[Clinical features of 89 patients with primary non-Hodgkin's lymphoma of the tonsil].

BACKGROUND & OBJECTIVE: Head and neck lymphoma develops predominantly in the tonsil. This study was to investigate the clinical features of primary non-Hodgkin's lymphoma (NHL) of the tonsil, and to explore possible ways to improve the prognosis and quality of life of the patients after treatment. METHODS: Clinical data of 89 naive patients with NHL of the tonsil, treated from May 1990 to Jan. 2003, were retrospectively reviewed. All patients were confirmed pathologically and classified according to revised European-American Lymphoid Neoplasms and World Health Organization Classification, and staged according to the Ann Arbor classification. Stage I-II patients received radiochemotherapy-predominant treatment, whereas stage III-IV patients received chemotherapy-predominant treatment. RESULTS: Of the 89 cases, 60 (67%) were diffuse large B-cell subtype, 11 (12%) were peripheral T-cell subtype, 5 (6%) were indolent lymphoma, 1 was anaplastic large T-cell lymphoma, and 1 was T lymphoblastic lymphoma; 81 (91%) were stage I-II disease. Of the 89 patients, 58 (72%) received radiochemotherapy, 19 (21%) received radiotherapy alone, 3 received chemotherapy alone, and 1 received radiochemotherapy combined with rituximab. The 5-year overall survival rate was 80%, that of stage I-II patients was 84%. Cox regression multivariate analysis showed that the survival rate was correlated to the value of international prognostic index (IPI), and whether the patient had primary refractory or relapsed disease, but was not correlated to sex, age, pathologic subtype, B symptoms, and bulky disease. CONCLUSIONS: Most patients with NHL of the tonsil are at early stages, with good prognosis. Diffuse large B-cell lymphoma is the most common pathologic subtype. Primary refractory, relapse, and IPI>1 are independent prognostic factors.

[Clinical analysis of 68 patients with primary gastric lymphoma].

BACKGROUND & OBJECTIVES: Stomach is the most common extranodal involvement site of lymphoma. Treatment patterns for primary gastric lymphoma (PGL) are controversial now. This study was to investigate clinical features, treatment patterns, and prognostic factors of patients with PGL. METHODS: Records of 68 patients with PGL, including 37(54.4%) men,and 31(45.6%) women with a median age of 50(25-82) years,were retrospectively analyzed. Thirty-seven patients received surgery plus chemotherapy,7 received surgery plus chemoradiotherapy,9 received surgery plus radiotherapy,9 received surgery plus chemotherapy, 4 received surgery alone,and 2 were untreated. Survival rate was calculated by Kaplan-Meier method,prognosis factors were analyzed by univariate analysis, and Cox model multivariate analysis. RESULTS: Common symptoms of PGL were abdominal pain, and weight loss. Common lesions of PGL were in gastric body, and gastric antrum. All 68 patients with PGL were diagnosed of non-Hodgkin's lymphoma (NHL) by pathology, which constituted about 3.4% of all gastric malignancies synchronously, 1 was T cell original, 67 were B cell original. Diagnosis rate of gastroscopy biopsy was 53.2%, that of X-ray barium meal was 40.9%. The overall 1-, 3-, and 5-year survival rates were 90.5%, 78.2%, and 75.7%, respectively. Univariate analysis showed that clinical stage (Ann Arbor), international prognostic index (IPI), and surgery were significant prognostic factors for PGL patients. Cox model multivariate analysis indicated that only surgery was independent prognostic factor for PGL patients. CONCLUSIONS: Treatment of PGL should be based on combined therapy of surgery, chemotherapy, and radiotherapy. Surgery may be an independent prognostic factor for PGL patients.

[Primary central nervous system lymphoma: a report of 28 patients].

OBJECTIVE: To evaluate the clinical characteristics, reasonable mode of treatment and prognostic factors in patients with primary central nervous system lymphoma (PCNSL). METHODS: Twenty-eight patients with PCNSL treated from 1989 to 2002 were retrospectively reviewed. The clinical characteristics, results of treatment and prognostic factors were analyzed by SPSS10.0 statistic software. RESULTS: Of 28 patients, 18 men and 10 women with a median age of 52 years. The median survival time was 2 years (range 6 months-6 years). The 5-year survival rate was 21.4%. Nineteen patients had single-locus lesion and 9 multi-locus lesion, 78.6% of the patients were diagnosed as having B-cell origin, its main type being diffuse large cell lymphoma. According to international working formulation (WF), moderate-grade of histopathology was observed in 57.7% (15/28). Cox regression analysis revealed that single- or multi-locus lesion was only independent prognostic factor (P = 0.0417). Combined chemotherapy showed significant efficacy for those patients who had lesion of B-cell origin, high grade or multi-locus lesion, and the efficacy of irregular chemotherapy was better than that of regular chemotherapy. CONCLUSION: Primary central nervous system lymphoma has a special prognostic factor. Chemotherapy plays a very important role in comprehensive treatment, irregular chemotherapy should be adopted as a regular treatment.

[Primary non-Hodgkin lymphoma in the female genital system: a report of 28 cases].

OBJECTIVE: To evaluate the clinical characteristics, results of treatment, and prognostic factors of patients diagnosed as having primary female genital system lymphoma (PFGSL). METHODS: Twenty-eight cases of PFGSL were retrospectively surveyed and the clinical data of the patients were analyzed by statistic software package of SPSS10.0 for relation between clinical stage, grade, pathologic feature, treatment and prognosis. RESULTS: The median age was 44 in the cohort. It mainly involved cervix uterus, ovary and vulva. The disease had a broad range of pathologic type and 20 patients were diagnosed as suffering from B-cell by immunophenotyping, 4 patients were diagnosed as T-cell and 4 patients lesions were indefinite. According to International Working Formulation (IWF), 66.7% belonged to the intermediate-grade. The Ann Arbor stage included: Stage I(E)-12 pts (42.86%), Stage II(E)-3 pts (10.7%), Stage III(E)-1 pts (3.6%) and Stage IV-12 pts (42.86%). According to International Prognostic Index (IPI), 10 were low risk, 9 low-medium risk, 3 medium-high risk and 6 high risk, The median follow-up of the surviving patients was 2.0 years (range: 3 months-17 years), The 5-year overall survival rate was 39.3%. Most patients were given comprehensive treatment without any mode showing significant advantage over the others in survival (P = 0.2554), The involved organs, Ann Arbor stage, IWF and also IPI were significant prognostic factors for survival, CONCLUSION: The management of PFGSL should be based on comprehensive treatment including chemotherapy as the chief means. The significant prognostic factors of survival is Ann Arbor stage, IPI, IWF and the kind of involved organs.