Extranodal malignant lymphoma of the upperaerodigestive tract in King Chulalongkorn Memorial Hospital according to WHO classification.

BACKGROUND

The Working Formulation commonly used to classify NHL in Thailand has been recognized as imperfect for primary extranodal lymphoma, especially in head and neck regions.

OBJECTIVE

To study the clinicopathological and immunohistochemical features of extranodal malignant lymphoma of the upper aerodigestive tract according to WHO classification.

SETTING

King Chulalongkorn Memorial Hospital.

DESIGN

Descriptive study.

PATIENTS: 77 Thai patients who presented between 1998 and 2003.

METHODS

Routine histology was performed and stained with H&E and immunohistochemistry, and clinical characteristics were recorded.

RESULTS

The patients included 42 males and 35 females, with an average age of 53.87 years. Tumor sites were as follows: Waldeyer ring (n = 42, 54.55%), sinonasal areas (n = 19, 24.67%), oral cavity (n = 9, 11.69%), hypopharynx (n = 4, 5.19%), and larynx (n = 3, 3.90%). Immunohistochemically, 57 tumors (74.02%) were of B-cell phenotype and 19 tumors (24.68%) were of T-cell phenotype. According to the WHO classification, 45 cases (58.43%) were large B-cell, 3 (3.90%) were Burkitt, 3 (3.90%) were marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT), 4 (5.19%) were follicular lymphoma, 1 (1.30%) was precursor B-lymphoblastic lymphoma, and 1 (1.30%) were mantle cell lymphoma. Among the T-cell lymphomas, 9 (11.69%) were of peripheral T-cell lymphoma, unspecified, 9 (11.69%) were extranodal NK/T cell lymphoma, nasal type, and 1 (1.30%) were anaplastic large-cell lymphomas. In nasal cavity, 8 tumors (42.11%) were extranodal NK/T-cell lymphoma, nasal type, 5 (26.32%) were diffuse large B-cell lymphoma, 4 (21.05%) were peripheral T-cell lymphoma, unclassified, and 1 (5.26%) was Burkitt lymphoma.

CONCLUSION

Our data correspond with series from Japan, Hong Kong, and Korea, but there is a significant difference from Western population in T-cell lymphomas of sinonasal area especially extranodal NK/T cell lymphoma of nasal type and peripheral T-cell lymphoma, unspecified which had a higher frequency in Thailand, Japan, Hong Kong, and Korea.