762Cases Of Head And Neck Malignant Lymphoma Maxillofacial Clinicopathological Analysis

ObjectiveThe head and neck malignant lymphoma is the third most common cancer after squamouscell carcinoma and salivary gland tumors [2], which have shown an upward trend in the incidenceof developed countries and China. Owing to clinical manifestations of the head and neckmaxillofacial lymphoma is very diverse, pathological type is more complex, so the cause ofclinical misdiagnosis rate is relatively high. Therefore, to understand and master the clinicalfeatures and prognosis of head and neck maxillofacial lymphoma, which improve the diagnosisand treatment of individual patients play a crucial role. The study collected762cases in MilitaryHospital of Henan Province Department of Pathology from January2006to December2012,which had diagnosed of malignant lymphoma by immunohistochemical, sorting the clinicaland pathological data, then analyze the gender, age, first clinical manifestation,disease location,histological type and immunohistochemical examination and prognosis of the situation, in order tofurther explore on the incidence and prognosis of lymphoma at Henan, Providing certain clinicalbasis for the prevention,early diagnosis,effective treatment,prognosis of head and neckmaxillofacial malignant lymphoma in the region.MethodsCollecting762cases in Military Hospital of Henan Province Department of Pathology fromJanuary2006to December2012,which had consultation by patholopy expert of consultationcenter Henan Anti-cancer Association and diagnosed of malignant lymphoma starting at the headand neck maxillofacial by histopathological and immunohistochemical.All patients met theinclusion criteria underwent surgical excision biopsy,as an index to final pathology results,allwere diagnosed as the head and neck maxillofacial malignant lymphoma. Statistics762cases ofmalignant lymphoma in general, the starting position, pathological type and prognosis.Comparing the cases by category, and investigating the relationship between the factors. UsingSPSS17.0statistical software for statistical analysis, Kaplan-Meier method and Log rank test wasused for statistical tests, all results P <0.05was considered statistically significant. Results1．General information analysis:①age from3to85years old, the average age is47years.Age of onset of malignant lymphoma from31years old to start an upward trend, from61to70years old reached a peak stage. Diseased parts up to the neck (45.7%), others werenasopharynx(20.2%), tonsil parts(10.24%), mandible (4.2%), palate (8.92%), parotid gland(1.6%), gum (1.6%), cheek (1.3%), maxillary sinus (2.36%), ear area (1.2%), larynx(0.8%), eyes (1.05%), tongue (0.3%), as well as other issues such as the scalp, foreheadtumor(0.7%). The patients of male to female ratio was1.53:1, in addition to the scalp,forehead tumor, the incidence of other parts at male patients were more than female.②Hodgkin’s lymphoma occurred in the head and neck maxillofacial malignant lymphoma was15.35%; and non-Hodgkin ’s lymphoma was84.65%;extranodal non-Hodgkin’s lymphomapatients occurred in the head and neck maxillofacial malignant lymphoma was57.87%,the goodsite were nasopharynx (46.81%), tonsils (17.69%), palate (15.42%), salivary glands(11.36%), mandible, the bottom of the mouth, sinus, gums, cheeks, but eyes and scalp was less.③The good site of painless mass were the neck and nasopharynx, the performance of the primarysite was ulcer with necrotic,a more common to palate and tonsils; Diffuse inflammatoryinfiltration in the nasopharynx and palate was more common, primary tissue edema erythema wascommon in cheek.2．Clinical stage and pathological type: clinical Ⅰ and Ⅱwas more, accounted for65.89%,Ⅲ and Ⅳaccounted for34.11%. Hodgkin’s lymphoma occurred in the head and neckmaxillofacial malignant lymphoma was15.35%; and non-Hodgkin ’s lymphoma was84.65%.In645cases of non-Hodgkin’s lymphoma, malignant lymphoma from B cell was common (478cases), accounted for74.11%, common types were diffuse large B-cell lymphoma (DLBCL),Burkitt’s lymphoma, follicular lymphoma, mucosa-associated lymphoid tissue extranodalmarginal zone lymphoma (MALT), mantle cell lymphoma, small lymphocytic lymphoma samples,the cell lymphoma and lymphoid plasma cell tumors; malignant lymphoid from T cell had167cases in non-Hodgkin’s lymphoma, accounted for25.89%, the most common is extranodal NK/T-cell lymphoma, followed by precursor T lymphoblastoid cell tumor, anaplastic large celllymphoma, peripheral T-cell lymphoid tumors (PTCL), angioimmunoblastic T-cell lymphoma andsubcutaneous panniculitis-like T-cell lymphoma.3．Prognostic analysis:Clinical data shows the patient’s age, clinical stage, histological typeand whether chemotherapy and radiotherapy had great impact on head and neck malignant lymphoma prognosis maxillofacial. B-cell lymphoma prognosis was better than T cell lymphoma;60years as the critical point,<60years of patients had good prognosis; Ⅰ and Ⅱof lymphomaprognosis was better than Ⅲ and ⅳof lymphoma; patients`prognosis with radiotherapy andchemotherapy was better than those without radiotherapy or chemotherapy.Conclusions1．Age from3to85years old, the average age is47years. Age of onset of malignantlymphoma from31years old to start an upward trend, from61to70years old reached a peakstage.The patients of male to female ratio was1.53:1. Diseased parts up to the neck.2．Clinical Ⅰ and Ⅱ was more; B cell type more common than T-cell in Non-Hodgkin’slymphoma. B cell origin of malignant lymphoma is the most common type of diffuse large B-celllymphoma (DLBCL), T cell-derived malignant lymphoma is the most common extranodal NK/T-cell lymphoma.3．NHL1-year survival rate is high, but is low of5-year survival; age, disease stage,pathological type is risk factors of NHL prognostic; The higher the age,the worse the prognosis ofNHL patients;early prognosis was significantly better in patients with late stage; B-celllymphoma cells compared with T prognosis is better; chemotherapy is protective factors ofprognostic NHL， that means patients prognosis who receiving chemotherapy is better than notchemotherapy.Due to the number of cases is small,clinical follow-up time is short and medical records islimitied,the complete data is missing more in this study,herefore,,the factors of neck andmaxillofacial malignant lymphoma prognosis also need to be further research,for example,expanding the number of cases,prolonging follow-up time.