ABSTRACT
PURPOSE: This study was performed to evaluate survival, failure patterns, and prognositc factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. MATERIALS AND METHODS: A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy form June 1985 to November 1992. There were 19 male and 4 female patients. The patients' age ranged from 17 to 71 years(median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in 30% of the patients. He nasal cavity was most frequently involved. No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total 45~54 Gy(median 50.4 Gy) using 6 MV X-ray. No patients received chemotherapy as initial treatment. RESULTS: Overall 5-year and 10-yar survival rates were 52.4% and 44.1%, respectively. Seventy percent(12/17) of the patients achieved complete response to radiotherapy., and 29.4%(5/17) achieved partial response. The patients with complete response showed a better 5-year survival rate than those with partial response (66.9% vs. 20%, p-0.004). Symptom duration before diagnosis, the presence of systemic symptom, ad the number of primary sites had no influence on survival. The patterns of failure were as flows: local failure(1), failure in adjacent site(1), local and distant failure(1), distant metastasis(2), and conversion to malignant lymphoma(1). W could not find factors associated with the patterns of failure. CONCLUSION: The most important factor associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However, about 50% of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.
Subject(s)
Female , Humans , Male , Diagnosis , Drug Therapy , Fever , Nasal Cavity , Neoplasm Metastasis , Radiotherapy , Retrospective Studies , Survival Rate , Weight LossABSTRACT
Malignant lymphomas of the upper respiratory tract are relatively common in the Orient including Korea. They have a marked clinicopathologic and immunophenotypic diversity. We retrospectively reviewed 20 cases of malignant lymphomas with features of polymorphic reticulosis in the upper respiratory tract. Histopathologic findings consisted of polymorphism of lymphoid cells in 17 cases(85%), angiocentricity in 14 cases(70%), coagulation necrosis in 12 cases(60%), and epitheliotropism in 8 cases(40%). By Working Formulation, 14 cases(70%) were classified as diffuse large cell type, 4 cases(20%) as diffuse mixed small cleaved and large cell type, one case as immunoblastic type, and one case as anaplastic large cell type. On immunostaining, one showed B-cell phenotype and 19 cases showed T-cell phenotype. The B-cell type was histologically diffuse large cell type. From these results, we concluded that polymorphic reticulosis is a type of peripheral T-cell lymphoma with angiocentricity.
ABSTRACT
Midline malignant reticulosis is a relentlessly progressive, localized, destructive inflammatory process of upper respiratory tract including the nose, nasopharynx, palate, paranasal sinuses, and midface. Histologically, it is characterized by a dense aceumulation of pleomorphic mononuclear cells with an admixture of inflammatory cells. We report a case of midline malignant reticulosis developed in a 64-year-old man, who showed a serosanguineous nasal discharge, perforation of nasal septum, persistent ulceration of hard palate, and disseminated lesions on the abdominal skin, which was confirmed by histopathalogical examination. In addition we studied infiltrated cells with atypical nuclei by immunohistochemical staining with a pannel of monoclonal antibodies. The results revealed that the atypical cells expressed the T-cell marker, but not the macrophage and B-cell marker.