RESUMO
BACKGROUND: Lymphomas are malignant neoplasms of the lymphocyte cell lines affecting the lymph nodes, spleen and other nonhemopoietic tissues. Of the extranodal lymphomas found in the head and neck region, 3-5% of malignant lymphomas arise in the oral and paraoral region, mainly from Waldeyer's ring. The involvement of the base of the tongue is extremely rare. SUMMARISED CASE: Case 1: 64 year old female who presented initially with an enlarged occipital lymph node which gradually became generalized cervical lymphadenopathy with initial histology confirmed reactive lymphoid hyperplasia. Biopsy of left postero-lateral tongue lesion eventually showed high grade T cell lymphoma. Case 2: 85 year old male presented with history of dysphagia for one year who was found to have a lesion extending from his base of tongue into the nasopharynx. Histology showed a diffuse B cell lymphoma. DISCUSSION: Both patients were noted to have lesion of the tongue, but tongue lesions are noted in the literature to be extremely rare. When tongue lymphomas do occur, most are of B-cell origin; the diffuse large-cell variety is the most common. Extranodal lymphomas of the T cell phenotype tend more to be sinonasal in origin than of the tongue, with T cell lymphomas of the tongue being even rarer than B cell lymphomas. CONCLUSION: With regards to tumours arising in the tongue, squamous cell carcinomas are still classified as the most common. Lymphomas however, should still be kept in consideration as a differential diagnosis with regards to lesions arising from this site.
RESUMO
OBJECTIVE: To measure the control of bronchial asthma, quality of life, trigger factors and co-morbidities in patients of different weight classes. SUBJECTS AND METHODS: This cross-sectional study involved 365 adult asthmatics from outpatient clinics at four major health facilities in Trinidad. Data were obtained from patient interviews, asthma control test (ACT) and the Mini Asthma Quality of Life Questionnaire (Mini AQLQ). Weight and height measurements were taken to determine body mass index (BMI), waist circumference and waist/hip ratio. Data obtained were analysed to determine associations between obesity and asthma control, associated co-morbidities, risk factors and impaired quality of life. RESULTS: A significant number of participants was females(81%), aged 60+ years (37%), Indo-Trinidadians (62%),obese (41%) and uncontrolled asthmatics (72%). Chisquared analysis revealed significant association between obesity and asthma control status (5.810; df = 1; p =0.016). Receiver operating characteristic analysis revealed BMI (AUC = 0.648) as the strongest predictor of asthma control among all obesity parameters. Logistic regression showed that higher BMI (OR = 1.05; p = 0.008) or general obesity (OR = 2.37; p = 0.003) were significantly associated with the increased odds of having uncontrolled asthma. Major trigger factors and co-morbidities were similar among obese and non-obese asthmatics. Sub analysis of obese asthmatics showed that the following were significantly associated with poor asthma control: sleep apnoea (OR = 0.45, p = 0.006), allergic rhinitis (OR= 0.562, p = 0.031) and stress (OR = 0.480, p = 0.027). CONCLUSION: Obesity negatively affects asthma control and the quality of life of asthmatics. Further studies are needed to confirm these findings and to evaluate the role of weight reduction in asthma control.
