scholarly journals Varied Presentations of Non-Hodgkin Lymphoma in Head and Neck Region

2020 ◽  
Vol 28 (1) ◽  
pp. 30-36
Author(s):  
Chiranjib Das ◽  
Pritam Chatterjee
Keyword(s):  
Head And Neck ◽  
Hodgkin Lymphoma ◽  
Nk Cell ◽  
Tertiary Care ◽  
Cervical Lymphadenopathy ◽  
Neck Region ◽  
Care Hospital ◽  
Head And Neck Region ◽  
Non Hodgkin Lymphoma ◽  
A Prospective Study

Introduction Majority of lymphomas involving the head and neck are Non-Hodgkin lymphoma (NHL). Most of them present as cervical lymphadenopathy. The objectives of this study are to present the problems encountered in the diagnosis of extra-nodal NHL in head and neck region and show the importance of thorough clinical examination and proper investigation. Materials and Methods A prospective study was done in the department of ENT in a tertiary care hospital of West Bengal from July 2015 to June 2018. Patients diagnosed as NHL on the basis of histopathology and immunohistochemistry were included in this study. Patients who were lost in follow up were excluded from the study. Patients were treated with chemotherapy and radiotherapy by Oncologist. All patients were followed up routinely both by Otorhinolaryngologist and Oncologist.     Results There were 26 male and 11 female patients in this study. Patients were between 22 years to 76 years of age with highest incidence in 6th decade of life. Patients presented with only cervical lymphadenopathy; asymmetrical tonsillar enlargement with cervical lymphadenopathy; unilateral tonsillar enlargement only; huge inta-oral mass with stridor; parotid gland swelling; thyroid swelling with multiple cervical lymphadenopathy; epistaxis, palatal ulcer and cheek swelling; severe trismus with inconspicuous retro-mandibular mass. Majority of patients did well with chemoradiotherapy. Two patients succumbed to death, one with huge intra-oral NHL and another with nasal T/NK-cell lymphoma.  Conclusion Good knowledge of the clinical characteristics of extra-nodal NHL and the methods to establish the diagnosis are essential for a correct and timely therapy of the disease.

Disease Spectrum of Cervical Lymphadenopathy in adults

2021 ◽  
Vol 15 (11) ◽  
pp. 2853-2855
Author(s):  
Rabia Amin Butt ◽  
Zonaira Rathore ◽  
Afia Sarwar ◽  
Faiza Azam ◽  
Faria Waqar Khan ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Tertiary Care ◽  
Cervical Lymphadenopathy ◽  
Diagnostic Tools ◽  
Tuberculous Lymphadenitis ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Non Hodgkin Lymphoma ◽  
Malignant Lesions ◽  
Age Range

Aim: To determine the frequency of different diseases resulting in cervical lymphadenopathy in specimens of patients presenting in tertiary care hospital. Methodology: It was a cross sectional study conducted at the histopathology section of the pathology department of Services Institute of Medical Sciences/Services Hospital Lahore. The study was approved by the ethical committee of the institution. The study was completed in six months.100 cases fulfilling the inclusion criteria were registered. Inclusion criteria included patients above 16 years of age, patients from both sexes, unilateral or bilateral irrespective of duration. Lymph nodes less than 1cm were not included in the study. Informed consent was taken. Both FNAC and Biopsy were used as diagnostic tools. All the data was analysed with SPSS version 11. Results: During a period of six months, a total of 100 cases of cervical lymphadenopathy were studied. These included 75 benign and 25 malignant cases. Out of benign cases 53% were diagnosed as tuberculous lymphadenitis. About 81.3% were in the age range of 16-25 years and 18.7% were in the age range of 26-35 years. 22% cases were diagnosed as reactive lymphadenitis. About 54.54% of these patients were in the age range of 16-25 years and 45.46% were in the age range of 26-35 years. The highest frequency among malignant lesions consisted of Non-Hodgkin lymphoma 16% followed by Hodgkin lymphoma 5% and metastatic disease 4%.The age range of malignant lesions was in the range of 36-78 years. Conclusion: Our study concludes that cervical lymphadenopathy is the common clinical presentation in our setup and tuberculosis is the commonest cause. Keywords: Hodgkin lymphoma, Non-Hodgkin lymphoma, Fine needle aspiration cytology

scholarly journals A study of FNAC of head and neck region at a tertiary level hospital

2021 ◽  
Vol 6 (2) ◽  
pp. 91-96
Author(s):  
Jyoti P Sapre ◽  
Kirti N Vyas ◽  
Alpeshkumar M Maru
Keyword(s):  
Salivary Gland ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
Neck Region ◽  
Care Hospital ◽  
Head And Neck Region

Swellings in the Head and Neck region are very common and are evaluated with the help of a detailed clinical history, physical examination and investigations like FNAC, USG, CT scan or excisional biopsy. Fine Needle Aspiration Cytology (FNAC) is a simple, quick, inexpensive and minimally invasive OPD procedure used in the diagnosis of different swellings of Lymph nodes, thyroid, salivary gland and soft tissues in the Head and Neck region.We did this study with the purpose of identifying the frequency and distribution of different pathologies found in FNAC done in patients presenting with a swelling in the Head and Neck region as per the site, age, sex and type of the lesion.A retrospective study was conducted on the patients presenting with swelling in the Head and Neck region at the Pathology department of a tertiary care hospital between the duration of 1 August 2019 to 30 April 2021. FNAC was performed on total 260 patients.Out of 260 cases, 157 cases (60.4%) were from Lymph nodes, 50 cases (19.2%) from thyroid gland, 27 cases (10.3%) from skin and subcutaneous tissue, 23 cases (8.84%) from salivary gland and 3 cases (1.1%) were inconclusive due to inadequate material aspiration. 149 cases (57.98%) were inflammatory, 70 cases (27.24%) benign and 38 cases (14.78%) were found to be malignant.FNAC is a simple, quick, inexpensive, minimally invasive OPD procedure and used as first line of investigation in the diagnosis of swellings in the Head and Neck region.

scholarly journals The role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region

2019 ◽  
Vol 10 (1) ◽  
pp. 48-53
Author(s):  
Mohammad Sowkat Hossain ◽  
S M Mahbubul Alam ◽  
Sk Md Jaynul Islam ◽  
Wasim Selimul Haque ◽  
Shamoli Yasmin
Keyword(s):  
Head And Neck ◽  
Soft Tissues ◽  
Histopathological Examination ◽  
Malignant Neoplasm ◽  
Cervical Lymphadenopathy ◽  
Neck Region ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Head And Neck Region

Background: Undifferentiated tumours in the head and neck region are not uncommon. They can arise from different sites like in mucosa as well as in salivary glands, soft tissues or lymph nodes. Histopathological examination plays a central role in the diagnosis but difficulties arise with some tumours which are poorlydifferentiated due to their high inter- and intra-observer variability. In those cases, immunohistochemistry has greatly assisted to diagnose the tumours that cannot be accurately identified using routine histopathological procedures. The correct histopathological diagnosis is essential especially in case of malignant tumourwhere subsequent specific therapy is required. The aim of this study was to determine the role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region. Methods: This cross-sectional study was conducted during July 2014 to June 2015. A total of 35 Bangladeshi patient’s specimens of head and neck swelling were collected from two renowned laboratories in Dhaka city.These cases were diagnosed as undifferentiated tumour in histopathological examination.Standard protocol was followed for immunohistochemistry.Then primary immunohistochemical panel which included the markers for Epithelial CK (AE1/AE3),mesenchymal marker (Vimentin) and lymphoid marker (LCA) were used.The cases which were not resolved by primary immunohistochemistry panel, the second panel was applied for further sub classification (Desmin, Chromogranin, CK20, CEA, CD20, CD30, HMB45, NSE). Based on interpretation of immunohistochemical findings final diagnoses were made.Data analysis was performed using the Statistical Package for the Social Sciences for Windows version 22.0 (SPSS, Chicago, Illinois, USA). Results: A total of 35 undifferentiated tumorsof head-neck region were studied.The mean age was 46.3±17.6 years and male to female ratio was 4.8:1. The majority 13 (37.1%) patient had cervical lymphadenopathy, 11 (31.4%) had neck mass and 4(11.4%) had in nasal/sinonasal mass.Regarding histopathologicalcell types, round cell was 21 (60.0%), spindle cell 6 (17.1%), pleomorphic cells 6(17.1%) and epithelioid cells 2(5.7%). In initial histopathological examination, majority 25(71.4%) were undifferentiated malignant neoplasm, 8(22.8%) were metastatic undifferentiated carcinoma, 1(2.9%) was pleomorphic sarcoma and the remaining 1(2.9%) had malignant adnexal tumour. By application of immunohistochemistry, most (33, 94.3%) of the cases were resolved and the two cases remained unresolved. Among the resolved cases majority (15, 45.5%) were lymphoma, 4(12.1%) were metastatic carcinoma, 3(9.1%) were Ewing’s sarcoma and malignant melanoma were found in 3(9.1%) cases. Conclusion: This study supports that the immunohistochemical technique has a fundamental role in the investigation of undifferentiated tumour origin, to determine the correct guidance for treatment and improving the prognosis for head and neck tumour patients. Birdem Med J 2020; 10(1): 48-53

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