Clinical Study of Lymphoma Detected In the Head and Neck Region: A Retrospective Cohort Study

Kuribayashi N, Onda Y, Komiyama Y, Kawamata H and Uchida D

Published on: 2023-10-21

Abstract

Lymphoma occurred in the head and neck regions often pose a significant diagnostic dilemma. Thus, we retrospectively investigated the clinical characteristics of 21 cases of lymphoma diagnosed in our department, detected in the head and neck regions. The mean age of the patients were 61.8 ± 16.1 years. Twelve and 9 cases were oral lesions (extranodal lymphoma; EL) and neck lesions (nodal lymphoma; NL), respectively. The most common site was gingiva in EL and submandibular lymph node in NL. Although half cases in EL were initially diagnosed as oral cancer, mean time to confirmed diagnosis was 34.7 days. In contrast, 5 cases out of 9 in NL were initially diagnosed as lymphoma only by the clinical symptoms. The combination with several imaging examinations were useful for diagnosing NL; however, 2 cases complicated with another neck disease were hard to being diagnosed as NL because of the delayed-excisional biopsy, resulted in the prolonged mean time to confirmed diagnosis at 66 days. The most common histopathological finding was diffuse large B-cell lymphoma in EL and follicular lymphoma in NL. In tumor marker analysis, serum thymidine kinase (TK) showed positive results in 18 of the 19 measurable cases. Moreover, the cases having a TK value of over 40 U/mL had a significantly poorer prognosis. The results of the current study suggested that imaging examinations (including different modalities) combined with blood tests, including TK, early biopsy without hesitation for NL, and collection of a large biopsy specimen without crushing are important for diagnosing head and neck lymphoma.