B- and T-lymphoblastic neoplasms, mature B-cell lymphomas, mature T-cell and NK-cell lymphomas and Hodgkin lymphomas. A modern diagnostic work-up of lymphomas is based on morphology, immunohistochemistry and increasingly on molecular studies. Last but not least the evaluation of all these findings by an expert haematopathologist, who collaborates closely with the treating clinicians, is essential. The aim is to give an overview of the most frequent mature B-cell lymphomas and the most important classical Hodgkin lymphomas with focus on morphology and immunohistochemistry.


Assuntos
Linfoma/patologia , Progressão da Doença , Doença de Hodgkin/classificação , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/patologia , Humanos , Leucemia Linfocítica Crônica de Células B/classificação , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/patologia , Linfonodos/patologia , Linfoma/classificação , Linfoma/diagnóstico , Linfoma Folicular/classificação , Linfoma Folicular/diagnóstico , Linfoma Folicular/patologia , Linfoma Difuso de Grandes Células B , Prognóstico
4.
Quintessence Int ; 41(2): 93-7, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20165740

RESUMO

Non-Hodgkin lymphomas (NHLs) in the head and neck region are malignant lymphoid neoplasms that usually originate from B-lymphocytic cell lines. Primary extranodal manifestations of this hematolymphoid tumor in the oral cavity are rare and involve the maxillary jaw including the palatal soft tissues, the mandible, and gingival tissues in patients between 60 and 70 years of age without sex predilection. This case report of an extra-nodal NHL in the palate of a 75-year-old patient emphasizes the importance of accurate clinical, radiographic, and histologic diagnostic procedures to avoid delayed diagnosis or inappropriate treatment strategies. Chemotherapy, radiotherapy, or a combination of the two with a regular clinical and hemic follow-up is recommended.


Assuntos
Linfoma de Células B/patologia , Neoplasias Palatinas/patologia , Palato Duro/patologia , Idoso , Anticorpos Monoclonais Murinos/uso terapêutico , Antineoplásicos/uso terapêutico , Diagnóstico Diferencial , Humanos , Linfoma de Células B/tratamento farmacológico , Linfoma de Células B/radioterapia , Masculino , Neoplasias Palatinas/tratamento farmacológico , Neoplasias Palatinas/radioterapia , Palato Mole/patologia , Indução de Remissão , Rituximab
5.
Med Klin (Munich) ; 103(4): 245-8, 2008 Apr 15.
Artigo em Alemão | MEDLINE | ID: mdl-18484209

RESUMO

BACKGROUND: Malignant lymphoma of the prostate is rare. In the literature, about 165 cases with either a primary lymphoma of the prostate or secondary infiltration of the prostate by a lymphoma are described. CASE REPORT: The case of a 59-year-old patient with an irregular tumor in the prostatic region, but normal prostate-specific antigen (PSA), a fracture in the vertebral column and a bilateral enlargement of the suprarenal glands is presented. Repetitive prostate biopsy revealed the diagnosis of a diffuse large B cell lymphoma. Further staging examinations gave hints to an epidural infiltration. A polychemotherapy including intrathecal drug applications was initiated. Staging after four therapeutic cycles already showed good partial remission of all lymphoma manifestations. After two further therapeutic cycles, a CT scan showed a small rest of prostatic bulk, but PET-CT did not detect vital lymphatic tissue (complete remission). CONCLUSION: In cases of irregular prostatic enlargements, carcinoma has to be considered as the most frequent diagnosis. Nevertheless, also a solitary lymphoma or infiltration of the prostate by a systemic lymphoma has to be taken into account, especially if the PSA value is in the normal range.


Assuntos
Linfoma Difuso de Grandes Células B , Neoplasias da Próstata , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Linfoma Difuso de Grandes Células B/sangue , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons , Prednisona/uso terapêutico , Próstata/patologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/patologia , Indução de Remissão , Tomografia Computadorizada por Raios X , Vincristina/uso terapêutico
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