Clinical and Pathologic Characterization of Mucosa-Associated Lymphoid Tissue Lymphoma of the Head and Neck

1998 ◽  
Vol 107 (9) ◽  
pp. 801-806 ◽  
Author(s):  
Neil Bhattacharyya ◽  
Robert A. Frankenthaler ◽  
Marshall E. Kadin ◽  
Hilary I. Gomolin ◽  
Arthur M. Lauretano
Keyword(s):  
Head And Neck ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Immunohistochemical Analysis ◽  
Surgical Excision ◽  
Response To Treatment ◽  
Positive Staining ◽  
Low Grade ◽  
Primary Therapy ◽  
Histologic Diagnosis

Mucosa-associated lymphoid tissue (MALT) has recently been recognized as a possible site of origin for low-grade lymphomas of the B-cell type. Though relatively rare, these MALT lymphomas may arise within several sites in the head and neck, and often present diagnostic and therapeutic challenges. We review 4 cases of primary MALT lymphoma of the head and neck, treated with surgical excision (3 cases), irradiation (2 cases), and chemotherapy (1 case), to further characterize this new subtype of head and neck malignancy. The mean time from onset of symptoms to histologic diagnosis was 15 months. Fine needle aspiration identified an atypical lymphoid infiltrate in only 1 of 3 patients. Immunohistochemical analysis was essential in establishing the diagnosis of MALT lymphoma in all 4 of the cases, and demonstrated characteristic negative staining for CD3, CD5, and CD43, positive staining for CD20, and monotypic staining for either κ or Λ; light chain immunoglobulin markers. All patients achieved complete remission after primary therapy, and all remain free of disease with follow-up ranging from 6 to 54 months (mean 33 months). The diagnosis of MALT lymphoma should be considered in cases of atypical lymphoid infiltrates in the head and neck, and increased awareness coupled with detailed immunohistochemical analysis is essential to securing an accurate diagnosis. Clinical remission of MALT lymphoma may be achieved with several modalities, but further study will be required to determine the long-term response to treatment.

scholarly journals 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings in Mucosa-Associated Lymphoid Tissue Lymphoma of the Larynx: A Case Report and Literature Review

2012 ◽  
Vol 40 (3) ◽  
pp. 1192-1206 ◽  
Author(s):  
K Zhao ◽  
Y-Z Luo ◽  
S-H Zhou ◽  
B-L Dai ◽  
X-M Luo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Immunohistochemical Analysis ◽  
Emission Tomography ◽  
Positron Emission ◽  
Laryngeal Mucosa ◽  
Pet Ct ◽  
Fdg Pet Ct

Laryngeal mucosa-associated lymphoid tissue (MALT) lymphoma is rare, with only 25 cases reported in the literature. This report presents a case of laryngeal MALT lymphoma in a 35-year-old female with a 6-year history of progressively worsening hoarseness. MALT lymphoma was diagnosed based on biopsy and immunohistochemical analysis. The patient received two cycles of cyclo-phosphamide + epirubicin + vincristine + prednisone (CHOP) chemo therapy, which was ineffective. 18F-fluoro deoxy glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) showed 18F-FDG accumulation in the larynx only and identified stage IE lymphoma. CHOP chemotherapy was terminated and the patient was treated with radiotherapy. After 3 months (total radiation dose 27 Gy), 18F-FDG PET/CT scan showed that the laryngeal lesion was in complete remission. A review of the literature on the MEDLINE®/PubMed® databases regarding laryngeal MALT lymphoma and the use of PET/CT found that radiotherapy is the firstline treatment for stage I and II MALT lymphoma.

T(11;18)(q21;q21) is associated with advanced mucosa-associated lymphoid tissue lymphoma that expresses nuclear BCL10

Blood ◽  
2001 ◽  
Vol 98 (4) ◽  
pp. 1182-1187 ◽  
Author(s):  
Hongxiang Liu ◽  
Hongtao Ye ◽  
Ahmet Dogan ◽  
Renzo Ranaldi ◽  
Rifat A. Hamoudi ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Fusion Transcript ◽  
Low Grade ◽  
Chain Reaction ◽  
Nuclear Expression ◽  
Molecular Events ◽  
Multistep Process ◽  
Polymerase Chain ◽  
H Pylori

The development of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a multistep process and can be clinico-pathologically divided into Helicobacter pylori-associated gastritis, low-grade tumors, and high-grade tumors. The molecular events underlying this progression are largely unknown. However, identification of the genes involved in MALT lymphoma-specific t(11;18)(q21;q21) and t(1;14)(p22;q32) has provided fresh insights into the pathogenesis of this disease. T(11;18)(q21;q21) results in a chimeric transcript between the API2 and theMALT1 genes, whereas t(1;14) (p22;q32) causes aberrant nuclear BCL10 expression. Significantly, nuclear BCL10 expression also occurs frequently in MALT lymphomas without t(1;14)(p22;q32), suggesting an important role for BCL10 in lymphoma development. Thirty-three cases of H pylori gastritis, 72 MALT lymphomas, and 11 mucosal diffuse large B-cell lymphomas (DLBCL) were screened for t(11;18)(q21;q21) by reverse transcription–polymerase chain reaction followed by sequencing. BCL10 expression in lymphoma cases was examined by immunohistochemistry. The API2–MALT1 fusion transcript was not detected in H pylorigastritis and mucosal DLBCL but was found in 25 of 72 (35%) MALT lymphomas of various sites. Nuclear BCL10 expression was seen in 28 of 53 (53%) of MALT lymphomas. Of the gastric cases, the largest group studied, the frequency of both t(11;18)(q21;q21) and nuclear BCL10 expression was significantly higher in tumors that showed dissemination to local lymph nodes or distal sites (14 of 18 = 78% and 14 of 15 = 93%, respectively) than those confined to the stomach (3 of 29 = 10% and 10 of 26 = 38%). Furthermore, t(11;18)(q21;q21) closely correlated with BCL10 nuclear expression. These results indicate that both t(11;18)(q21;q21) and BCL10 nuclear expression are associated with advanced MALT lymphoma and that their oncogenic activities may be related to each other.

scholarly journals Interesting Clinical Presentation of Myxoid Liposarcoma of Oropharynx

2013 ◽  
Vol 4 (1) ◽  
pp. 57-58
Author(s):  
Sagaya Raj ◽  
Shuaib Merchant ◽  
Azeem Mohiyuddin ◽  
P Arun
Keyword(s):  
Head And Neck ◽  
Clinical Presentation ◽  
Surgical Excision ◽  
Myxoid Liposarcoma ◽  
Lateral Wall ◽  
Posterior Wall ◽  
Low Grade ◽  
Present Case Report ◽  
Case Presentation ◽  
Histologic Pattern

ABSTRACT Aims To describe an unusual presentation of myxoid liposarcoma of oropharynx and a brief review of literature. Introduction Liposarcomas of head and neck are very rare. Its treatment and prognosis mainly depends on the site and the histologic pattern of the tumor. Case presentation The present case report describes a 65-year-old male with complaints of dysphagia, dyspnea, and a peculiar complaint of mass in the throat which turned out to be a low-grade myxoid liposarcoma arising from right lateral wall of oropharynx extending intraluminal in the esophagus, compressing posterior wall of trachea. The mass was successfully excised surgically and postoperative period was uneventful and patient was asymptomatic 4 months after surgery. Conclusion Myxoid liposarcoma is a rare tumor in head and neck and surgical excision with adequate margin is the treatment of choice. How to cite this article Mohiyuddin A, Raj S, Merchant S, Arun P. Interesting Clinical Presentation of Myxoid Liposarcoma of Oropharynx. Int J Head and Neck Surg 2013;4(1):57-58.

Clinical study of mucosa-associated lymphoid tissue lymphomas of the head and neck

2011 ◽  
Vol 126 (3) ◽  
pp. 271-275
Author(s):  
S Hosokawa ◽  
J Okamura ◽  
Y Takizawa ◽  
G Takahashi ◽  
K Hosokawa ◽  
...  
Keyword(s):  
Head And Neck ◽  
Surgical Resection ◽  
Lymphoid Tissue ◽  
Early Stage ◽  
Local Treatment ◽  
Response To Treatment ◽  
Limited Information ◽  
Early Stage Disease ◽  
First Choice

AbstractBackground:Limited information is available on mucosa-associated lymphoid tissue lymphomas arising in the head and neck.Method:A retrospective analysis was conducted of 20 patients who were histologically diagnosed with mucosa-associated lymphoid tissue lymphoma and treated at our institution between January 1990 and December 2009.Results:Treatment consisted of surgical resection alone in two patients (10 per cent), surgical resection with consecutive radiotherapy in one (5 per cent), and radiotherapy alone in eight (40 per cent). Three patients (15 per cent) were treated with systemic chemotherapy, and three (15 per cent) received chemoradiotherapy. Three patients (15 per cent) were informed of the diagnosis but not treated for their condition.Conclusion:All of the 20 patients were still alive after a mean follow-up period of 50.8 months. Local treatment for mucosa-associated lymphoid tissue lymphoma of the head and neck should be the first choice in early-stage disease. However, prolonged follow up is important to determine these patients' long-term response to treatment.

Simultaneous Phenotypically Distinct but Clonally Identical Mucosa-Associated Lymphoid Tissue and Follicular Lymphoma in a Patient With Sjögren’s Syndrome

Blood ◽  
1999 ◽  
Vol 94 (7) ◽  
pp. 2247-2251 ◽  
Author(s):  
Antonella Aiello ◽  
Ming-Qing Du ◽  
Tim C. Diss ◽  
Huai-Zheng Peng ◽  
Francesco Pezzella ◽  
...  
Keyword(s):  
Lymph Node ◽  
Parotid Gland ◽  
Follicular Lymphoma ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Molecular Genetic ◽  
Pcr Amplification ◽  
Pcr Analysis ◽  
Chain Gene ◽  
Low Grade

A 44-year-old woman with a 12-year history of Sjögren’s syndrome (SS) developed a low-grade mucosa-associated lymphoid tissue (MALT) lymphoma in the parotid gland. Two years later, she presented with generalized lymphadenopathy and hepatosplenomegaly and a follicular lymphoma was diagnosed. To investigate the relationship of the two histologically distinct lymphomas, we re-examined their histology and immunophenotype and studied the lymphomatous tissue from the parotid, cervical lymph node, and spleen using molecular genetic methods. Histologic and immunophenotypic studies confirmed the previous diagnoses and also identified a previously unnoticed focus of follicular lymphoma in the second parotid gland biopsy. Polymerase chain reaction (PCR) amplification of the rearranged Ig heavy-chain gene showed the same sized dominant product in the MALT lymphoma and the follicular lymphoma. Similarly, PCR analysis of the t(14:18) translocation yielded an identical sized band from both MALT and follicular lymphoma. Cloning and sequencing of the Ig PCR products showed an identical CDR3 sequence from each lesion, indicating a common clonal lineage. The follicular lymphoma of the parotid gland lymph node and the follicular lymphoma of the spleen showed an identical mutation signature to that of the salivary gland MALT lymphoma. We propose that follicular lymphoma in the parotid gland lymph node may have resulted from colonization of lymphoid follicles by MALT lymphoma cells, following which the tumor cells were induced to express a follicular lymphoma phenotype, due to Bcl-2 overexpression caused by t(14;18), leading to a change in clinical behavior resulting in rapid widespread dissemination of disease. These observations suggest that the distinct phenotypes of low-grade B-cell lymphomas may be the consequence of interplay between genetic and local microenvironmental factors.

scholarly journals Trisomy 3 in low-grade B-cell lymphomas of mucosa-associated lymphoid tissue

Blood ◽  
1995 ◽  
Vol 85 (8) ◽  
pp. 2000-2004 ◽  
Author(s):  
AC Wotherspoon ◽  
TM Finn ◽  
PG Isaacson
Keyword(s):  
B Cell ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Marginal Zone ◽  
B Cell Lymphoma ◽  
Low Grade ◽  
B Cell Lymphomas ◽  
Splenic Lymphoma ◽  
Trisomy 3 ◽  
Primary Splenic Lymphoma

Characteristic chromosomal aberrations have been associated with subtypes of non-Hodgkin's lymphoma with distinct clinicopathologic features. Low-grade B-cell lymphomas of mucosa-associated lymphoid tissue (MALT) form such a group and might be expected to be characterized by a specific cytogenetic abnormality. Metaphase analyses of MALT lymphoma are rare due to problems with fresh tissue collection and poor in vitro proliferation. However, the small number of published series suggests that chromosome trisomies, particularly trisomy 3, might be characteristic of these tumors. The application of interphase cytogenetic techniques to routinely processed material allows the examination of a large series of archival cases and is particularly useful for the demonstration of chromosome trisomies. We have used this technique to analyze 70 cases of low-grade MALT lymphoma from various sites and found trisomy 3 in 60%. This finding compares with 16% in low-grade nodal B-cell lymphoma and 27% in primary splenic lymphoma of marginal zone type (splenic lymphoma with villous lymphocytes). These results provide further evidence that low-grade MALT lymphomas from all sites form a single pathologic entity distinct from nodal B-cell lymphomas. Although MALT lymphoma and primary splenic lymphoma may arise from marginal zone B cells, they are genetically distinct.

scholarly journals Multiple Relapses of Parathyroid Carcinoma with Severe Systemic Complications - Case Report and Literature Review

2021 ◽  
Vol 28 (4) ◽  
pp. 441-446
Author(s):  
Andreea ILIESIU ◽  
◽  
Ana-Maria CIONGARIU ◽  
Bogdan SOCEA ◽  
Mihail-Constantin CEAUSU ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Parathyroid Carcinoma ◽  
Primary Tumour ◽  
Malignant Lesion ◽  
Immunohistochemical Analysis ◽  
Surgical Excision ◽  
Positive Staining ◽  
Ki 67 ◽  
Systemic Complications ◽  
Parathyroid Tumours

Parathyroid carcinoma is an exceptionally uncommon endocrine neoplasm, accounting for less than 1% of parathyroid tumours and also a rare cause of primary hyperparathyroidism. Although this malignant lesion is usually slowly progressive, it is frequently associated with local recurrences and also with metastases involving the local lymph nodes or distant sites. We present a 59-year-old male patient who developed a parathyroid carcinoma metastasis involving the anterior mediastinal lymph nodes and thymus remnants, 3 years after the primary tumour was identified and treated by surgical excision followed by chemo and radiotherapy. The patient presented with severe, symptomatic hyperparathyroidism and a gamma scan revealed increased uptake hyperfixation in the paratracheal lymph nodes. A lymphadenectomy was performed and the gross examination of the specimen showed a pinkish – white, firm, poorly circumscribed mass. The microscopic examination revealed an epithelial proliferation with a predominantly nodular/solid growth pattern, composed of cells exhibiting moderate nuclear pleomorphism, prominent nucleoli and high mitotic activity, involving two lymph nodes and thymus remnants. Upon immunohistochemical analysis, the proliferation showed positive staining for GATA 3, as well as a high Ki 67 index, whereas TTF 1 and thyroglobulin were negative in the tumour cells. Thus, the diagnosis of metastatic parathyroid carcinoma was established. The aim of this paper is to gain further knowledge about the histopathological and immunohistochemical features, as well as about the clinical behaviour of parathyroid malignant lesions, especially considering their rarity.

scholarly journals Endobronchial low-grade MALT lymphoma causing unilateral hypertranslucency

2004 ◽  
Vol 61 (4) ◽  
Author(s):  
A.E. Erbaycu ◽  
I. Karasu ◽  
F.G. Özdemirkıran ◽  
N. Yücel ◽  
A. Özsöz ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Left Lung ◽  
Fiberoptic Bronchoscopy ◽  
Low Grade ◽  
Left Main ◽  
Bronchoscopic Biopsy ◽  
One Year ◽  
The Right

Mucosa-associated lymphoid tissue-derived lymphoma (MALT lymphoma) arises not only from the stomach but also from various non-gastrointestinal sites. A thirty two year old woman, suffering from breathlessness for one year, had been treated for bronchial asthma. A chest radiograph showed a mediastinum and heart transposition to the right side and emphysema of the left lung. In the thorax spiral tomography, a mass narrowing left main bronchi, five centimeters in length from the carina, was seen. A fiberoptic bronchoscopy revealed millimetric polypoid lesions those nearly totally obstructed the left main bronchi. The bronchoscopic biopsy showed a diagnosis of MALT lymphoma. She was seen for check-ups following chemotherapy but no further treatment has been carried out.

Efficacy of single-agent chemotherapy in low-grade B-cell mucosa-associated lymphoid tissue lymphoma with prominent gastric expression.

1995 ◽  
Vol 13 (10) ◽  
pp. 2524-2529 ◽  
Author(s):  
P Hammel ◽  
C Haioun ◽  
M T Chaumette ◽  
P Gaulard ◽  
M Divine ◽  
...  
Keyword(s):  
B Cell ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Alkylating Agent ◽  
Bone Marrow Involvement ◽  
Single Agent ◽  
Stage Iv ◽  
Large Cell ◽  
Disease Stage ◽  
Low Grade

PURPOSE The treatment of low-grade B-cell mucosa-associated lymphoid tissue (MALT) lymphoma with prominent gastric expression is controversial. Total gastrectomy has been proposed, but is associated with significant morbidity. The aim of this monocentric study was to assess the efficacy of continuous oral chemotherapy with a single alkylating agent. PATIENTS AND METHODS Twenty-four consecutive patients, 13 men and 11 women, were studied. Their mean age was 51 years (range, 22 to 79). Low-grade B-cell MALT lymphoma was diagnosed by histologic and immunohistologic examination of endoscopic biopsies. Seventeen patients had stage I disease and seven stage IV disease, with lung and gastric involvement. Two of these seven patients also had bone marrow involvement. The alkylating agent (cyclophosphamide or chlorambucil) was administered orally and daily for periods of 12 to 24 months. RESULTS The median follow-up time was 45 months (range, 14 months to 14 years). Complete remission was obtained in 18 patients (75%) after a median treatment duration of 12 months. Five patients relapsed; two of them were successfully re-treated, and one died of MALT lymphoma that had transformed into large-cell lymphoma. Chemotherapy was stopped after 24 months for six patients who only achieved a partial remission; two of them required further treatment for progressive disease (surgery for a small-bowel localization in one case and cyclophosphamide rechallenge in the other). Nine patients had neutropenia that required a reduced chemotherapy dosage. CONCLUSION In low-grade MALT lymphoma with prominent gastric expression, continuous monochemotherapy may constitute an efficient alternative to gastrectomy, regardless of disease stage.

Nongastrointestinal Low-Grade Mucosa-Associated Lymphoid Tissue Lymphoma: Analysis of 75 Patients

1999 ◽  
Vol 17 (4) ◽  
pp. 1254-1254 ◽  
Author(s):  
Pier Luigi Zinzani ◽  
Massimo Magagnoli ◽  
Piero Galieni ◽  
Maurizio Martelli ◽  
Venerino Poletti ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Good Prognosis ◽  
Low Grade ◽  
Therapeutic Approaches ◽  
Lachrymal Gland ◽  
Treatment Failure Rate ◽  
Initial Location ◽  
Significant Efficacy

PURPOSE: Nongastrointestinal locations represent about 30% to 40% of all low-grade mucosa-associated lymphoid tissue (MALT) lymphomas. We report a retrospective analysis of 75 patients with nongastrointestinal low-grade MALT lymphoma, presenting their clinical, therapeutic, and follow-up data with respect to the initial location of the lymphoma. PATIENTS AND METHODS: From January 1988 to October 1997, 75 patients with untreated nongastrointestinal low-grade MALT lymphoma were subjected to treatments ranging from local radiotherapy and local interferon alfa administration to chemotherapy. The lymphomas were located in the lung (19 patients), orbital soft tissue (16 patients), skin (seven patients), thyroid (seven patients), lachrymal gland (six patients), conjunctiva (six patients), salivary gland (six patients), breast (three patients), eyelid (two patients), larynx (one patient), bone marrow (one patient), and trachea (one patient). RESULTS: Complete and partial remissions were achieved in 59 (79%) and 16 (21%) of the 75 patients, respectively, with an overall response rate of 100%. All but two of the patients are still alive, with a median follow-up of 47 months; these two patients died from other causes. The estimated time to treatment failure rate is 30% at 5 years. In the thyroid and lachrymal gland sites, no relapses were reported. CONCLUSION: Our data regarding the largest reported series of nongastrointestinal MALT lymphomas confirm the good prognosis of this particular clinicopathologic entity and the significant efficacy of different therapeutic approaches to specific sites.

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