• Radiation Oncology Journal
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• 제8권2호
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• pp.261-267
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• 1990

인제대학교 백병원 치료 방사선과 교실에서는 1984년에서 1990년 까지 조직학적으로 확진된 Waldeyer's ring 임파종 환자 20명이 치료를 받았으며 이 중 17명의 환자가 조사기능하여 후향성으로 분석하였다. 방사선 조사량은 Waldeyer's ring에 35내지 50 Gy를 조사하였고 원발 병소 부위에 5 내지 10 Gy를 첨가로 조사하였다. 경부 하부 임파절은 35내지 60 Gy를 조사 받았다. 관찰기간은 9개월에서 78개월(중앙값 : 23개월)이었다. 5년 생존율은 $46.8{\%}$이고 5년 무병 생존율은 $43.8{\%}$였다. 재발은 치료 후 평균 10개월에 발견되었으며 대부분의 재발은 전신적으로 발생하였다. 1기 환자는 병소가 진행된 경우보다 경과가 좋았으며, 세포 유형도 예후에 영향을 나타내었다. 조기 병기의 환자에서는 방사선 조사의 결과와 방사선 조사와 화학요법을 병행한 결과의 차이가 거의 없었으나 진행된 병기의 환자에서는 병행요법이 단독 치료 방법에 비해 예후가 좋았다.

• 대한두경부종양학회지
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• 제15권1호
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• pp.22-28
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• 1999

Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권3호
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• pp.187-192
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• 2009

Out of all oral malignant tumor, malignant lymphoma occurs in only 3.5%. Especially, most of the primary malignant lymphomas, which occur in the head & neck region are high-grade diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue (MALT) marginal zone B-cell lymphoma is very rare. In the head & neck region, malignant lymphoma is reported to occur in the thyroid, salivary gland, trachea, larynx, orbital lobe and the Waldeyer's ring. Among the Waldeyer's ring, palatal tonsil is reported to be the most common region, but, only 1 case report was published in Korea. Until now, there were no case reports of MALT lymphoma that occurred in the tongue. The purpose of this case report is to report and discuss on a case of MALT lymphoma of the tongue.

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 1993년도 제10차 학술대회 연제순서 및 초록집
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• pp.276.2-277
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• 1993

• 대한두경부종양학회지
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• 제23권2호
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• pp.174-177
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• 2007

Mucosa-Associated Lymphoid Tissue(MALT) lymphoma is the most common extranodal B cell lymphoma among peripheral one. Although palatine tonsil is common origin among Waldeyer's ring, there is no presented case in Korea. This lymphoma is known to be less invasive than other subtype of low grade B cell Non-Hodgkin lymphoma. Because MALT lymphoma has a tendency of localizing one area for a long time, there are many cases treated by local treatment like radiotherapy, or local excision and radiotherapy. We report a case of MALT lymphoma originated from left tonsil.

• Imaging Science in Dentistry
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• 제43권1호
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• pp.59-62
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• 2013

Non-Hodgkin's lymphoma (NHL) constitutes a group of malignancies those arises from cellular components of lymphoid or extranodal tissues. The head and neck is the most common area for the presentation of these lymphoproliferative disorders. Primary involvement of salivary glands is uncommon. This report described a case of a 73-year-old female patient who presented with involvement of both nodal and extranodal sites, with predominant involvement of salivary glands. The tumor staging worked up along with imaging, histopathological, and immunohistochemical findings were discussed. Computed tomographic images showed the involvement of Waldeyer's ring, larynx, orbit, and spleen. This report described imaging and prognostic tumor markers in diagnosing, treatment planning, and prognosis.

• Radiation Oncology Journal
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• 제13권2호
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• pp.129-142
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• 1995

Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.

• 대한두경부종양학회지
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• 제23권2호
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• pp.170-173
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• 2007

About 20% of non-Hodgkin' lymphoma occur in the extra-nodal region in the head and neck area and more than half of extra-nodal lymphoma in the head and neck area involves the Waldeyer' ring. Malignant lymphoma arising in the parotid glands are relatively rare, although 90% of all salivary gland lymphomas, appear in parotid gland and are classified as extranodal non Hodgkin' lymphoma. We experienced one rare case of non-Hodgkin' lymphoma in the right parotid gland, with a painless swelling of the cheek region as the chief complaint. We treated with CHOP(cyclophosphamide, $750mg/m^2$ i.v. day1 ; doxorubicin, $50mg/m^2$ i.v. day 1 ; vincristine, $1.4mg/m^2$ i.v. day 1;prednisone, $50mg/m^2$ orally days 1 to 5. repeat every 21 days) and Rituximab combination therapy. We aimed to report here one case of non-Hodgkin' lymphoma in the right parotid gland with review of literature.

• 대한두경부종양학회지
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• 제37권1호
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• pp.23-27
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• 2021

Mantle cell lymphoma (MCL) is a rare subtype of B-cell neoplasm and it accounts for about 3~6% of all non-Hodgkin's lymphomas. It occurs mainly in middle-aged or elderly man, involving the extra-nodal sites such as gastrointestinal tract, bone marrow and Waldeyer's ring. The incidence of the MCL in salivary gland is about 3%. The blastoid MCL is a rare variant and it has a very aggressive clinical course. It is extremely rare to be arising from the parotid gland. To our knowledge, similar case has not been reported in domestic literature, one case has been described in English literature. We experienced a rare and unique disease entity and report it with brief literature review.

• Radiation Oncology Journal
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• 제34권4호
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• pp.273-279
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• 2016

Purpose: Although each Waldeyer's ring sub-site is considered an independent prognostic factor, few studies have assessed the prognosis and treatment of tonsillar lymphoma. Treatment outcomes were analyzed in patients with primary tonsillar lymphoma who were treated with chemotherapy and radiotherapy (RT). Materials and Methods: Nineteen patients with diffuse large B-cell lymphoma were evaluated, with a median follow-up of 53 months. Age, sex, and histology, amongst other factors, were reviewed. Progression-free survival (PFS) and overall survival (OS) rates were analyzed. Results: Most patients had Ann Arbor stage I-II (94.7%), IPI score of 0 (89.5%), and complete remission after chemotherapy (89.5%). The 5-year PFS and OS rates were 74.6% and 80%, respectively. In univariate analysis, the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen resulted in a better PFS than the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen (88.9% vs. 50.0%; p = 0.053). RT dose was related to the survival outcome (p = 0.010 for PFS, p = 0.044 for OS). Patients were classified into the CHOP + RT (>40 Gy) group and R-CHOP + RT (${\leq}40Gy$) group. The 5-year PFS rates were 50% in the CHOP + RT group, and 100 % in the R-CHOP + RT group (p = 0.018). The 5-year OS rates were 66.7% and 100%, respectively (p = 0.087). Conclusion: Primary tonsillar lymphoma patients typically have favorable outcomes. Chemotherapy (R-CHOP) combined with relatively lower dose consolidative RT may be safe and effective for primary tonsillar lymphoma.