• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.4889-4895
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• 2012

Background and Aim: The incidence of extra nodal non Hodgkin lymphoma (ENL) is rising throughout the world. However, data regarding ENL as a group is limited. The aim was to study the epidemiological and histomorphological trends of primary ENL (pENL) in India. Material and Methods: The biopsy materials from sixty eight patients with pENL (45 male, 23 female, M:F= 1.9:1), diagnosed over a five year period (2005-2009), were analysed and pathologically reclassified according to the World Health Organization (WHO) classification, 2008 criteria. Results: Primary extra nodal non Hodgkin lymphomas constituted 22.0% (68/308) of all non Hodgkin lymphomas (NHL). The mean age at presentation for pENL and primary nodal NHL was 43 years and 58 years, respectively with a male predilection (M: F=2:1). Central nervous system (CNS) constituted the most common extranodal site (20/68, 29.5%) followed by gastrointestinal tract (17/68, 25%), and nose/nasopharynx (8/68, 11.8%). Diffuse large B-cell lymphoma (DLBCL, not otherwise specified), extranodal marginal lymphoma of mucosa associated lymphoid tissue (MALT) type, and B cell NHL unclassified (U) were the three most common histological types observed. T-cell phenotype was rarely noted (4%). Follicular lymphomas and anaplastic large cell lymphoma, seen among nodal NHL, were absent at extra nodal sites. Majority (41/68, 60%) of the patients with pENL were immunocompetent and 55% were in stage I-II with favorable prognosis. Conclusion: Central nervous system was the most common site of ENL, followed by gastrointestinal tract. Majority of pENL occurred in immunocompetent hosts with a favorable prognosis.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7207-7211
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• 2014

Background: The aim of this study was to assess the epidemiological and clinicopathological characteristics of primary extranodal non-Hodgkin's lymphoma (pENL) patients, focusing on treatment and survival outcome. Materials and Methods: Between October 2003 and March 2012, 802 patients with non-Hodgkin's lymphoma (NHL) were diagnosed and treated in two different cancer centers of Southern Turkey. Results: pENL, constituted 12.4% (100/802) of all NHL studied during this period. Median age of the patients was 56 years (range 17-87 years) and the male: female distribution was 3:2. Eighty-five of 100 patients (85%) were in stage I/II, 9/100 (9%) in stage III, whereas 6/100 (6%) were in stage IV. Head and neck constituted the most common site (51/100, 51%), followed by gastrointestinal tract (GIL) (37/100, 37%), and cerebrum (CL) (5/100, 5%). Diffuse large B cell lymphoma (DLBCL) was the most common histological type, observed in 53% of patients, followed by marginal zone extranodal lymphoma (13%). Most of patients (76%) received a CHOP containing regimen. Complete remission (CR) were achieved in 71% of patients. The median follow-up duration of all patients was reported as 37.6 months (range, 0.8-165 months). This period was reported as 137.5 months (range, 117.5-1578.6 months) in gastrointestinal lymphoma (GIL) patients, 119.0 months (range, 91.8-146.1 months) in head and neck lymphoma (HNL) patients, and 18.4 months (range, 12.6-24.1 months) in cerebral lymphoma (CL) patients. Conclusions: Head and neck, and the gastrointestinal tract were the two most common extranodal sites observed. Histologically DLBC accounted for the majority of cases. Most patients were on earlier stages, had low-low intermediate IPI scores and had a favorable prognosis.

• 대한두경부종양학회지
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• 제40권1호
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• pp.23-26
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• 2024

Mucosa-associated lymphoid tissue (MALT) lymphomas comprise 7.6% of non-Hodgkin's lymphomas (NHLs) and they are recently recognized B-cell subset of NHLs. They are originated from gastrointestinal tract most frequently but may also occur in other organs including head and neck, lung, skin, thyroid and breast. Primary thyroid lymphomas (PTLs) constitute up to 5% of all thyroid malignancies. Diffuse large B-cell lymphoma is most common type of PTLs and MALT lymphoma is relatively rare subtype of PTLs. Thyroid MALToma arises in chronic inflammatory conditions with autoimmune or infectious etiologies. The optimal treatment regimen still remains controversial. However, It is reported that localized thyroid MALT lymphoma has excellent survival rate after surgical resection alone. We report a case of 48-years-old woman with primary thyroid MALToma.

• Radiation Oncology Journal
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• 제2권1호
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• pp.93-100
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• 1984

Among 238 patients with Non-Hodgkin's lymphoma received radiotherapy at Yonsei Cancer center, Yonsei University Medical College, from 1970 to 1981, 30 patients presented with localized(Stage I&II ) gastrointestinal lymphomas. Retrospective analysis of these 30 cases in an attempt to evaluate the influence of various prognostic factors and the effectiveness of therapy is presented. Overall 5 year survival rate of 30 cases of primary gastrointestinal lymphoma was $48\%$. Bulk of residual disease after initial surgery and stage were significant prognostic factors. Stage I with small residual disease treated with post-op irradiation achieved $100\%$ 5 year survival rate. So above group is considered curable with surgery and post-op irradiation. $80\%$ of Stage II with large residual disease were died with intra-abdominal local tumor control failure. Stage II with small residual disease showed $31.5\%$ 5 year survival rate. Non of them died with local failure. So, we suggest that complete surgical resection of tumor mass should be attempted initially in the management of localized gastrointestinal lypmhomas and systemic chemotherapy is needed in addition to post-op irradiation in the cases of Stage II and large residual disease after initial surgery.

• Journal of Gastric Cancer
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• 제1권4호
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• pp.215-220
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• 2001

Purpose: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. Materials and Methods: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. Results: The lower one-third of the stomach was the most frequent site ($42\%$), and the most frequent chief complaint was epigastric pain ($54\%$). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases ($82\%$), a carcinoma in 15 cases ($13\%$), an ulcer in 4 cases ($4\%$), and a gastrointestinal stromal tumor in 1 case ($1\%$). The stage distributions by Musshoff's criteria were 71 cases ($54\%$) of stage IE, 36 cases ($27\%$) of stage $II_{1}E$, 8 cases ($6\%$) of stage $II_{2}E$, 2 cases ($2\%$) of stage IIIE, and 15 cases ($11\%$) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases ($23\%$) of low grade, 96 cases ($73\%$) of intermediate grade, and 5 cases ($4\%$) of high grade. Chemotherapy-related complications occurred in 25 cases ($22\%$) while operation-related complications occurred in 6 cases ($5\%$). Seventeen patients ($13\%$) only underwent surgery, 19 ($14\%$) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients ($73\%$) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was $85\%$ in stage I or II and $47\%$ in stage III or IV (P=0.0000). Conclusion: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.

• Radiation Oncology Journal
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• 제11권1호
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• pp.159-166
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• 1993

A retrospective analysis was done for 69 patients with Stage I and II non-Hodgkin's lymphoma who were treated from May 1981 to December 1990, in the Department of Radiadtion Oncology, Korea University Hospital. We used Ann Arbor Staging system and Working Formulation for histological classification. Forty-three patients (43/69, $62.3{\%}$) were Stage I and 26 patients (26/69, $37.7{\%}$) were Stage II, and B symptom was found in $10.1{\%}$ (7/69). Nodal lymphoma was $21.7{\%}$ (15/69); 14 patients with supradiaphragmatic disease and 1 patient with infradiaphragmatic disease. Extranodal lymphoma was $78.3{\%}$ (54/69): $64.8{\%}$ (35/54) for head and neck, $25.9{\%}$ (14/54) for gastrointestinal tract. Histologically, low grade consists of $8.7{\%}$ (6/69), intermediate grade $84.2{\%}$ (56/69), high grade $10.1{\%}$ (7/69), and diffuse large cell type was the most frequent form with 36 patients (36/69, $52.2{\%}$). Eighteen patients ($26.1{\%}$) were treated with radiation therapy alone,20 patients ($29.0{\%}$) with radiation therapy combined with chemotherapy, 15 patients ($21.7{\%}$) with radiation therapy combined with surgery and chemotherapy, Median survival duration was 28 months, and the range of survival time was from 1 month to 134 months. Overall five-year survival rate for Stage I and II disease was $54.2{\%}$, with $64.5{\%}$ for Stage I and $37.1{\%}$ for Stage II. For nodal lymphoma,5-year survival rate was $45.9{\%}$, and $56.5{\%}$ for extranodal lymphoma; $60.6{\%}$ for head and neck, $52.9{\%}$ for GI tract primary disease. Local control rate for all patients was $88.4{\%}$ (61/69), with $80{\%}$ (12/15) for nodal lymphoma and $90.7{\%}$ (49/54) for extranodal lymphoma. The total failure rate was $34.8{\%}$ (24/69). Five of 24 ($20.8{\%}$) patients who were failed developed local failure only, $12.5{\%}$ (3/24) local failure with distant failure, and distant failure only were found in $66.7{\%}$ (16/24). Between nodal lymphoma and extranodal lymphoma, there was no significant survival difference, but extranodal lymphoma showed higher incidence.

• Radiation Oncology Journal
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• 제5권1호
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• pp.23-30
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• 1987

I, II기 원방성 위장관 임파종 환자 38명의 수술후 방사선 치료 결과를 분석하였다. 방사선 치료 중 6예의 원격전이가 관찰되었고, 방사선 치료 전 병소의 크기에 따른 치료실패율은 5cm 미만에서 $31\%$, 5cm 이상에서 $75\%$로 유의한 차이가 있었다(p<0.05). 방사선 치료를 계획대로 받은 28예서 5년 생존율은 $69.2\%$였고, 그중 병소의 크기가 5cm 미만인 경우는 $72\%$였다. 병소의 크기에 따른 5년 무병생존율에도 차이가 있어 5cm 미만인 경우엔 $71\%$, 5cm 이상인 경우엔 $25\%$였다(p<0.05). 반면에 병기, 병리학적 유형 및 원발장기 등에 따른 생존율의 차이는 유의하지 않았다. 따라서 방사선 치료 전 병소 크기가 5cm 미만일 경우는 완치가 가능하나, 5cm 이상으로 클 경우에는 항암화학요법의 병용이 시도될 수 있겠다.

• 보험의학회지
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• 제27권2호
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• pp.68-74
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• 2008

Medical verification of cancer diagnosis in insurance claims is a very important procedure in insurance administrations. Claims staffs are in need of medical experts' opinions about claim administration. This procedure is called medical claim review (MCR) and is composed of verification and advice. MCR verification evaluates the insured’s physical condition by medical records and compares it with product coverage. It is divided into assessment of living assurance benefit, verification of cancer, and assessment of the cause of death. Actually cancer verification of MCR is applicable to coding because the risk ratio in product development is usually coded data. There are some confusing neoplastic diseases in assessing the verification of cancer. This article reviews gastrointestinal stromal tumors (GIST) and mucosa-associated lymphoid tissue tumors (MALToma) of the stomach. The second most common group of stromal or mesenchymal neoplasms affecting the gastrointestinal tract is GIST. Nowadays there are many articles about the pathophysiology of GIST. However there are few confirmative theories except molecular cell biology of KIT mutation and some tyrosine kinase. Therefore, coding the GIST, which has previously been classified as an intermediate risk group according to NIH2001 criteria, for cancer verification of MCR is suitable for D37.1; neoplasm of uncertain or unknown behavior of digestive organs and the stomach. The gastrointestinal tract is the predominant site of extranodal non-Hodgkin's lymphomas. B-cell lymphomas of the MALT type, now called extranodal marginal zone B-cell lymphoma of MALT type in the REAL/WHO classification, are the most common primary gastric lymphomas worldwide. Its characteristics are as follows. First, it is different from traditional stomach cancers such as gastric adenocarcinoma. Second, the primary therapy of MALToma is the eradication of H. pylori by antibiotics and the remission rate is over 80%. Third, it has a different clinical course compared to traditional malignant lymphoma. Someone insisted that cancer verification is not possible for the above reasons. However, there have been findings on pathologic mechanism, and according to WHO classification, MALToma is classified into malignant B-cell lymphoma and it must be verified as malignancy in MCR.

• Radiation Oncology Journal
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• 제12권3호
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• pp.349-359
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• 1994

목적 : 일차성 위장관 악성 림프종은 기장 흔한 림프절외 림프종으로서 치료 방법으로 주로 수술과 수술후 방사선치료 또는 약물치료가 시행되어 왔다. 그러나 빈도수가 낮을뿐만 아니라 체계적인 무작위 비교 연구가 없어 수술후의 치료방침에 대해서는 아직 확립되어 있지 않다. 이에 본 저자들은 위장관에 국한된 악성 림프종의 치료성적 및 예후인자를 분석 고찰하고 그에 따른 생존 분석을 통하여 외과적 절제술후의 적절한 치료방침을 세우는데 도움이 되고자 본 연구를 시행하였다. 방법 : 1976년 1월부터 1991년 4월까지 본원에서 국소적 위장관 악성 림프종으로 진단받고 외과적인 절제술을 시행받은 73명의 환자를 대상으로 치료방법을 포함하여 다변량 예후인자 분석을 시행하고, 치료방법과 예후인자에 따른 치료성적을 비교 분석하였다. 결과 : 전체 환자의 5년 생존율은 62.3%였으며 Ann Arbor 병기 I에서는 86.0%, 병기 II에서는 45.7%였다. 외과적 절제술후에 약물치료의 시행 여부, 병기, 잔류암의 유무가 통계적으로 유의한 독립 예후인자였다. 또한 수술후 방사선치료 또는 약물치료가 시행된 경운에 통계적으로 유의한 생존율의 향상을 나타냈으며 병기 II이거나 수술후 잔류암이 남은 위험군에서는 수술후 방사선치료와 약물치료가 병행 시행되는 경우 가장 좋은 생존율을 보여 주었다. 결론 : 약물치료 여부, 병기, 수술후 잔류암 유무가 중요한 예후인자 였으며 병기 II 또는 수술후 잔류암이 남은 경우를 위험인자로 보았을 때 위험인자가 없는 경우에는 수술후에 방사선치료 또는 약물치료중 어느 한가지만이 시행되어도 충분하며 위험인자를 가지고 있는 경우에는 방사선치료와 약물치료를 병합 시행하는것이 필요하다고 생각된다.