Malignant non-Hodgkin lymphomas of the lymphoid ring, paranasal sinuses and salivary glands

Reevaluation and classification according to Rappaport were performed on the histological sections from 63 of 78 adult patients having been treated for malignant non-Hodgkin lymphomas (NHL) within the otolaryngological region, between 1951 and 1976. Of the extranodal lymphomas, 84% were localized in the lymphoid ring, two thirds of them in the tonsil. The site of the tumor did not influence survival rates, and regional predominance of a certain histological type did not appear. 61/63 cases had a diffuse cellular pattern. Diffuse lymphocytic poorly differentiated, and diffuse histiocytic types were histologically preponderant, each species comprising nearly a third of the cases. Within the diffuse cellular pattern, no differences with regard to the rate of recurrences or of survival as a function of the histological type could be found. In accordance with the Ann-Arbor staging, 49/63 patients were ranged in the stages I E or II E. Only 13/49 cases, however, were staged in the manner now approved. In stage I E, of 12 patients without staging obtained 5-year survival free from recurrences, and also of the 6 patients with an actual staging. Radiation therapy prior to thorough staging has to be refused for clinical-stage II E patients, with the exception of a critical situation, since the disease has spread about already in a high percentage; primary radiation therapy is not indicated. Of all the 23 patients with stage II E, only 2 had 4-year survival without recurrences following sole radiation therapy, but of the clearly diagnosed patients, 60% obtained 4-year survival without recurrences. In 18% of the cases, recurrences in previously irradiated areas occurred during the total course of the disease. In 10% of the patients was affected the otolaryngological region and the gastrointestinal tract. (orig./MG)